Carpal tunnel syndrome and trigger fingers are two of the most common problems that present to a hand and wrist surgeon. Carpal tunnel causes pain at night and numbness, especially around the thumb and index finger. It can be treated without an operation, using splints and injections. If that fails, then a carpal tunnel release is an easy, quick operation with excellent results.
Trigger fingers occur when then tendon that bends the finger gets caught in a tight space. This too can be amendable to splinting and injections, but if that fails, the tendon can be freed up and allowed to run smoothly with a quick, easy operation.
Degeneration in the wrist can be caused by arthritis (generalised wear and tear as we age) but more commonly occurs as a result of previous trauma and untreated fractures. It can also result from inflammatory conditions such as rheumatoid arthritis. In general, no matter what the cause of the arthritis, the treatment paths are similar. They often revolve around either joint replacement or bone fusions. If symptoms are not too bad, trial of braces, physio and injections are warranted. If these fail, then surgical treatment may be recommended. Key-hole surgery can play a part, but often only a minor role when the joint is arthritic.
Instability refers to the wrist giving way, which can result in weakness and pain. It often stars occurring after a "sprained wrist" a while back. Often during a sprain, either the bone or a ligament is damaged. There are a couple of important bones and ligaments within the wrist that can cause ongoing problems. These include the scaphoid (causes thumb side pain), the scapholunate ligament (causes central pain) and the triangular fibrocartilage complex (causes little finger side pain). The long term results may be better if these conditions are treated early, as when the wrist gives way and feels unstable, it may be causing wear and tear which may not be reversible. These problems can be ammendable to key-hole surgery, using 3 to 4 small skin incisions to fix the problem.
Fractures (or broken bones) around the wrist are common. They can occur in the younger patient from sporting injuries, and in the older patient as a result of osteoporosis. They can be treated in plaster or a splint or may require surgery. The aim of the any intervention is to try and reduce or stop long term degeneration and instability of the wrist, whilst reducing pain and allowing range of motion early. Key-hole surgery may be used to treat fractures, especially fractures extending into the wrist joint.