Some hand and finger conditions may require surgery – especially if conservative treatment options haven’t been successful.
For example, a trigger finger may need to be released if anti-inflammatory medications and cortisone injections are ineffective. Dupuytren’s Contractures may also require surgery to remove scar tissue that prevents the fingers from straightening.
Hand and Wrist Surgery
Hand and finger surgeries like trigger finger or Dupuytren’s Contracture releases are outpatient procedures, which means you arrive at the facility about an hour before your actual surgery time, and don’t have to stay overnight in the hospital.
Our staff will check you in and conduct a brief health check, listening to your heart and lungs and checking your blood pressure, pulse, and temperature. We’ll start an IV to give you fluids and medications, and complete a skin prep at the surgery site.
The anesthesia staff will meet with you and review your health history, past surgeries, and current medications, and discuss anesthesia options.
Often, you’re given a sedative which relaxes you but lets you be awake during the procedure; however, most patients do not recall details of their time in the operating room. Your surgery time can vary depending on what needs to be done, but can last from 30 minutes to an hour.
Once you’re rolled into the operating room, you’ll be moved to the operating table with your arm outstretched. A sheet is placed between you and your hand to block your view, and your hand is placed in a holder to keep your fingers out of the way of your surgeon.
A tourniquet will be applied to your arm to keep blood from flowing into the arm while the surgeon is operating. This may be slightly uncomfortable, but most patients say it feels like their arm is asleep. A local anesthetic is injected into the area so you won’t feel anything during the procedure.
When your hand is fully numb, your surgeon makes an incision and will usually fix any repairable damage they find, even if it was unexpected. A Physician Assistant (PA) is often part of the surgical team and understands everything that was done.
After surgery, your surgeon will explain what they found and any limitations you’ll have. Your hand will have a bulky dressing that has to remain in place for the first few days. You’ll be told when and how to change the dressing after that time.
Usually, your surgeon asks you to just rest and recover for a few days after surgery. It can be difficult to care for yourself after hand surgery, and you may need extra help. Your surgeon will detail any post-surgery restrictions.
In a week or two, expect to meet with either your surgeon or a PA to discuss what they found, what was done, and your recovery process.
It takes most patients a few weeks before they are back to daily activities; however, it can take six months to a year before they no longer notice hand pain.
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Dupuytren's Contracture and Surgical Release
The palm of your hand is covered with connective tissue, which helps flatten your palm. Sometimes people get scar tissue or nodules in the webbing between their fingers, which can cause the fingers to fold into the palm. Over time, it can become almost impossible to straighten the fingers.
During corrective surgery, your surgeon makes an incision over the band of scar tissue (which is easily felt through the skin), carefully separates the tissue, identifies the finger tendons, and finds and removes the abnormal tissue, restoring full finger motion. The incision is sewn closed and a bulky dressing placed on the hand.
Until the stitches are removed, typically about 10-14 days after surgery, you may shower but not soak the hand, take a bath or do dishes. The stitches may limit your activities initially, but once they are removed and your incision is healed, you can return to normal activities.
There will be some mild tenderness over the incision for a few weeks, but this will completely resolve over a few months.
Trigger Finger and Surgical Release
Each finger has tendons that flex or bend your finger toward your palm. Each tendon is in its own individual sheath. Inflammation or nodules can develop in the sheath, causing a painful catching or triggering in the finger that can limit the motion of your fingers. If oral anti-inflammatories and cortisone injections are ineffective, surgical release is an option.
During the procedure, your surgeon makes an incision over the band of scar tissue (which is easily felt through the skin), carefully separates the tissue, identifies the tendon sheath, and finds and removes the abnormal tissue, restoring full finger motion. The incision is sewn closed and a bulky dressing placed on the finger or fingers.
After surgery, you shouldn’t soak your hand, take a bath, or do dishes until the stitches are removed (typically 10-14 days after your procedure), though you can shower. The stitches may limit your activities, but once they are removed and your incision is healed, you are allowed to return to normal activities.
There will be some mild tenderness over the incision for a few weeks, but this completely resolves over a few months.