Common Hand Problems Diagnosed & Treated at Brown Hand Center
At Brown Hand Center, the common hand problems afflicting our patients go beyond Carpal Tunnel Syndrome, and these afflictions are additional areas of concentration for us. Because we focus on you, successfully managing every disease that affects the human hand has been carefully studied. To discover how Brown Hand Center treats other common hand problems, see the sample range of diseases, and treatments below.
Trigger Finger: Brown Endoscopic Trigger Release (BETR)
Trigger finger is a very common and often very painful condition that affects the thumb and forefingers. The flexor tendons that bend the fingers pass through a series of pulleys, comprising the tendon sheath. With there being just enough room for the tendons and tenosynovium to pass through, a problem arises when the tenosynovium swells due to overuse, injury, arthritis, other diseases, or even for no definable reason. The tendon does not glide freely, and the tenosynovium is squeezed through the pulley to pop out the other side. This “triggering” effect can cause popping of the finger, or the finger may become locked down in the palm. The condition can be easily treated by dividing the pulley, allowing the tendon to glide freely. Dr. Brown (retired) saw a need for an endoscopic procedure, due to the painful healing of the open procedure, and developed the Brown Endoscopic Trigger Release (BETR). BETR is performed in much the same way as the Brown Procedure for Carpal Tunnel Syndrome, with a typical seven day recovery and no postoperative therapy.
Osteoarthritis: Brown Trapezial Arthroplasty/Rheumatoid Arthritis
Osteoarthritis is “wear and tear” degenerative arthritis. The gliding, smooth cartilage in the joints becomes thin, wearing away to cause pain and swelling as the disease progresses. We have developed procedures for an outpatient total joint replacement to reduce or eliminate pain and restore function, using the Brown Trapezial Arthoplasty. Rheumatoid arthritis is an autoimmune disorder that causes inflammatory changes and edema in joint synovium. Traditionally, it affects the wrist and metacarpal phalangeal joints first. Maximal function can be achieved when this is addressed early, often by therapy and night splinting. If needed, total joint replacement, with today’s advanced implants and our highly refined techniques, can be life-changing.
Ganglion/Mucous Cysts & Tumors
Surrounding the joint is thick synovial fluid that, when there is an opening, leaks out, causing a cyst. Any joint can give rise to a ganglion cyst, and a mucous cyst is the name given to a ganglion cyst that forms at the end joint of the finger. Puncturing the cyst can result in an infection, attempting to pull the fluid out is futile as more flows into the space, and steroid injection is not advised. All methods may cause scar tissue, complicating future removal. We remove the cyst and repair the joint capsule to reduce the chance of recurrence. Most tumors in the hand are benign; however, it is impossible to distinguish whether a tumor is benign or malignant unless it is surgically removed and undergoes pathological examination. Therefore, all tumors should be removed as even benign tumors can enlarge enough to compromise hand function.
Dupuytren’s is an inherited disease. The palm of the hand has a layer of skin, a fat layer, and a layer of fibrous tissue, called palmer fascia. In this case, the palmer fascia becomes diseased, forming nodules that progress to thickened longitudinal cords, causing the fingers to contract toward the palm. We remove the thickened band of tissue and all potentially diseased tissue. This is an extensive reconstructive procedure that will require months of healing and therapy, but, when performed correctly, can restore function to a disabled hand.
A hand surgeon is trained in bone repair, blood vessel repair, nerve repair, and skin and soft tissue repair. An in-depth knowledge of all tissues and their harmonious interdependence is essential to obtain the best reconstruction and functional result. In an emergency, there is no guarantee a patient will be provided with a hand surgeon in the emergency room, which is why we maintain a hand surgeon on call, 24 hours a day.
This is a minimally invasive technique of treating torn ligaments and cartilage inside the wrist joint. Without treatment, wear and tear to the cartilage can ensue, requiring major wrist reconstruction or total joint replacement. Wrist arthroscopy is performed on an outpatient basis, and recovery is generally rapid.
Tennis Elbow is a common problem, causing pain at the elbow on either the medial or lateral side. We have developed a treatment for tennis elbow that has been highly effective. We release and lengthen the muscle origins, but instead of doing this in the traditional manner, we perform a z-plasty lengthening and closure of the lengthened muscle tendon units. This leaves no raw, exposed muscle to heal. Healing is typically rapid at several weeks compared to several months for the traditional manner.
Nerve Entrapment Syndromes
Entrapment neuropathy simply means the nerve is pinched. In addition to Carpal Tunnel Syndrome, we treat Pronator Syndrome, Anterior Interosseous Syndrome, Cubital Tunnel Syndrome, Ulnar Nerve Entrapment in Guyon’s Canal, Radial Tunnel Syndrome, Posterior Interosseous Nerve Syndrome and Wartenberg’s Syndrome. The treatment depends on the syndrome and severity.
Contact Us for All Hand & Arm Problems
In addition to these common hand and arm problems, we also provide treatment for Post-Traumatic Arthritis Joint Replacement, Congenital Birth Deformities, Hypothenar Hammer Syndrome, Kienbock’s Disease, Skier’s Thumb, Tendon Transfers, Boutonniere Mallet Finger/Swan Neck Deformities, as well as many other unique hand and arm ailments.