Hand and wrist surgery in Brentford

While these provide movement, function, sensation and strength to your hand and wrist, so much complexity contained within such a small space does mean that a seemingly minor problem can have a significant impact.

Mr Edward Ibrahim, a consultant orthopaedic upper limb surgeon, says that most people he sees at Syon Clinic for a hand and wrist condition will have one or more of these symptoms:

• Pain
• Stiffness
• Weakness
• Tingling/numbness in their fingers
• A curled finger that locks in place

There are a number of conditions that might affect your hand or wrist. Common conditions that can affect your hand and wrist include:

• Osteoarthritis, which most commonly affects the base of your thumb, but can also affect your fingers and wrist
• Rheumatoid arthritis, which might lead to deformities in your fingers
• Carpal tunnel syndrome, which happens when your carpal bones form a small space in your wrist known as the 'carpal tunnel'. Your median nerve passes down your arm and through this space. If you have any swelling in the carpal tunnel, it means your median nerve will be compressed, and this can cause symptoms like weakness, pain or tingling
• Tendonitis, which happens when you experience pain and inflammation in your tendon
• Ganglion cyst, which is usually harmless, but if it is causing you pain treatment may be recommended
• Trigger finger, which can cause pain and stiffness when you attempt to move your finger or thumb. If left untreated, your affected finger or thumb can become trapped in a bent position, significantly reducing movement and making simple everyday tasks challenging
• Dupuytren's disease/contracture, which causes one or more of your fingers to bend inwards and point towards your palm, resulting in discomfort and limited mobility in your hands. The disease most commonly affects your ring and little fingers. It is possible to have it in both hands at the same time

• What symptoms you have in your hand and wrist
• When your symptoms first started
• Whether they have been getting worse over time
• If you have already received or are currently receiving any type of treatment

They will also want to know how your symptoms are affecting you in daily life, because this will often help direct your treatment options. They will carry out a physical examination of both your hands and wrists, looking carefully for any differences between them in appearance, movement, and grip strength.

As well as examining your hand and wrist, they will often also examine your entire arm, up to and including your shoulder. This is because some hand or wrist symptoms can be caused by a problem further up your arm (this is known as referred pain).

Diagnostic scans for your hand and wrist

In some cases, this may be all that is needed to make a diagnosis. In others, further investigations can be helpful to either confirm your diagnosis or plan your treatment.

Syon Clinic has a well-staffed diagnostic imaging department offering fast access to a range of tests and investigations.

Mr Ibrahim explains the different investigations that can be done, and gives examples of when they would be used for certain hand and wrist conditions:

"For people showing carpal tunnel symptoms, we would normally arrange nerve tests. These are done on-site by our neurophysiologist. If somebody has injured their hand or wrist, or could have arthritis, I will often arrange a plain X-Ray as these can show up bony abnormalities.

If I suspect the problem is a soft tissue one, MRI or ultrasound can be helpful. Ultrasound has the added advantage that an injection can be given at the same time if needed."

Non-operative treatment for hand and wrist conditions

In Mr Ibrahim's experience, around 90% of the people he sees with hand and wrist problems will not need surgery as non-operative treatments will successfully relieve and manage their symptoms.

Non-surgical treatment options include:

• Pain relief medication
• Hand and wrist splinting - this may be during the day or only at night
• Physiotherapy - this is to help you regain as much movement and function as possible
• Injection therapies

While most people will require non-operative treatment, hand surgery will be an option for certain conditions that cannot be effectively treated with non-surgical options.

• Carpal tunnel syndrome surgery/Carpal tunnel release (CTR) - Carpal tunnel release surgery can help resolve these symptoms by cutting your carpal ligament, which travels across the base of your palm, giving your median nerve and other nerves the space to move
• Trigger finger release - Trigger finger release surgery is a highly effective treatment option. It is rare for the condition to reappear after surgery
• Hand surgery for Dupuytren's disease -Dupuytren's symptoms can be eased or even corrected by surgery. You might undergo a fasciectomy, a needle fasciotomy, or a dermafasciectomy as part of your treatment for Dupuytren's disease
• Ganglion removal surgery - This is a routine and minor procedure to remove the ganglion

Please note that if surgery is needed, it will be carried out at our sister hospital, The Clementine Churchill Hospital.

• Flexible appointment times to fit your schedule
• The freedom to choose your hospital and your consultant  
• Bespoke, consultant-led treatment plans tailored to your individual needs
• Private ensuite rooms as standard  
• Tasty and nutritious meals cooked onsite to your dietary requirements
• Support from the same compassionate clinical team from beginning to end
• Affordable, fixed-price packages with aftercare included  
• Flexible payment options to help spread the cost of your care

If you want to know more about whether orthopaedic surgery is the right option for you, book your appointment online today or call a member of our team directly on 0141 300 5009.