I perform about 30 surgeries on hands per year. Carpal Tunnel Syndrome Carpal tunnel syndrome refers to a compression syndrome of the median nerve, the “middle arm nerve”, in the area of the carpal root. Symptoms include pain in the wrist or discomfort in the first three to four fingers, which can radiate throughout the arm. At an advanced stage, carpal tunnel syndrome can lead to a reduction in palpation and grip strength as well as muscular atrophy in the area of the ball of the thumb. As a rule, women are affected about three times more often than men.
Slight forms of carpal tunnel syndrome can be treated conservatively with special night splints or support bandages. Here, the discomfort is at least temporarily eliminated. In more severe cases, however, surgery is unavoidable.
During a surgical treatment, the constricted nerve is relieved by a 3 cm long incision in the palm of the hand. Special pain therapy means that there is no significant pain in the postsurgical phase.
Dupuytren’s Contracture Dupuytren’s contracture is a benign growth of connective tissue, usually at the base joint of the small finger or ring finger. In the end, the affected fingers can no longer be stretched, and the function of the hand is severely impaired.
An innovative treatment with an injection that removes the connective tissue strands has existed for several years. The injected active substance is an enzyme (microbial collagenase) obtained from the bacterium clostridium histolyticum. The pain caused by the injection is not very noticeable and can be compared to a bee sting. The injected substance works overnight – if the strand dissolved by it does not tear by itself, it is broken open the next day by the treating doctor with a little effort (not painful). Of course, a surgery is also possible, but due to the large scar and the greater probability of complications (e.g. numbness in the hand as skin nerves are inevitably injured) we rarely perform it.