Reconstructive
Hand Surgery
We offer treatment for the following hand conditions: congenital hand deformities (hand problems you are born with), arthritis of the hand and wrist, trigger finger, Dupuytren’s contracture, nerve compression (including carpal tunnel syndrome), treatment of traumatic injuries and treatment of some types of cancers of the hand.
Congenital Hand
Children may be born with too many, not enough fingers or fingers that catch (trigger finger). When a person is born with too many fingers, it is called polydactyly. Syndactyly refers to fingers that are stuck together. Rarely, people can be born with an absent or underdeveloped thumb, called thumb hypoplasia or aplasia. We offer a variety of surgical treatments to help make the hand more functional and normal in appearance.
Arthritis of the Hand and Wrist
People may develop arthritis from prior injuries, overuse or medical conditions (rheumatoid arthritis is one example). We offer a variety of treatment options, including joint rebalancing operations, joint fusions and joint replacements that can help make your hand more functional. These operations are typically done under general anesthesia by a hand surgeon (you are completely asleep, with a breathing tube in your throat). Most often, you are able to go home the same day. Postoperative hand therapy is required, and typically lasts six to ten weeks.
Non-surgical
Arthritis of the base of the thumb (the “carpo-metacarpal joint, or ‘CMC’”) is a frequent condition in adults 50 years of age and older. We treat many patients with thumb CMC arthritis, primarily with non-surgical means including splinting of the thumb, lifestyle modification, and steroid injection. A subset of these patients require surgical treatment (see below).
Surgery
Among the surgical treatment options we offer for wrist and hand arthritis, surgery specifically for treatment of thumb CMC arthritis is the most common procedure we do, and for these we perform the TRACS procedure (Trapeziectomy with CMC joint Suspensionplasty ). The video below illustrates this type of surgery. This operation involves removal of one of the wrist bones (the trapezium) and reconstruction of the ligament support system of the CMC joint with a combination of a nylon cable and piece of the patient’s own tendon, and two synthetic screw anchors. We have many patients that have been able to return to normal light to medium level activity, with much less pain, after this surgery. Recovery from this surgery is typically 3 months, in terms of return to normal activities. Recovery does involve a prolonged period of casting and hand therapy during the first 3 months after surgery.
National Center for Biotechnology Information
Trigger Finger
This is a very common condition, with a variety of causes. We offer both nonsurgical treatment (steroid injection) and surgical treatment (trigger finger release). Surgery typically takes five to ten minutes and is done under local anesthesia (you are wide awake, but the finger is numb). Recovery typically takes two weeks.
Dupuytren’s Contracture
This is a condition where the finger(s) gradually become more bent (flexed). Occasionally, this may be so bad that you can’t reach around objects (soda can) to grasp them or you can no longer put your hand in your pocket or a glove. Unfortunately, there is no cure for this condition, but there are good options to help improve the function of your hand. We offer both surgical and nonsurgical treatment.
Nonsurgical treatment consists of injecting an enzyme (collagenase) just below the skin where the contracture is located. The injection treatment is administered in the office, typically without the need for anesthesia. Dupuytren’s tissue, which is rich in collagen, is broken down by the collagenase. When you return the following day, numbing medicine is injected into your hand, and the contractures are broken by manipulating the hand. You then typically require four to six weeks of post-treatment hand therapy. The injections are usually covered by insurance.
Surgery is done under general anesthesia (you are completely asleep, with a tube in your throat) and typically lasts two hours. You usually go home the same day and then require six to eight weeks of hand therapy. Your orthopedic surgeon will discuss with you which option (surgery or enzyme injection) is best for you.
Nerve Compression
Many people can suffer from various types of nerve compression, including carpal tunnel syndrome (median nerve), cubital tunnel syndrome (ulnar nerve) and radial tunnel syndrome (radial nerve), to name just a few. We offer treatment for most every type of nerve compression in the hand and forearm.
Certain medical conditions are frequently associated with carpal tunnel syndrome, including diabetes, hypothyroidism, obesity and pregnancy, so treatment of them can often help relieve the symptoms of carpal tunnel syndrome. Certain types of environmental/work exposure can worsen the symptoms of carpal tunnel syndrome, as well, so it is important that you follow appropriate ergonomic techniques when at work or at home.
Hand Trauma
We treat nearly all types of hand injuries, including fractures, dislocations, tendon and nerve injuries, amputations and infections, to name but a few conditions. We have a very experienced team who can help get you back to having a hand that works, looks and feels better.
Cancers of the Hand
Cancers of the hand are, thankfully, rare. Nonetheless, we have extensive experience in treatment of many types of cancer of the hand and can help you get the appropriate treatment you need. Our goal is to treat the cancer as aggressively as possible and yet leave you with a hand as functional as possible. Often, we work with the oncology (cancer) doctors, in addition to working closely with your primary care doctor, when treating these types of conditions.
To learn more about our reconstructive surgery procedures, please call 641.494.5360 today or use our online form to schedule an appointment. Our reconstructive patients come to us from Albert Lea, Algona, Belmond, Britt, Buffalo Center, Charles City, Clarion, Cresco, Emmetsburg, Forest City, Garner, Greene, Hampton, Iowa Falls, Lake Mills, Mason City, New Hampton, Northwood, Osage, Waverly and surrounding communities.