Carpal Tunnel Syndrome
The carpal tunnel is a space at the palmar side of the wrist allowing the passage of tendons and a major nerve (the median nerve) into the hand. Pressure may build up within the tunnel because of trauma, disease (e.g. rheumatoid arthritis), fluid retention (pregnancy), overuse or repetitive motions. The build up of pressure around the nerve within the tunnel causes the symptoms of tingling in the hand, usually accompanied by numbness, aching and impaired hand function.
Treatment is variable and may involve splints, anti-inflammatory medications or surgery.
Surgery involves making an incision at the base of the hand and wrist, releasing the carpal tunnel to relieve the pressure.
Dupuytren’s Contracture
Dupuytren’s disease is a disorder of the tissues underlying the skin on the palmar surface of the hand, which leads thick scar like tissue to form. These ‘cords’ of tissue may extend into the fingers and cause restricted motion (contracture) of one or more digits. The disorder is generally inherited and develops in mid life.
Surgery is generally the best treatment. This involves excising the thickened and diseased tissues to relieve the contracture and to restore mobility of the affected fingers. The operation is done carefully to preserve the nerves that supply sensation to the fingers. In advanced cases skin graft or flaps are required to replace tightened or contracted skin that is removed.
The results of the surgery vary with the severity of the disease.
Trauma-Injuries
Hand injuries are the most common reason for operative procedures to the hand.
The most common procedures are to:
- Repair severed tendons, nerves or blood vessels.
- Restore the position of joints and fractured bones.
- Repair injuries such as cuts or burns to the skin.
