Hand surgery

Carpal tunnel syndrome is one of the most common causes of wrist pain and the most frequent disorder of the peripheral nervous system.

It is caused by a compressed nerve in the wrist. The nerve is squashed by the carpal tunnel, which is a narrow space in the wrist. Symptoms occur if this irritates or damages the nerve. They range from a light tingling and pain in the first three fingers to severe pain, a feeling of numbness and weakness in the fingers. In severe cases, carpal tunnel syndrome leads to lasting damage.

Carpal tunnel syndrome is most common in people between 40 and 50 years of age but can also affect younger or older people. Women suffer from carpal tunnel syndrome more often than men.
 

This means a compression of the Nervus ulnaris in the cubital tunnel of the elbow joint. The treatment comprises the splitting of the roof of the cubital tunnel and even the forward displacement of the nerve. In individual cases, the so-called epicondylectomy is carried out. 

This is a compression syndrome of the Nervus ulnaris in the wrist. In this case, the roof of the Guyon’s canal is split.

Dupuytren’s contracture is a disorder that causes one or more fingers to bend towards the palm of the hand in which knots of tissue form that shorten, leading to bending contractions of the fingers.

The affected fingers can no longer be properly moved. In severe cases, a complete stiffening of the affected finger can occur. If an operation is necessary, the knotty strands are removed to restore the mobility of the fingers. 

The bending tendons on the fingers are fixed to the bones by means of special ring ligament systems. If the ring ligaments are too tight, the bending tendons can no longer slide through these channels, leading to the phenomenon of “trigger finger”.

The cause is usually a trauma or a thickening of the ring ligament. This can lead to severe pain. In some cases, a surgical intervention is necessary.

These are small, benign growths that usually occur on the wrist, on the finger joints or on the tendon sheaths. In some cases, the growths are so prominent that they hinder movement or cause pain and therefore have to be operatively removed.

Wrist ganglions occur frequently and are an expression of a weakness of the ligament system.

They cause a protrusion of the wrist cap. This protrusion forces itself between the ligaments and then forms a cyst that is filled with synovial fluid. This thickens and forms a gelatinous liquid. Depending on whether there is a valve mechanism in the wrist ganglion stem, the cyst fills more and more and the ganglion “grows”. 

Arthrosis is a degenerative disorder of the joints caused by wear and tear. Hand surgery can help here by removing destroyed cartilage and other tissue and restoring the affected joints. This allows patients to take full part in everyday life again.

Nerve and tendon injuries are caused most frequently by accidents. Surgical treatment options for nerve and tendon injuries comprise the restoration or realignment of the affected structures. In some cases, transplantation may be necessary.

There are many forms of genetically caused malformations of the hands, such as syndactyly (webbing or fusion of two fingers), hypoplasia (atrophied parts of the hand), duplicatures (two thumbs, two fingers), as well as severe malformations (e.g. clubbed hand). This problems are congenital but can be surgically treated.

Tumours and cysts occur relatively frequently among both adults and children. If the tumour is malignant, it must be completely removed. We generally carry out the respective reconstruction of the missing functional structures and layers of tissue in the same operative step.

The treatment of paralysis depends on the cause. Spastic cerebral paresis can occur due to an injury to the brain or a lack of oxygen during birth.

Depending on the degree of severity, physical measures, Botox injections, operations on the peripheral nervous system and a so-called hyperselective neurotomy in combination with muscle-tendon displacements and tendon extension operations are necessary.