Richard has a sound understanding and experience in management of compression neuropathies of the hand, including carpal tunnel syndrome (median nerve compression at the wrist) and cubital tunnel syndrome (ulnar nerve compression at the elbow).
In addition, Richard also has widespread experience in the management of:
- Trigger finger
- De Quervain’s tenosynovitis
- Wrist ganglia
Possible complications:
The decision to undergo hand surgery should only be made after considering if the potential benefits can achieve your aims, and whether the risks are acceptable to you. The possible risks/ complications of hand surgery include (but are not limited to):
- Cardiac problems, including heart attack or arrythmias.
- Venous thromboembolism (including deep vein thrombosis and pulmonary embolism, which may be fatal).
- Surgical site infection.
- Haematoma/ seroma requiring return to theatre.
- Wound breakdown, delayed healing or protruding sutures. This may take a considerable time to settle.
- Conspicuous scars, including hypertrophic, stretched or migrated scars.
- Possible need for revisional surgery. Richard will only consider revising your hand surgery if he believes:
- there is a definable structural issue,
- this issue is realistically able to be improved with surgery and
- the risk of revisional surgery causing a worse result are minimal.
- Contour asymmetry.
- Nerve/ vessel/ tendon injury.
- Malunion/ non-union of fractures
- Joint instability or stiffness.
- Failed reconstruction including skin grafts or local flap reconstructions.
- Donor site wound breakdown, infection or delayed healing.
- Imperfect function is common after hand surgery and all interventions carry limitations on what may be realistically achieved. It is critical that patients understand the role of appropriate post-operative hand therapy and undertake to comply with all post-operative instructions.