Illinois/Chicago Area Plastic Surgery Procedures:
Hand Surgery

In addition to taking care of soft tissue injuries of the hand referred through the Emergency Department, Lake Forest Plastic Surgery offers a number of elective hand surgery procedures, including:

Carpal Tunnel Release
Trigger Finger Injections/Release
Dupuytren's Contracture Excision

"Carpal Tunnel Syndrome" is a nerve compression syndrome often as the result of "cumulative" trauma in the area of the base of the palm. The median nerve, which provides sensation to the thumb, index, middle and half of the ring finger, as well as motor innervation to several muscles of the palm, principally the thumb, is compressed by inflammation of the tunnel through which it passes at the base of the palm. Symptoms include paresthesias ("pins and needles") of the fingers described, occasionally awakening the patient at night, or in more advanced cases, numbness or even weakness of the hand. These symptoms are usually worsened by activities that initiated the process in the first place, or by positioning that places stress on the tunnel, such as typing or driving. Carpal tunnel syndrome is treated by release of the "roof" of the tunnel via a short lengthwise incision overlying the tunnel at the base of the palm, although this occasionally can be performed with small scopes. Other nerve compression syndromes at either the elbow, forearm or base of the palm regions are treated in a similar manner.

"Trigger finger" (or stenosing tenosynovitis), is more or a restriction abnormality, this time involving the tendons at the base of the affected finger. In this situation, the small pulley through which the tendons pass becomes inflamed, and the fingers occasionally "stick" in a flexed position, leading to "locking" of the finger, which occasionally requires the patient to manually pull the finger back to the extended position. This can be treated by a steroid injection into the affected area, but if this fails after several attempts, open decompression under local anesthesia is recommended.

"Dupuytren's Contracture" is a progressive scarring process of the subcutaneous tissues of the palm, and occasionally the overlying skin, usually involving the ring or little fingers. These often are pulled down into a flexed position, and cannot be actively or passively re-extended. This condition cannot be "cured", but rather alleviated by making zig-zag incisions through the involved area, excising the scar tissue extending from the palmar area, and releasing the digital sensory nerves, which are often pulled into the scar tissue. A splint to hold the fingers in extension, and occasionally physical therapy, is required in the immediate post-operative period.

For more information about hand surgery procedures (some of which we do not routinely perform), please see ASPS Hand Surgeries information page.

(Link references used with permission from ASPS; our approach to certain procedures may differ from those described by the ASPS.)