Regain Form and Function
Hand surgery is one of the most enjoyable specialties in medicine. The hand represents our primary interaction with our environment and also our prime ability to alter our environment. It gives us music—all who have ever enjoyed listening to guitar, drums, piano, and most other instruments in concert have appreciated the artist creating sound through the use of their hands. The hands also give outlet for visual artists. Any trip through the Milwaukee Art Museum lets us marvel at the beauty created as the artist’s hand guides brush and paint on canvas. Wisconsin also has a great tradition of woodworking—each piece stands as testament to the versatility and ability of the hand.
Hand surgeons in Wisconsin see patients for multiple different conditions. Most commonly, people think of carpal tunnel syndrome when they think of hand surgery. Carpal tunnel syndrome is the most common form of nerve compression syndrome in the upper extremity. Nerve compression syndromes can and do occur in all major nerves of the upper extremity. Symptoms commonly include numbness in the nerve distribution, weakness, aching, night waking, and loss of function. The median nerve—which is compressed in carpal tunnel syndrome—can also be compressed at the elbow. Ulnar nerve compression can also occur, causing numbness in the small and ring fingers. The third major nerve in the arm is the radial nerve. Compression of this nerve is usually in the forearm near the elbow. Compression of this nerve doesn’t give the standard issues with numbness, as the nerve doesn’t supply a large area with important sensation. Rather, compression of the radial nerve causes a deep aching pain and loss of function of the arm. There are several different treatments for nerve compression syndromes of the arm—not all of which include surgery. A well-trained hand surgeon can help you to determine if you have problems with nerve compression and also help you to find the appropriate treatment that will bring relief.
Hand trauma is an unfortunately common occurrence. Wisconsin has a very proud history of farming and manufacturing. Our people are hard-working and inventive. Hand trauma is one of the things that comes with an active lifestyle. The hand surgeon plays an active roll in supporting Wisconsin’s working community. These injuries include the person who made the mistake of clearing a clogged snow blower with their hands, the hand caught in a table saw, the burned hand, and the hand caught in machinery. In addition, we treat people whose injuries develop from repeated workplace exposure. Dr. McCall has a long history of responding to emergencies across Waukesha County. Many people have been able to regain hand function because of her interventions.
Hand arthritis is another common condition in hand surgery. The most common area for most people to develop arthritis is in the base of the thumb, where the thumb bones meet the wrist. This area can become painful as the joint deteriorates from years of use. Fortunately, there are many options for treatment. Many times a steroid injection into the joint will relieve pain and allow for up to a year or more of improved function. For those who don’t respond well to injections, there is a wide variety of surgical procedures available for the treatment of this joint. Rheumatoid arthritis is another condition that causes deterioration of the joints. Rheumatoid arthritis patients lose function in the hands slowly over time. Fortunately, there have been many advances in the medical treatment of RA, so there is now less of a demand for surgery. Still, people will occasionally need treatments for tendons that are out of alignment or for joints that are no longer functional.
Sometimes the hand problems come not from the outside, but from our own genetics. Dupuytren’s disease is a disease where the tough layer of fascia on the palm of the hand will start to contract. Instead of remaining soft and supple, the palm of the hand starts to show cords that eventually pull the fingers into flexion. Surgery has been a mainstay of treatment for many years. Recently, a new injection has been developed to allow the tight cords to be ruptured in a simple office procedure. Xiaflex is appropriate for many but not all Dupuytren’s sufferers.