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Most hand-related problems develop slowly, and over a longer period of time. Patients seek medical care when the pain impacts daily activities, cause sleepless nights, or limits function, such as with carpal tunnel or osteoarthritis. At Regency, we offer diagnosis and elective hand surgery to treat these types of conditions. Our goal is for you to return to work or life with reduced pain and minimal downtime. We offer a wide range of options for elective hand surgeries that will help enhance your quality of life — including, but not limited to, the conditions below. 

Tenosynovitis/trigger finger

To ensure minimal friction with tendon movement, tendons are bathed in a lubricant called synovial fluid which is produced by synovium that surrounds each tendon.

Synovium may become inflamed, resulting in increased friction with tendon gliding and associated pain with finger movement. Without treatment, inflammation continues and the tendon will “catch” during movement, and may only release with forced manipulation of the digit, causing “triggering” of the finger.

Ganglion

This is the most common type of benign tumor affecting the hand, and represents an attritional tear to the joint capsule. It is characterized by a mass on the top or bottom of the wrist, and can cause pain.

Dupuytren’s disease

Dupuytren’s disease is a fixed flexion contracture of the hand. The disease is a slowly-progressing contracture of the palmar fascia in a process called palmar fibromatosis. The condition usually affects the little finger and ring finger. In advanced cases, the disease can also affect the long finger, but the index and thumb are almost always spared. The disease occurs primarily to those over the age of 40, and has a strong genetic preponderance to people of Scandinavian ancestry.

Treatment is to restore function to the hand, but it rarely cures the disease. The treatment may have to be repeated if the disease process is rapidly progressive. This varies between individuals. Treatments of Dupuytren’s disease include Collagenase injection, surgical limited fasciectomy, dermatofasciectomy, radiation, percutaneous needle fasciectomy, fasciectomy with grafting, and many more.

The wide variety of treatments illustrates the progressive nature of the disease and the varied attempts of physicians for two centuries to control the disease and slow its progression. Dr. Mussman uses limited fasciectomies, skin grafting, and adjacent tissue transfers when necessary to treat the disease.

Carpal tunnel syndrome

Carpal tunnel syndrome may be the cause of the pain, tingling, numbness, and weakness of the hand that you may be experiencing. The cause of carpal tunnel syndrome is compression of the median nerve as it enters the wrist and hand. The nerve travels through a tight opening along with nine other structures of the hand. The small opening is called the carpal tunnel. When the median nerve becomes compressed, pain, tingling, and numbness can happen. The symptoms are predominantly in the thumb, index, and middle fingers, but can radiate to the forearm. Frequently dropping things and worsening of the symptoms at night are common complaints.

Carpal tunnel syndrome can be associated several things:  frequent and repetitive hand movements, pregnancy, obesity, bone spurs, tumors, hypothyroidism, rheumatoid arthritis, and diabetes. Smoking can also worsen carpal tunnel, as it decreases blood flow to the hand. Carpal tunnel syndrome can frequently be relieved without surgery if caught early and treated with proper medical, behavioral, and positional changes. However, for many patients, surgery is the optimal choice. The surgery is done on an outpatient basis and typically lasts less then 30 minutes.

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