Hand & wrist surgery

Expert care for hand & wrist concerns

There are many parts of our bodies that we use every day and consider vital to our quality of life, but when it comes to the ability to do tactile things, our hands and wrists are right up there at the top of the list, so if something should happen to them, it can deeply affect us.

That is one reason why Three Shires Hospital in Northampton has specialists to help solve hand and wrist problems whether they are short term problems such as an accident or long term such as a degenerative disease like osteoarthritis.

In many cases problems with both hand and wrist can be helped without the need for surgery or more invasive processes, however, in cases where this is necessary, Three Shires has a specialist team ready to help you through the problem.

That applies whether you've been referred to us by your GP or other medical professional (e.g., a physiotherapist) or you've been referred by your medical insurance company, or even if you've decided to pay privately to have your treatment done as quickly as possible or you just want a second opinion.

Whatever reason you may have, we are just a phone call away on 01604 620311. We are situated in close proximity to Northampton General Hospital and within easy reach by taxi or bus of the city centre and railway station.

The hand and wrist are complex affairs made up of 27 bones. 8 of which make up the wrist and connect to the 2 main bones of the lower arm (the radius and the ulna).

There is a labyrinth of criss-crossing tendons, ligaments, and muscles (which is what gives us such flexibility) so it's no wonder that if something goes wrong, it can have major implications on not just the movement of our hands, but also of the potential for pain, some of which can reduce the ability to use our hands to zero.

Perhaps the most common problem of the wrist is carpal tunnel syndrome. A major symptom of this is a feeling of numbness in the hand. This happens when the median nerve that travels down the arm and branches out into the fingers becomes trapped by swelling within the tunnel, formed by what's called the transverse carpal ligament.

If you see someone wearing a splint or wrist brace on their wrist, they may well have carpal tunnel syndrome as this gives a certain amount of relief because it holds the wrist in the optimal position to relieve some of the pressure on the nerve.

If wearing a brace does not help and the inflammation in the carpal tunnel remains, then a steroid injection may help, but failing that, surgery is always an option. This releases the pressure on the nerve allowing the hand and wrist to operate normally again, however, like all surgery, there are risks, and carpal tunnel syndrome can return.

This will be discussed in detail if surgery is thought to be the best option so you can make a decision you feel comfortable with.

If you feel any pain in the base of your thumb or 3rd or 4th fingers (ring and little finger), it may be an early sign of something called trigger finger (it can also be arthritis, but we'll get to that later).

As the condition worsens, you'll find it harder to bend one or more of those fingers (it can occur on either hand), and it may also get stuck in a bent position. The finger can sometimes free itself, in which case it will pop back to its normal position (often with a sound). Hence the name trigger finger.

The cause of trigger finger is not clear, but what happens is that the sheath through which the tendon runs can swell up (as can the tendon itself) and cause the tendon to stop flowing freely.

It's also possible for the tendon to not just get stuck but to contract or recoil on itself causing a major obstacle to movement of the finger. That's what's happening when the finger locks up completely.

For many people, a steroid injection into the affected joint will be sufficient to reduce the swelling and allow the finger to move again, but further injections may also be necessary.

If an injection does not work and no further action is taken, the affected finger may get worse to the point that recovery after surgery is less guaranteed. Your consultant will bring up all these points with you during your consultation.

This disease occurs when tissue under the skin usually at the base of the ring or little finger starts to thicken. It can eventually cause cords to form, which act on the finger by contracting or pulling it in towards the palm of the hand. This is why it's also known as Dupuytren's contracture.

A simple way to test for it is called the tabletop test, in which the hand is placed palm down on a flat table. If the hand cannot be fully flattened, then Dupuytren's is a possible cause.

The disease can take months or even years to fully develop and if left untreated can become severe, therefore it's important to have it investigated as early as possible in order to reduce later complications.

If the condition has not been allowed to continue for too long, surgery is an option that works for many patients, but it's not a cure (there is no known cure for Dupuytern's disease), and it is unlikely to ever straighten the finger out completely, but it does usually allow the finger to return closer to its full flexibility.

There are many types of arthritis including osteoarthritis, which is a degenerative disease associated with aging and natural wear and tear on our joints, but for the hand, and in particular the joints in the fingers and thumb, rheumatoid arthritis may also be the culprit (although osteoarthritis is a lot more common comparatively).

When a joint becomes inflamed (which is what arthritis is), it causes the cartilage between the joints to break down, eventually leading to the bones rubbing together, which not just affects the flexibility of the joint, it can be very painful too.

If you suspect you may have arthritis, we will check your joints (which may also involve an Xray) to verify it and discover what type of arthritis it is. In many cases medication is all that is needed, but a steroid injection or surgery may also be options to help you recover at least some of the lost flexibility again.

In all cases, our consulting team will explain all your options along with any procedures thought necessary and the benefits and risks associated with them.

Most operations of the hand can be carried out the same day so no overnight stay is required, but should there be a need for it, all our rooms are private and include full en-suite facilities and 24-hour medical staff to look after you.

If you'd like to talk with us about your options, please do call Three Shires Hospital on 01604 620311