Osteoarthritis of the wrist | Osteoarthritis of the end joint of the finger | Carpal tunnel syndrome | Dupuytren’s disease | Trigger finger | Hand injuries | Rejuvenation of the back of the hand | Elbow
Since the 1930s, hand surgery has developed into a separate discipline within plastic and reconstructive surgery. While in the early years it was primarily concerned with the treatment of infections, tumours and accidents, nowadays hand surgery involves surgical and non-surgical treatment of a range of conditions.
The range of treatments in hand surgery includes degenerative and rheumatological joint diseases such as osteoarthritis of the finger joint, nerve compression syndromes such as carpal tunnel syndrome, Dupuytren’s disease, soft tissue diseases and tumours, correction of malpositioning, injuries of the hand and back of the hand, injuries and rejuvenation of the back of the hand and treatment of the elbow.
Treatment options for osteoarthritis of the wrist include splinting the hand to stabilise the thumb, although this affects the mobility and the usability of the thumb. Other options include cortisone injections or deep x-ray therapy, which can also be used to relieve the symptoms. However this will not stop the condition from progressing. Once all conservative treatment options have been exhausted, surgical treatment may be considered, with good prospects of success. Well-established techniques from plastic surgery and hand surgery are available for this.
Surgical treatment
The procedure is performed under regional or general anaesthetic and involves a stay at the clinic (for one night). The bones that form the basal joint (multangular bones) are removed. A new joint is then constructed with the help of tendon fibres from the patient’s own tissue. After immobilising the joint for four weeks in a plaster cast, the hand may be used again. An additional period of several weeks is also required before the hand will regain its full range of movement. The end result can be expected after about a year.
Inflammatory processes in the fingers and often the thumbs can lead to changes in the synovial sheaths and to thickening of the tissue. Trigger finger is a “triggering phenomenon” that causes the individual to have difficulty flexing or extending their fingers. This can in turn result in painful restriction of the person’s mobility in everyday life. Cortisone injections can be administered as a conservative form of therapy. If this does not lead to long-term improvement, the annular ligament can be surgically transected in order to achieve full freedom of movement again.
Plastic surgery, and hand surgery in particular, includes treatment of various conditions as well as open and closed wounds.
Open wounds that involve damage to the skin should be surgically treated within six hours. We do not have an emergency ward at the Pyramid Clinic, but we can perform emergency surgery on request if spare operating theatre capacity is available, in consultation with your doctor. If this is not possible, we will immediately refer you to a reliable hand surgery centre.
Closed wounds allow surgery to be planned in advance and these procedures are performed on our own premises. This typically occurs in the case of broken bones that leave the skin unharmed. The surgery will be planned by the specialist as part of a preliminary consultation, but in some circumstances may not be possible until several days after the accident.
As well as treating annoying age spots (with laser therapy or peeling), it is also possible to improve the quality of the skin on the back of the hand with skin boosters. This increases the moisture in the uppermost layer of skin and increases tissue firmness, smoothing out fine lines.
The cost for rejuvenation of the back of the hand is from CHF 1,000 per session. For optimal results, three sessions every four to six weeks are required.