Hand Procedures That Work

Hand trauma, overuse injury, and deformity can limit your ability to perform simple and complex actions and reduce your quality of life. If you’re suffering from a fracture, arthritis, tendon tear, carpal tunnel syndrome, or other bothersome hand condition, Dr. Cobb offers surgical and non-surgical treatment options designed to improve function, decrease discomfort, and enhance your well-being with as little downtime as possible.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is known as one of the most common disorder of the hands and wrists, causing pain, numbness, and tingling. It occurs as a result of the median nerve within the wrist is squeezed or compressed, and continues to worsen over time, eventually leading to pain, numbness, and even mobility issues. Mild cases, or those identified early enough, may be treated with nighttime splints, anti-inflammatory medications, therapy, or steroid injections. For those with severe symptoms, the latest surgical techniques, such as ultrasound guided endoscopic carpal tunnel release, are utilized to improve safety, shorten recovery time, reduce pain, and improve mobility through a minimally invasive procedure.

Cubital Tunnel Syndrome

Cubital tunnel syndrome occurs when the ulnar nerve is compressed within the elbow. Symptoms include numbness and tingling of the ring and small fingers, and elbow pain and weakness. Patients who have experienced a previous fracture, swelling, arthritis or keeping the elbow bent for long periods of time are more likely to be diagnosed with cubital tunnel syndrome. In mild cases, it may be treated with nighttime splinting, avoidance of certain activities or actions, use of anti-inflammatory medications, or therapy. However, should symptoms not improve or worsen, surgery is recommended. Using minimally-invasive endoscopic cubital tunnel release, only an approximately 1-inch incision is made on the elbow, and the technique leaves the patient with less scarring, less pain, and a faster recovery.

Arthritis in Hands and Fingers

Arthritis is the loss of cartilage between bones that results in bone-on-bone contact. Symptoms include pain, swelling, stiffness, warm or tender joints, and deformities such as enlarged knuckles or crooked fingers. Arthritis occurring in the hands and fingers most commonly is due to rheumatoid arthritis or osteoarthritis. In any case, non-surgical treatment options include splinting, anti-inflammatory medications, or corticosteroid injections, but for worsening symptoms, minimally invasive surgery or small joint replacement surgery may be needed.

Thumb Carpometacarpal (CMC) Arthritis

Thumb CMC arthritis is just like a typical case of arthritis, caused by loss of cartilage between the bones due to wear and tear or injury. Patients experience pain and a more limited range of motion, but because it is occurring in the thumb, it can also cause pain in the wrist, pinch and grip weakness, and an inability to perform certain tasks, such as opening jars. Mild cases may be treated with splinting, avoiding certain activities, anti-inflammatory medications, therapy, or cortisone injections. For patients with worsening symptoms, minimally-invasive arthroscopic CMC surgery may be performed, allowing most patients to return to normal activities much sooner than traditional surgical methods.

Trigger Finger

Trigger finger is caused by a tight ligament that causes inflammation and pain in the palm. In severe cases, it causes your finger to “lock down” when making a fist, not extending when you open your hand. Symptoms include pain, swelling or stiffness in the fingers or finger joints, a finger stuck in a bent position, and a clicking, snapping, or locking when you move your finger. Splinting, avoiding certain activities, taking anti-inflammatory medications, and corticosteroid injections may be used as non-surgical treatments for mild cases. In patients with severe symptoms, surgical treatment may be utilized. Minimally-invasive endoscopic trigger finger release requires only small incisions, typically needing no stitches, and allows patients to return to work as early as the next day.

Dupuytren’s Contracture

Dupuytren’s contracture is a hereditary condition causing thickening or tightening of some of the tissue in the palm of the hand that results in an inability to straighten the fingers due to the formation of dense cords. Patients typically won’t experience pain, but may have curled fingers, grip weakness, or nodules within the palm. For a simple, non-surgical solution, patients have a collagenase injected into the palm to dissolve and disrupt the cord. If traditional surgery is used, the cord is removed completely.

Fractures Resulting in Nonunion

Broken bones within the hand or wrist may result in a “nonunion,” which means it didn’t heal. Non-surgical treatments may be used, such as a cast or receiving treatments with a bone stimulator to promote healing. However, if the fracture is more severe, plates and screws may be required, which would be placed surgically, to promote proper alignment. The options of vascularized bone grafts or adult autologous stem cell stimulation may also be used to encourage healing of the area.

Tennis Elbow (Lateral Epicondylosis)

Lateral epicondylosis, more commonly known as tennis elbow, is when the tendons where the forearm muscles meet the outer elbow are injured. Tennis elbow is most common in individuals that use their forearm muscles in the same fashion repetitively, like tennis players, but also may affect professionals such as painters, auto mechanics, plumbers, carpenters, electricians, and butchers. Symptoms include pain or burning on the outer portion of the elbow and a weakened grip strength. If the condition is chronic, pain will continue despite rest. Most patients see improvement with anti-inflammatory medications, rest, elbow straps, or therapy. However, if symptoms do not improve, minimally-invasive surgery may be recommended to remove diseased tissue to allow new, healthy tissue to form. Non-repetitive use of the forearm may be resumed in as little as 2 days, progressing further based on tolerance after 5 days. However, heavy use is discouraged for about 6 weeks.

Distal Biceps Tendon Rupture

Occurs most commonly in middle aged men, but can occur in women at any age. The rupture usually happens while lifting heavy objects, but can be a chronic, progressive disorder with partial tears. When the tendon completely ruptures, it is often associated with a “pop” and the muscle frequently shortens and moves up the arm. Dr. Cobb has developed and patented specialized surgical instruments that he uses to perform a minimally invasive repair through a very small incision.
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