Hand & Wrist

Our specialized hand and wrist care, led by Dr. Brian Janz and Dr. Khurram Pervaiz, integrates advanced diagnostic imaging and nerve assessment services on-site. This streamlined approach ensures swift and accurate diagnoses for conditions like arthritis that impact the joints, nerves, bones, ligaments, and tendons in the hands and wrists. Whether it be conservative treatments or state-of-the-art surgeries, our team of dedicated and skilled hand surgeons offers personalized solutions to address your specific needs effectively.

Conditions We Treat

At The Centers for Advanced Orthopaedics Orthopaedic Associates of Central Maryland Division, our expertise lies in delivering exceptional care for various hand and wrist conditions.

Carpal tunnel syndrome (CTS) is a prevalent condition affecting the hand and wrist, impacting up to 10% of the population. It occurs when the median nerve in the wrist is compressed within the carpal tunnel. This nerve is responsible for transmitting signals for sensation and muscle movement to the hands and fingers. Symptoms of CTS include numbness, pain, and tingling in the fingers, wrists, and arms, often leading to difficulty with grasping and gripping activities due to discomfort or weakness.

Cubital tunnel syndrome, affecting the ulnar nerve in the arm, causes moderate to severe pain and numbness in the elbow and fingers. Often referred to as the "funny bone," this condition results from compression or irritation of the nerve, leading to discomfort and impaired sensation in affected areas.

Dupuytren's contracture involves the gradual thickening of tissue beneath the skin in the hand, leading to the ring and pinky fingers pulling towards the palm. This condition results in discomfort and hampers daily activities.

Hand, finger, and wrist arthritis cause pain, stiffness, and swelling, affecting daily activities. Treatment options include medication, therapy, splints, and surgery for severe cases. Regular exercise and lifestyle changes can help manage symptoms and improve quality of life.

Cuts, pressure, stretching, or crush injuries can damage hand nerves, often resulting from falls, vehicle accidents, gunshot wounds, and other physical traumas. Additionally, burns, freezing temperatures, electrical shock, radiation, and vibration can cause nerve injuries. The hand's main nerves—the radial, median, and ulnar nerves—control movement and sensation in various hand and finger regions.

Injured nerves may lead to loss of sensation, movement, or both, with some injuries healing spontaneously, while severe cases may necessitate surgical intervention.

Wrist fractures often occur due to falls onto an outstretched hand, with the scaphoid, located on the thumb side of the wrist, being the most commonly fractured bone. Symptoms can be minimal, leading to misdiagnosis as a sprained wrist.

Treatment for a wrist fracture, either casting or surgery, depends on the fracture's location. Fractures near the thumb typically heal well with casting, while those in areas with poor blood supply or displacement often require surgery.

Treatments

Treatment for hand and wrist conditions at The Centers for Advanced Orthopaedics Orthopaedic Associates of Central Maryland Division is personalized to address individual needs, aiming to alleviate pain and enhance function.

Endoscopic carpal tunnel release provides a minimally invasive surgical approach for relieving pressure on the median nerve in carpal tunnel syndrome. Utilizing an endoscope inserted through a small incision, surgeons gain a clear view of the carpal tunnel without disturbing surrounding tissue. This technique offers faster healing and reduced discomfort compared to traditional open release surgery, as it involves a smaller incision and spares some palm tissue. Similarly, endoscopic cubital tunnel release targets decompression of the ulnar nerve, employing specialized tools for precise treatment.

Nerve injuries ranging from first- to third-degree often resolve spontaneously, while fourth- and fifth-degree injuries typically necessitate surgical intervention. Various surgical options exist for nerve repair in the hand, selected based on factors like injury severity and the gap between nerve ends. Surgical timing depends on the cause of injury, with immediate intervention for sharp object cuts and a brief waiting period for crush injuries to initiate natural healing processes.

Enzymes are injected directly into the palm to target and soften the thickened tissue. This enzymatic action allows for greater flexibility and mobility in the affected area. With the tissue softened, a hand surgeon can then delicately manipulate the fingers back to their correct alignment and position, facilitating improved hand function and comfort.

The standard surgical procedure for treating carpal tunnel syndrome is known as an open release. During this procedure, your hand surgeon will administer a local or regional anesthetic to numb the area. A 2- to 3-inch incision is then made along the palm, providing access to the transverse carpal ligament, which forms the roof of the carpal tunnel.

Your surgeon will then carefully make an incision across the transverse carpal ligament to widen the tunnel, relieving pressure on the median nerve. This straightforward procedure typically takes approximately 15 minutes to complete.

Treatment options for hand, finger, and wrist arthritis include medication, physical therapy, splints, and surgery for severe cases. Exercise and lifestyle adjustments help manage symptoms and improve quality of life.

Hand and Wrist Arthritis Treatment in Central Maryland

Scheduling your appointment with our hand and wrist specialists at The Centers for Advanced Orthopaedics Orthopaedic Associates of Central Maryland Division is hassle-free. Book online, message us via Klara, or call directly. For appointments, visit our website or call (410) 644-1880 or toll-free at (855) 4MD-BONE. For physical therapy, call (443) 478-4449. Your health is our priority.