The Froedtert & the Medical College of Wisconsin Hand and Upper Extremity Program offers a multidisciplinary approach to hand issues, including noninvasive treatments and surgery when needed.
As part of eastern Wisconsin’s only adult Level I Trauma Center, the Hand and Upper Extremity team treats some of the most severe injuries; however, patients with hand conditions of all kinds benefit from the team’s expertise.
“Just because a person comes to a hand surgeon doesn’t mean we will need to do surgery,” said Connor Sullivan, MD, hand surgeon and MCW faculty member. “We evaluate their hand issue and provide intervention that may prevent the need for surgery in the future. It helps to see patients when symptoms begin, so the most treatment options are available.”
Common Hand and Wrist Problems
Hand surgeons treat chronic problems that can compromise a person’s ability to do daily tasks. These include conditions affecting the nerves, tendons, joints and other areas of the hand.
Carpal Tunnel Syndrome
Carpal tunnel syndrome affects the median nerve that runs through a narrow passageway in the wrist, known as the carpal tunnel. If repetitive motion like computer use irritates the area and causes swelling, the median nerve can become compressed.
“Over time, that can cause numbness in the hand,” Dr. Sullivan said. “People can wake up at night with discomfort and pain.”
Treatments may start with anti-inflammatory medications and braces to stabilize the area and reduce unnecessary motion. If those efforts don’t resolve the pain, surgery may be an option.
“We make a small incision in the palm to cut the transverse carpal ligament, relieving the pressure,” Dr. Sullivan said. “This procedure is usually done while the patient’s hand is numbed with local anesthetic, but the patient remains awake during the surgery. The patient can go home shortly thereafter.”
Ganglion cysts are fluid- or jelly-filled cysts that usually occur near the wrists. The cysts can become painful and interfere with joint movement. While there are some home remedy options, it is best to seek medical attention first.
“Home care options may provide a temporary solution, but the cyst can return,” said Kate Krucoff, MD, plastic and reconstructive surgeon and MCW faculty member. “Needle aspiration or surgery to remove the cyst may be needed.”
Osteoarthritis occurs as cartilage and other joint tissues wear down over time, causing stiffness or pain. While it may be tempting to assume arthritis is just something everyone has to live with, topical creams, anti-inflammatory medications, bracing or physical therapy can provide relief.
Tendon problems can also affect different parts of the hands. With Dupuytren’s disease (also known as dupuytren's contracture), the tissue in the palm becomes thick or hardened, keeping the fingers in a fixed, contracted position. Surgery used to be the only treatment, but injections and physical therapy can break up the contracted tissue and restore mobility to the fingers.
Trigger finger occurs if the sheath that encloses the tendon becomes inflamed or thickened, causing the finger to suddenly lock. It may be treated with steroid injections, anti-inflammatory medications or surgery.
“People generally have a good response to nonsurgical hand treatments,” Dr. Sullivan said.
Traumatic Hand Injuries
Traumatic injuries of the hand require an expert approach. Torn tendons must be fixed, and severed nerves or blood vessels may require microsurgery. The surgeon, with the help of a microscope, reattaches the vital tissue.
“We’re equipped to fix common and the most complex hand conditions,” Dr. Sullivan said.
Seek Treatment for Hand Injury
The Hand and Upper Extremity Program combines the skills of various professionals, including occupational and physical therapists, to ensure patients receive comprehensive care. If nerves are involved, patients may be referred to a neurologist. The program also includes psychologists specially trained in treating people with hand issues.
“Hand problems can be stressful, especially if you have had a traumatic injury or can’t work or care for your family,” Dr. Krucoff said. “Our team is trained to help people through these life challenges.”
Hand Pain Warning Signs
If hand pain is interfering with your ability to sleep or do household tasks, it’s time to see a physician for treatment. Other warning signs include numbness or tingling that doesn’t resolve after 30 seconds, pain that doesn’t go away when resting and any lumps or bumps that are getting bigger.
“Timely intervention can mean the difference between noninvasive treatments and surgery,” Dr. Krucoff said. “There’s no need to be tough when it comes to the hands. I would encourage people to be assessed. There are so many things we can do to relieve or improve symptoms.”
Our hand experts help restore maximum function, reduce pain and help people return to regular activities. Call 414-777-7700 to make an appointment or visit froedtert.com/hand to learn more.
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