EXTENDED HOURS FOR YOUR CONVENIENCE | OPEN WEEKLY UNTIL 7PM | SAME DAY APPOINTMENTS | MULTILINGUAL : ENGLISH, SPANISH, KOREAN, MANDARIN
Hand and Wrist Surgery
Hand and Wrist Surgery
Hand and Wrist Surgery in Atlanta
Going through life with limited range of motion or loss of sensation in the hands isn’t just difficult, it makes many daily activities virtually impossible for many patients. This results in missing out on hobbies, job opportunities, driving and independence. Virtually all facets of a patient’s life can be affected.
The amount the hands are used for nearly every activity also means they are some of the most likely body parts to be injured. Statistics show that approximately one in three accidents in the home or workplace involve some type of injury to the hands.
In addition to injuries, there are several diseases, syndromes and degenerative conditions that can rob people of their ability to feel, grip or move their fingers in a normal range of motion.
Scott Barbour, MD and his staff at Barbour Orthopaedics offer an array of hand surgery treatments and non-invasive solutions to help patients in the Atlanta area regain dexterity, feeling and the effective use of their hands.
Contact Us Today
By submitting this form, you acknowledge and agree that you are granting permission for us to contact you through text message or email.
Wrist Arthroscopy
The wrist is a delicate part of the body that contains a complex collection of bones, tendons and nerves. Traditional open wrist surgery can cause significant trauma and result in long recovery times and months of rehabilitation. Wrist arthroscopy allows for a much more delicate, targeted approach to wrist surgery.
Small incisions are made at key points around the wrist. A miniaturized camera, the arthroscope, is inserted into one of these incisions, letting the arthroscopic surgeon get a closeup view of the wrist’s internal structure and any damage or disease that may be affecting it. One to three additional small incisions will be made in order to insert other small instruments to perform the surgery itself.
Wrist arthroscopic can potentially be used to treat a wide range of wrist injuries or conditions, including wrist fractures, ganglion cysts, ligament and TFCC tears, carpal tunnel release and more.
Wrist Joint Replacement Surgery
Although knee and hip joint replacements are more common than wrist joint replacement, they are significantly less complicated, which is why your choice of wrist joint replacement surgeon is an important one.
As with other joint replacement surgeries, the damaged sections of bone are removed, and artificial components are put in their place. In most cases, the end of the lower arm bones and the first carpal bones are replaced with prosthetics. The replacement carpals are cemented or screwed into the remaining natural carpal bones.
A cast is put on the wrist following surgery. This can usually be removed within a few weeks of the procedure, after which the patient will likely need to use a splint for one and a half to two months.
Although certain activities should still be avoided, wrist joint replacement surgery has the potential to restore a significant amount of wrist movement to patients with little or no wrist mobility.
Total Wrist Arthrodesis
Total wrist arthrodesis is a potential surgical treatment for patients who are suffering from rheumatoid arthritis, posttraumatic osteoarthritis, cerebral palsy, brachial plexus injuries, carpal instability, previous failed wrist surgeries or other conditions that cause chronic pain in the wrist. The procedure is most commonly prescribed to younger or middle-aged patients who are still active.
The goal of total wrist arthrodesis is to immobilize the joint by fusing the bones in the wrist and lower arm. An incision is made in the back of the wrist and arm. Articular cartilage is removed and replaced with bone grafts. A metal plate is then placed over the back of the wrist, which will stretch from the lower arm to the middle finger. Metal screws are then used to secure the plate in place, effectively holding the bones in position.
Trigger Finger Surgery (Tenolysis)
Stenosing tenosynovitis, commonly referred to as trigger finger, is a condition that can cause stiffness or a locking/catching sensation when a patient tries to bend or straighten their fingers.
The symptoms of the condition are due to the thickening of the sheath surrounding the tendons of the thumb and fingers. The thickened sheath will eventually cause the tendon to swell and become irritated.
