In recent years, there have been great advances in treating patients with hand injuries, degenerative disorders, and birth defects of the hand. There has also been an increase in repetitive stress disorders of the hand, for which new treatments are being developed. The leaders in these new techniques, which restore or improve both function and appearance, have been plastic surgeons. As part of his plastic surgery training, Dr. Reeder has had extensive training in hand surgery, and has kept abreast of new developments through his practice and through his associations with area medical training institutions. As hand surgeon on call at several area hospitals, he is also well-versed at treating major hand trauma.
Carpal Tunnel Overview
Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (although not the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The carpal tunnel – a narrow, rigid passageway of ligament and bones at the base of the hand ¾ houses the median nerve and tendons. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed. The result may be pain, weakness, or numbness in the hand and wrist, radiating up the arm. Although painful sensations may indicate other conditions, carpal tunnel syndrome is the most common and widely known of the entrapment neuropathies in which the body’s peripheral nerves are compressed or traumatized.
Ganglion Cysts Overview
Ganglion cysts arise from the capsule of a joint or the sheath of a tendon. They can be found at different places on the wrist. A ganglion cyst that grows on the top of the wrist is called a dorsal ganglion. Others are found on the underside of the wrist between the thumb and your pulse point, at the end joint of a finger, or at the base of a finger. Most of the time, these are harmless and will often disappear in time.
A ganglion cyst contains a thick, clear, mucus-like fluid similar to the fluid found in the joint. No one knows what triggers the formation of a ganglion. Women are more likely to be affected than men. Ganglia are common among gymnasts, who repeatedly apply stress to the wrist.
There are three main nerves that supply nervous stimulation to the hand: the ulnar nerve, the median nerve, and the radial nerve. Injuries may cause a lessening in ability to move the hand and experience feeling. While some nerve injuries may heal on their own, others require surgery. Surgery to investigate a damaged nerve that is not complicated by other injuries is usually performed early after the injury occurs in order to increase the likelihood of a full recovery. Nerve repairs that are associated with other, more complicated, injuries may occur weeks after the trauma. If severed, your surgeon may repair the nerve by reattaching it directly to the other end of the nerve, or by using a nerve graft (inserting nerves from other areas of the body in place of the damaged nerve) to repair the damaged section.