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Hand & wrist surgery

Expert help for your hand and wrist concerns

Your hands and wrists play a crucial role in a great number of daily tasks and activities. Whether you’re brushing your teeth, getting dressed, making a hot drink or driving your car, your hands and wrists are involved in making all of these things possible.

It is often only when there is a problem in them that most people realise just how much they rely on their hands and wrists! Common symptoms of a problem in a hand or wrist include:

  • Pain
  • Stiffness
  • Weakness
  • Tingling / numbness in the fingers
  • Finger(s) curling and seizing in place

If you are struggling with any type of problem in a hand or wrist that is concerning you, it is important to know that help is available. The experienced Consultant Hand & Wrist Surgeons at The Saxon Clinic in Milton Keynes are experts in treating a wide range of hand and wrist problems.

Through surgical and non-surgical treatment, they help people to get out of pain and back to better movement and function in their hand and wrist once more. They would be delighted to help you too.

Each hand contains 19 bones, while a wrist contains 8 small bones (known as the carpal bones). With a total of 27 bones contained in each hand and wrist, along with an intricate arrangement of ligaments, muscles and tendons and numerous small joints, it is easy to see just how much complexity is involved in what is a surprisingly small space. Each of these individual parts works together to give the hand and wrist its range of movement and function.

Unfortunately, if a hand or wrist is damaged – by injury, disease or the result of ageing – it can cause a number of problems. Common conditions that can affect the hand and wrist include:

  • Osteoarthritis – in a healthy joint, smooth articular cartilage lining the joint surfaces provides friction-free movement as the bones move against one another. Osteoarthritis causes a breakdown in this cartilage, leading to friction in the joint. The end result is increasing amounts of pain and stiffness in the joint. It can affect the fingers or wrist, but frequently occurs in the base of the thumb.


  • Rheumatoid arthritis – a long-term autoimmune disorder, causes pain, stiffness and swelling in joints. When it affects the hands, it may cause deformities in the fingers.


  • Carpal tunnel syndrome – the carpal tunnel is a small space in the wrist formed by the carpal bones. The median nerve passes down the arm and through this space. If anything causes swelling in the carpal tunnel, the median nerve will be compressed, causing weakness, pain or tingling.


  • Ganglion cyst – a small fluid-filled lump around a joint in the hand or wrist. They are usually harmless, but treatment may be needed if they cause pain.


  • Trigger finger – tendons connect muscle to bone. In the hand, they facilitate movement in the fingers. If a tendon becomes inflamed, it may cause the finger to curl unnaturally and lock into a ‘trigger finger’ position. If this occurs, surgery to ‘release’ the finger into its normal position may be needed,


  • Dupuytren’s disease/contracture – the layer of tissue beneath the skin of the palm thickens over a number of years. Eventually, this thickening may cause the fingers to bend.

A number of problems in the hand and wrist will often resolve themselves naturally over time. Others will require medical intervention to treat.

Treatments available at The Saxon Clinic include:

  • Pain relief medication
  • Splinting
  • Physiotherapy / hand therapy – given the incredible dexterity our hands provide it is important to get expert assistance to regain as much movement and function as possible. Our specialist Hand Therapists will work closely with you, both before and after any surgery to ensure you see the best results
  • Steroid injections – provides both pain relief and an anti-inflammatory action
  • Surgery

If surgery is needed, keyhole surgery (wrist arthroscopy) can be used for a number of different treatments. This minimally invasive surgery involves passing an arthroscope (a thin, flexible tube with a camera and light on one end) through a small cut in the wrist. The camera is connected to an external screen, giving your consultant an excellent view of the inside of your wrist.

Wrist arthroscopy can be helpful for diagnosis and for treatment, as a number of surgical repairs can be carried out during the procedure.

As arthroscopy involves tiny cuts in the skin, it causes less pain, minimal scarring and promotes a faster recovery.

Open surgery may be needed to treat some hand and wrist conditions.

