Degenerative Hand, Wrist, and Elbow Conditions

Orthopaedic surgeons at UT Southwestern Medical Center have more than 50 years of combined experience treating degenerative hand, wrist, and elbow conditions and are experts at the surgeries and treatments used to target these conditions.

Unmatched Orthopaedic Experience

When joints in the hands, wrists, and elbows degenerate from age or overuse, patients can lose the ability to use the joint.

At UT Southwestern, our hand surgeons specialize in repairing the numerous bones, joints, ligaments, and tendons that make up the hand, wrist, and elbow.

We offer patients access to the latest technology, including the newest biomaterials for joint replacements and the latest fixation devices for ligament reconstruction.

Hand, Wrist, and Elbow Conditions We Treat

Our orthopaedic surgeons treat the following hand, wrist, and elbow degenerative conditions:

• Dupuytren’s contracture
  
• Inflammatory arthritis of the hand, wrist, and elbow
  
• Osteomyelitis
  
• Osteonecrosis (avascular necrosis)
  
• Rheumatoid arthritis
  
• Thumb arthritis (basal joint arthritis)
  

Symptoms

Symptoms of degenerative hand, wrist, and elbow disease include:

• Limited motion
  
• Loss of strength
  
• Inability to grasp, pinch, or hold things
  
• Joint deformity
  
• Pain or tenderness in the joints
  
• Swelling in the joints
  

Diagnosis

To get an accurate diagnosis, our doctors talk with each patient to understand the history of the condition. We’ll conduct a thorough physical exam that can involve moving the affected joints and examining range of motion and severity of pain.

Many times, we’ll order X-rays and computed tomography (CT) scans to better understand the severity of the disease and see how much of the bone, joint, ligament, or tendon has deteriorated.

Treatment for Degenerative Hand, Wrist, and Elbow Conditions

Our orthopaedic surgeons create a comprehensive treatment plan for each patient to account for the patient’s age, activity level, and goals.

Nonurgent conditions are initially treated with nonsurgical treatments, such as ice, rest, anti-inflammatory medications, splints, or physical therapy.

For some conditions, such as rheumatoid arthritis and avascular necrosis, there is no cure. The goal of treatment is to control the symptoms and pain associated with the condition and prevent further bone and joint damage.

When nonsurgical treatments fail to control the symptoms, our doctors will work with the patient to determine if surgery is the best course of treatment.

Surgical Treatments

Surgery for degenerative hand, wrist, and elbow conditions includes:

• Acute tendon repair or reconstruction: Used to stabilize joints with chronic ligament damage. Our surgeons sew the tendons or nerves end-to-end using high-powered operative microscopes.
  
• Complex bone reconstruction: Performed when the bones have deteriorated, as with osteomyelitis or osteonecrosis. This procedure is often done as a microsurgery.
  
• Elbow arthroscopy: Used to relieve arthritis pain in the elbow. Our surgeons make multiple small incisions in the arm and insert small cameras to direct the surgeon’s use of tiny surgical instruments to remove any loose or degenerative tissue in the joint and smooth out irregular surfaces.
  
• Joint fusion: Used when joint replacement is not an option. Our doctors will surgically fuse the joint to stabilize or realign it. While this procedure offers pain relief, it also prevents the joint from moving.
  
• Joint replacement: Used when the joint surface is worn away completely. The deteriorated joint is replaced with a prosthetic joint or, in certain cases, the patient’s own body tissue. The goal of joint replacement is to relieve pain and restore function to the joint. While many of the joints in the hand and wrist can be replaced, it takes an experienced surgeon to do this surgery. Our doctors have the skills to perform joint replacement surgery and achieve positive outcomes.
  

Following surgery, patients meet with a physical therapist to undergo rehabilitation to help them regain movement and strength in the hand, wrist, or elbow.