Hand and Wrist Surgery

Our Hand and Wrist Orthopedic Specialist, Dr. Tanner Dunlop is able to see you for a private consultation.
He sees and treats a variety of conditions such as:

Wrist:

• Wrist arthroscopy (synovectomy, TFCC debridements / repairs)
• Wrist ligament repairs / reconstructions
• Wrist arthritis (proximal row carpectomy, scaphoidectomy and 3/4 corner fusions, wrist fusions)
• Ulnar shortening osteotomy
• Scaphoid fractures (acute and nonunion)
• Hook of hamate excision (for nonunion)
• Distal radius osteotomy for malunion
• Surgery for Kienbock’s
• DRUJ reconstructions for instability

Hand:

• Thumb CMC joint arthroscopy
• Basilar thumb osteoarthritis
• Trigger finger release
• DeQuervains Tenosynovitis (1st extensor compartment release)
• Ganglion excisions
• Carpal tunnel release

Carpal Tunnel is a syndrome pertaining to the wrist and hand, and may present with the following symptoms:

• Pain (specifically night pain)

• Numbness in the hand and fingers

• Paresthesia (tingling, pins and needles feeling)

• Difficulty with activities of daily living and hand/finger clumsiness

This is caused by an entrapment of the median nerve of the wrist and hand that travels through the wrist’s carpal tunnel.

Carpal tunnel syndrome (CTS) is usually progressive over time and can cause permanent median nerve damage if left untreated for too long.  About 90% of mild to moderate CTS cases respond to conservative management. However, some patients progress to requiring surgery (Sevy, Varacallo, 2022).

Diagnosis

A good history and evaluation by an orthopedic surgeon using clinical tests can typically diagnose carpal tunnel syndrome. Most people do not need an MRI to diagnose carpal tunnel syndrome. Some health care specialists suggest a nerve conduction study to aid the diagnosis of carpal tunnel syndrome.

Conservative treatment options:

• Physical therapy (such as athletic therapy, occupational therapy, physiotherapy) and activities of daily living modifications

• The use of immobilization (brace/splint/orthosis) could improve patient-reported outcomes

• The use of NSAID’s could help improve symptoms

• The use of a steroid injection could improve patient-reported outcomes

If these treatments have failed you, surgery is an option!

Surgical Treatment

The surgical release of the transverse carpal ligament can relieve carpal tunnel syndrome symptoms and improve function.

Patients who do not get better following conservative treatment and those who have severe carpal tunnel syndrome should be considered for surgery. The definitive treatment for persistent carpal tunnel syndrome is a surgical intervention with carpal tunnel release. Carpal tunnel release typically is performed by an orthopedic surgeon or hand surgeon. Carpal tunnel release is considered a minor surgery in which the transverse carpal ligament or flexor retinaculum is cut, opening more space in the carpal tunnel and decreasing pressure on the median nerve. Surgical release of the transverse ligament gives greater than 90% success rate, and low rates of complication (Sevy, Varacallo, 2022).