The Consultant Hand and Wrist Surgeons at The Saxon Clinic provide a full range of surgical treatments, including:

  • Carpal tunnel syndrome surgery / Carpal tunnel release (CTR) – carried out to relieve the pressure on the median nerve
  • Trigger finger release – carefully cutting the tendon sheath allows the finger to return to its normal position once more
  • Fasciectomy / needle fasciectomy – removal of the affected connective tissue in Dupuytren's contracture
  • Joint replacement – the natural joint is removed and replaced with an artificial one (prosthesis). This is most commonly advised when severe arthritis has damaged the joint extensively.
  • Drainage of Ganglion cyst

When you first meet with your consultant at The Saxon Clinic, they will talk with you about your symptoms in detail.

They will examine your hand and wrist, and often your entire arm, including the shoulder. Pain in the hand or wrist can sometimes be referred from a problem further up the arm, so it is always good to rule this out.

This may be all that is needed to make a diagnosis and to plan treatment, although additional investigations are often required for a number of hand and wrist conditions. Most commonly, this will be a standard X-ray of your hand and/or wrist, to look for any obvious abnormalities in the bones.

Ultrasound and MRI can also be helpful, especially for soft tissue problems. If you do require any investigations, we will arrange these for you as soon as possible.

Once any results are back and a diagnosis has been made, your consultant will meet with you again to discuss suitable treatment options with you.

If you have any questions or concerns, they will be very happy to talk these through with you, so that you have clarity and confidence about treatment.

People living in Milton Keynes and the surrounding areas of Buckinghamshire depend on our hand and wrist specialists for fast, effective treatment.

Many people are referred by their GP, physiotherapist or medical insurance provider. Others choose to self-refer to avoid delay.

When you choose The Saxon Clinic for your hand and wrist treatment, you will benefit from:

  • Rapid access to an expert – Hand and wrist problems can be incredibly limiting and the last thing you will want is to have to wait weeks (or even months) to see somebody for just an initial assessment. We can quickly and easily arrange a private appointment for you with a highly experienced Consultant Hand and Wrist Surgeon. Earlier assessment means you will have a diagnosis and be able to benefit from any treatment needed sooner.
  • Easy to book – It is simple to book an appointment for a time that is good for you. For your convenience, we also offer remote consultations by telephone or video call if required.
  • Consultant-led care, always – You will see the same consultant each time you visit, and they will oversee every aspect of your care, from first appointment through to treatment and post-treatment follow-up. They will tailor every aspect of your care to your unique requirements.
  • Free parking: Register your car at Reception when you arrive with us, and you won’t need to pay for parking during your visit.

For peace of mind and known expert care, book your appointment online today.

We look forward to welcoming you to The Saxon Clinic and helping to improve your hand and wrist health.

Specialists offering Hand & wrist surgery

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Mr Donald Wallace

Consultant Orthopaedic Surgeon

FRCS Royal College of Surgeons (London),FRCS (orthopaedics).

The Saxon Clinic

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Mr Sameer Singh

Consultant Orthopaedic Surgeon

MBBS, Bsc, FRCS (Trauma and Orthopaedics)

The Manor Hospital 1 more The Saxon Clinic

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Mr Nitin Vaingankar

Consultant Plastic Surgeon

MBBS MS MCh(Plast) FRCS(Plast)

The Manor Hospital 2 more The Saxon Clinic Three Shires Hospital

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Mr Joby George-Malal

Consultant Orthopaedic Surgeon

MBBS, MS (Ortho), D.Ortho, DNB (Ortho), MRCS, MSC, FRCS (Tr & Ortho)

The Manor Hospital 1 more The Saxon Clinic

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Mr Ramesh Chennagiri

Consultant Orthopaedic Surgeon

MBBS, MS (Orth), FRCS (G), FRCS (Tr and Orth), Dip Hand Surg

The Chiltern Hospital 1 more The Saxon Clinic

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