World War II taught the world many lessons. One of those discoveries was the importance of special training needed for successful surgery on hands, sparked by the many hand wounds suffered by soldiers. “Hand surgery as a specialty came into existence during World War II. It was evident based on the soldiers’ injuries that there was a need for surgeons trained in treating disorders of the skin, bone, tendons, vessels and nerves of the hand,” explains McLeod Orthopedic Hand Specialist Christopher Litts, MD. “Many people have aches and pains in their hands, the most common being carpal tunnel syndrome, arthritis and trigger finger.”
Carpal Tunnel Syndrome is by far the most common condition a hand surgeon treats. Carpal Tunnel is compression of the median nerve at the wrist. This nerve is responsible for supplying sensation to the thumb, index and long finger. It frequently bothers people when they are sleeping, holding a steering wheel or cellphone, or otherwise exercising their hand frequently. Early treatment usually consists of a nighttime wrist brace. Surgery is reserved for those with symptoms that don’t respond to splinting
Hand Arthritis most commonly affects the thumb and “hinge joints” in the fingers. Pain at the base of the thumb when pinching or grasping large objects can be an early sign of thumb arthritis. Surgery is an option for those, who do not obtain relief with adaptive device usage, splinting, injection, topical medications or over-the-counter arthritis medicines.
Trigger Finger gets its name from the painful “clicking” or “popping” sound when you try to bend your finger. Picture a fishing rod, where the tendon in your finger is like the line that goes through the guides. In the finger, if the tendon becomes too thick, it can’t easily glide through the opening. When you try to bend your finger, the tendon gets stuck, the suddenly shoots free. You hear a popping and experience pain.
We don’t really know what causes trigger finger. We do know that it can be associated with jobs involving repetitive gripping or hand flexing, such as using shears or hand tools. It’s more common in women than men and more frequent in people aged 40 to 60. People with diabetes or rheumatoid arthritis seem more likely to experience trigger finger.
Treatments start with splinting. Injection of corticosteroids follows with a 93% success rate, less in people who have suffered from trigger finger for longer than 6 months. If the injections fail to solve the problem over the long term, patients find surgery offers a successful solution.
Other Conditions benefit from the expertise of a hand surgeon. These include cysts, tendonitis, fractures, sprains and lacerations. The severity of symptoms guides the treatment of cysts. In addition, treatment of sprains, fractures and lacerations is aimed at obtaining returning the patient to maximum recovery of function in the shortest time possible.
In the same manner that hand surgery requires a specialist, patient symptoms improve and they experience a faster recovery if the rehabilitation is handled by a specialist in hand therapy.
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Sources include: McLeod Health, Current Review of Musculoskeletal Medicine, Journal of the American Medical Association, American Academy of Orthopedic Surgeons, American Society of Surgery of the Hand