Hand Surgery

Hand conditions treated by Dr Haddad

Dupuytren's contracture is a progressive condition where thickened tissue forms beneath the skin of the palm and fingers, creating cords that gradually pull the fingers into a bent position. The condition most commonly affects the ring and little fingers and can make it difficult to straighten the fingers fully, interfering with gripping objects and performing daily tasks.

The exact cause isn't fully understood, though genetic factors, age, gender (more common in men), and certain medical conditions may contribute. Treatment is typically considered when the contracture begins to significantly affect hand function.

Treatment approaches may include:

• Observation in early stages when function isn't significantly impaired

• Surgical removal of the thickened tissue (fasciectomy)

• Needle aponeurotomy (breaking up the cords with a needle)

Surgery aims to restore finger extension and improve hand function, though recurrence can occur over time.

Carpal tunnel syndrome results from compression of the median nerve as it passes through the carpal tunnel in the wrist. This causes numbness, tingling, and pain in the thumb, index, middle, and part of the ring finger. Symptoms often worsen at night and can progress to weakness and difficulty with fine motor tasks.

The condition may develop from repetitive hand use, pregnancy, arthritis, diabetes, thyroid problems, or sometimes without identifiable cause.

Treatment approaches may include:

• Wrist splinting, particularly at night

• Activity modification

• Anti-inflammatory medication

• Corticosteroid injections

• Surgical decompression (carpal tunnel release) when conservative treatment fails or nerve compression is severe

Surgery involves releasing the transverse carpal ligament to relieve pressure on the median nerve, typically providing good symptom relief, though recovery of sensation and strength can take time.

Trigger finger occurs when inflammation narrows the sheath surrounding a tendon in the finger or thumb, causing the tendon to catch or lock as it tries to glide through. This creates a triggering or snapping sensation when bending or straightening the digit, and in severe cases, the finger may become locked in a bent position.

The condition can result from repetitive gripping, certain medical conditions like diabetes or rheumatoid arthritis, or develop without clear cause.

Treatment approaches may include:

• Rest and activity modification

• Anti-inflammatory medication

• Splinting

• Corticosteroid injection into the tendon sheath

• Surgical release of the constricted tendon sheath when conservative measures fail

Surgery involves releasing the tight pulley to allow the tendon to glide freely again, typically providing significant relief.

Skin cancers on the hand are common, especially on the back of the hand, fingers or forearms. These are usually related to sun damage. Dr Haddad’s experience in skin cancer surgery and hand surgery is well positioned to facilitate care of the issue.

Most deeper masses of the hand are benign, but occasionally can be more aggressive. A thorough examination and imaging is usually required to assess the underlying issue. These can arise in the fingers or palm, and often may require surgical excision. Protection of vital structures, especially nerves is important.

Hand injuries from accidents, lacerations, or crushing injuries may damage tendons, nerves, blood vessels, bones, or combinations of these structures. Plastic surgery expertise is particularly valuable in complex hand trauma requiring microsurgical repair of small structures.

Treatment depends entirely on the nature and extent of injury but may involve:

• Tendon repair or reconstruction

• Nerve repair or grafting

• Fracture fixation

• Soft tissue reconstruction

• Skin grafting or flap coverage for wounds