Hand Surgery

For patients suffering from degenerative conditions of the hand, overuse injuries, or hand trauma, orthopaedic and plastic surgeons at UT Southwestern Medical Center provide customized surgery plans to help alleviate symptoms and restore function.  

We’re experts at evaluating, diagnosing, and treating both minor and complicated hand injuries and diseases. We also offer revisions to previous hand surgeries. 

Unmatched Experience in Hand Surgery

UT Southwestern’s orthopaedic and plastic surgeons have more than 60 years of combined experience treating every type of hand injury and condition.

Our experts are fellowship-trained specialists who:

• Adhere to a strict code of ethics
  
• Evaluate products and technology before they are available to the general public
  
• Lead continuing education for practicing physicians
  
• Participate in groundbreaking clinical trials
  
• Teach future surgeons
  

Our team is renowned for expertise in the replantation of severed fingers and hands, precisely restoring function. Our hand and peripheral nerve specialists work together using advanced microsurgical techniques to reconstruct arteries, veins, or nerves; restore blood flow; and transplant tissue within the body, such as a toe to thumb transplant.

In addition, our orthopaedic surgeons are skilled in the latest techniques for both wrist and elbow trauma and reconstruction surgeries.

Hand Conditions We Treat

Conditions that often respond to surgery include:

• Arthritis
  
• Bone fractures
  
• Carpal tunnel syndrome
  
• Congenital abnormalities
  
• Cubital tunnel syndrome
  
• Damaged nerves, tendons, or muscles
  
• Degenerative conditions
  
• De Quervain’s tenosynovitis
  
• Dupuytren’s contracture
  
• Ganglion cysts
  
• Hand tumors
  
• Finger osteomyelitis
  
• Fingernail injuries and deformities
  
• Hand tumors and cancer
  
• Hand pain
  
• Hand reconstruction
  
• Joint dislocations
  
• Lacerations
  
• Microvascular reconstruction, or replantation of fingers or limbs
  
• Overuse injuries
  
• Reattachment of amputated fingers and hands
  
• Sports-related injuries, such as skier’s thumb
  
• Tendon injuries
  
• Tendinitis
  
• Torn cartilage or ligaments
  
• Traumatic injuries
  
• Trigger finger
  

Symptoms

Symptoms of hand injuries or conditions can include:

• Abnormally bent joints
  
• Decreased grip strength
  
• Difficulty grasping or pinching
  
• Joint stiffness
  
• Noticeable bumps or deformities
  
• Numbness or tingling
  
• Persistent or intermittent pain
  
• Restricted range of motion
  
• Swelling of joints or tendons
  

Diagnosis

To diagnose a hand injury or condition, we start with a physical exam and patient history, taking time to find out how the injury is affecting a patient.    

We might order imaging tests, such as X-rays, magnetic resonance imaging (MRI), or ultrasound, to better evaluate the injury and rule out other conditions. For patients’ convenience, these imaging studies are done in the same building as the hand clinic.

Innovative Surgical Care

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

We offer a full range of surgical options, including the newest and most effective endoscopic procedures, computer-assisted 3D surgery, and innovative microsurgical techniques.

In each case, we create a comprehensive treatment plan to account for the patient’s age, activity level, and goals. The surgeon will also discuss with the patient his or her potential recovery time, which varies depending on the injury and the type of surgery.   

Minimally Invasive Surgery

When hand surgery is required, we will perform the least invasive procedure possible for the condition.

Hand surgeons were among the first to use minimally invasive surgery, in which a surgeon makes a small incision and inserts a tiny camera. The camera enables the surgeon to perform the procedure through the incision using small surgical instruments. Minimally invasive surgery is most often used to treat carpal tunnel syndrome and to diagnose and treat certain sources of wrist pain.

Minimally invasive surgery offers several important benefits compared to traditional surgery, including:

• A smaller incision
  
• Less scarring
  
• Shorter recovery time 

Open Surgery

If a patient is not a candidate for minimally invasive surgery, an open surgery might be required. For example, a fracture might require open surgery to align the bones and secure them in place. But even when such a traditional surgery is needed, advancements in open surgery techniques are enabling our surgeons to use the smallest incisions possible, which improves recovery times. 

Surgical Procedures

Our most common hand surgery procedures include: 

• Acute tendon repair or reconstruction: Injured tendons require urgent repair or reconstruction to restore hand function. Our surgeons are meticulous and achieve excellent results.
  
• Carpal tunnel release surgery: Our team has extensive experience performing endoscopic carpal tunnel release surgeries, which typically result in faster healing and fewer complications. Small, powerful cameras are used to direct the surgeon as he or she releases the tight ligament over the nerve.
  
• Cubital tunnel release surgery: Cubital tunnel causes numbness in the little finger due to a pinched ulnar nerve at the elbow. Cubital tunnel release surgery involves releasing the pinched nerve to restore feeling in the little finger. 
  
• Ganglion cyst excision: For cysts that return after aspiration or injection, excision can be a good option to remove the cyst completely.
  
• Fracture care: With 29 bones in the hand and wrist, fractures are very common. Our surgeons are experts at fixing fractures that occur anywhere from the forearm to the fingertip.
  
• Hand and wrist arthritis: Many types of arthritis can be treated with steroids. However, in select patients, our surgeons might recommend surgery to replace a joint or to perform a fusion when replacement is not an option. Arthritis surgeries can relieve pain and improve function, but it takes an experienced surgeon to be effective.
  
• Thumb base arthritis: One of the most common types of hand arthritis, this can significantly reduce hand function. Our surgeons use the newest techniques, as well as time-tested procedures, to treat arthritis pain while maintaining hand mobility.
  
• Trigger finger: One of the most common hand ailments, trigger finger can be painful and debilitating. When injections are not enough, our surgeons offer a quick and minimally invasive surgical treatment.
  

Innovative Treatments

For patients with traumatic hand injuries who require specialized treatment, we offer new types of bone plates and biologics such as bone morphogenetic protein (BMP), which supplements problematic bone healing. We also offer noninvasive enzyme treatment for Dupuytren’s contracture, which enables us to avoid surgery in many cases.

We might also use advanced grafting and flap surgery techniques to move skin, tissue, fat, blood vessels, or muscle from a healthy area of the body to the injured area. When needed, we use minimal incisions to allow the soft tissue to heal alongside the bone and avoid complications.

After Hand Surgery

Postoperative care is crucial to ensure patients regain full use of their hand. Following the operation, our surgeons work with certified hand therapists within our clinic to create a comprehensive treatment plan for each patient. If a patient prefers to visit a therapist closer to home, our team can help locate one.

Postoperative care typically includes rehabilitation to help regain movement and strength in the hand. We also might recommend fixation devices or technologies to help ensure the best result possible.