The fingers most commonly affected by trigger finger are the ring finger and thumbs.
Orthopaedic specialists usually begin treatment with anti-inflammatory drugs and cortisone injections. These solutions may not be enough for some patients, in which case trigger finger surgery may be suggested.
During tenolysis, or trigger finger release, an orthopaedic surgeon will release the A1 pulley so it no longer blocks the tendon. Once the tendon is freed, it will be able glide through the tendon sheath more freely.
Dupuytren’s Contracture
For patients with Dupuytren’s disease, the fascia of their hand thickens and hardens, resulting in reduced hand function. The fascia is the fibrous layer of tissue that helps anchor the skin on the palms of the hand. Without the layer, the skin on the palms would be loose like the skin on the back of the hand.
Dupuytren’s disease often manifests first as nodules in the palm. Over time, these nodules may lengthen and thicken into chords of unmalleable tissue underneath the skin of the palm. These cords can cause the affected fingers to curl up towards the palm and prevent them from being able to straighten or spread apart.
There are non-surgical treatments for Dupuytren’s Contracture, such as corticosteroid injections. These non-invasive treatments simply slow the growth of nodules and chords; they will not cause them to disappear.
During fasciotomy, the surgery to restore freedom of movement for patients affected by Dupuytren’s disease, an orthopaedic surgeon will use local anesthetic to numb the patient’s hand and surgically divide the chords to allow the affected fingers to move freely.
De Quervain's Tenosynovitis
This form of tendinosis specifically affects the thumb. Patients who suffer from De Quervain’s Tendinosis often experience pain and tenderness along the thumb side of the wrist, especially when gripping something, turning the wrist or making a fist. The condition is often attributed to overuse but has also been linked to rheumatoid disease (inflammation) and pregnancy.
A physician may first attempt splinting, anti-inflammatories and corticosteroid injections before resorting to a surgical solution. The surgical treatment for De Quervain’s tenosynovitis entails making an incision in the thumb compartment to make more room for the inflamed and irritated tendon.
Carpal Tunnel Syndrome
The frequency of carpal tunnel syndrome diagnosis has been increasing due to higher rates of computer use and other actions commonly attributed to the development of the condition. The source of carpal tunnel syndrome’s pain and numbness is increased pressure on the median nerve, which runs through the wrist and the center of the hand.
The carpal tunnel in the wrist is a roughly inch wide passage flanked by the carpal bones. This tunnel is designed to protect the median nerve and the flexor tendons that run through it. These tendons are what allow people to bend their fingers and thumbs. Because this tunnel is surrounded by bone and relatively rigid connective tissue, there is very little room for expansion.
Increased pressure is put on the median nerve when the carpal tunnel narrows or when the synovium tissues surrounding the flexors are irritated and swell.
Non-surgical treatment options include bracing or splinting, anti-inflammatory drugs, corticosteroid injections and changes in behavior, such as refraining from activities that cause the swelling. There are also certain exercises that can help promote better movement for the flexors and nerves within the carpal tunnel.
If non-surgical treatments are ineffective at relieving pain, open carpal tunnel release or endoscopic carpal tunnel release surgery may be suggested. During both procedures, the transverse carpal ligaments – the fibrous, rigid roof of the carpel tunnel – will be divided to create more room in the carpal tunnel and relieve pressure.
The endoscopic variant of the procedure offered by Dr. Barbour is the less invasive option and is performed with a miniature camera and specialized instruments to minimize soft-tissue trauma and decrease recovery time.
Ganglion Cyst Removal
Ganglion cysts are noncancerous, fluid-filled lumps that can form on the hand or wrists. These cysts can eventually press on nerves, causing pain and potentially restricting wrist movement. Other methods of treatment should be attempted prior to resorting to ganglion cyst removal surgery.
The surgery entails puncturing and draining the cyst with a needle before cutting out its stalk. If the cyst is only drained without stalk removal, the cyst will likely grow back.
