NERVE DAMAGE IN THE HAND/WRIST
Hand surgery is a very complex field and requires a significant level of specialized knowledge, training and expertise. At Y Plastic and Reconstructive Surgery, you can rest easy knowing that you are in the care of Dr. Asaf Yalif, an esteemed plastic surgeon who is triple Board Certified in Plastic Surgery, Hand Surgery, and Orthopedic Surgery. Dr. Yalif is highly experienced diagnosing and treating conditions involving nerve damage to the hands, wrists, and forearms, such as:
Carpal Tunnel Syndrome (CTS): CTS is a common problem affecting the hand and wrist that is caused by “nerve entrapment” or “compressive neuropathy,” meaning the size of the carpal tunnel is decreased (or the tissues inside the tunnel become enlarged) and the median nerve becomes squeezed inside the carpal tunnel of the wrist. CTS is often associated with occupations requiring chronic usage of the hands (i.e. typists, assembly work); however it is possible to develop CTS regardless of your occupation. One of the primary symptoms of CTS is gradual numbness and tingling in the areas supplied by the median nerve (i.e. thumb, middle, and index fingers), followed by dull pain where the nerve gives sensation in the hand. For patients with CTS, the hand may begin to feel like it’s asleep, particularly in the early morning hours. Pain associated with carpal tunnel syndrome may spread up the arm to the shoulder, potentially causing the thenar muscles of the thumb to weaken and atrophy—this can lead to difficulties picking up objects and grasping items such as a telephone or steering wheel.
Non-surgical treatment options for CTS typically include: activity modification, splints, and a steroid injection. If non-surgical measures prove insufficient surgery may be necessary. The standard surgical procedure to ameliorate the symptoms of CTS is called open release. During open release CTS surgery, a small incision is made down the front of the wrist and palm. The surgeon then cuts the transverse carpal ligament to ease pressure on the median nerve. Endoscopic carpal tunnel release is a less invasive surgical option wherein the surgeon merely nicks the skin in order to make one or two small openings for inserting the endoscope, which is a thin, fiber-optic TV camera that enables the surgeon to see inside the carpal tunnel and carefully release the transverse carpal ligament.
Cubital Tunnel Syndrome: the ulnar nerve is one of the main nerves of the hand—pressure on this nerve results in a condition known as Cubital tunnel syndrome, which is associated with symptoms such as: swelling, pain, clumsiness, or weakness of the hand; numbness or tingling of the ring and small fingers; and (in severe cases) elbow pain on the side of the arm next to the chest. Many individuals who suffer from cubital tunnel syndrome sleep with either their arms up by their head and/or their elbows bent, as both of these positions are likely to exacerbate the problem and lead to progressive nerve irritation and potential nerve damage.
Non-surgical treatment options for Cubital tunnel syndrome include: NSAIDS (non-steroidal anti-inflammatory medications), 100 mg daily of vitamin B6, a splint/brace while sleeping, using a small size soft knee splint on the elbow, correcting aggravating postures, and/or wrapping a towel around the elbow to hold it in place. Your physician may also prescribe stronger medications (i.e. cortisone, prescription NSAIDS), hand therapy, and/or a custom prescription splint. If non-surgical measures prove insufficient, surgery may be necessary to provide more space for the tendons and nerves while permanently reducing pressure on the nerve. Ulnar nerve transposition and medial epicondylectomy are two of the most common surgical options for patients suffering from cubital tunnel syndrome.
Dupuytren’s Disease (a.k.a. Dupuytren’s Contracture): this genetic condition is caused by an overgrowth of cells just below the palm skin, which leads to thickened cords and nodules within the palm and a progressive flexed posture (contracture) of the fingers. The ring or little fingers are most often the affected digits; however, any finger can be impacted by this disease. A new FDA-approved treatment for Dupuytren’s Contracture involves regular injections of XIAFLEX into the thickened cord to achieve straight, or nearly straight, fingers and improve range of motion. The treatment calls for up to three injections per cord at 30-day intervals, although some patients require fewer injections for the treatment to be effective. Fasciotomy surgery is also a potential treatment option for patients whose contracture is primarily located in the palm (as opposed to the fingers) or whose contracture is especially severe. During this procedure, zig-zag incisions are used to cut away affected tissue in the hand and fingers is cut away.
CONTACT Y PLASTIC AND RECONSTRUCTIVE SURGERY
Dr. Asaf Yalif, lead surgeon at Y Plastic and Reconstructive Surgery, is uniquely qualified to provide advanced, cutting-edge surgical treatment options for degenerative or traumatic hand and upper extremity issues. The only surgeon in the Atlanta area specializing in the rare combination of hand and plastic surgery, Dr. Yalif is triple Board Certified in Plastic Surgery, Hand Surgery, and Orthopedic Surgery. His unique perspective on soft tissue, joint, and bone-related conditions of the hand, fingers, wrist, and elbow enables him to offer a variety of medical and surgical options unavailable at traditional orthopedic practices. Y Plastic and Reconstructive Surgery is a friendly, welcoming boutique medical practice where cutting-edge surgical techniques are coupled with an emphasis on the patient experience; whether you are dealing with a traumatic injury or a long-standing degenerative disease, Dr. Yalif will take the time to listen to your concerns, answer your questions, and work closely with you to develop a personalized treatment plan tailored to ensure that your hands can work as hard as you do!
Y Plastic and Reconstructive Surgery has offices conveniently located in Atlanta, Roswell, and Woodstock, Georgia. If you are suffering from conditions related to nerve damage of the hands and/or wrist (i.e. Carpal tunnel syndrome, Cubital tunnel syndrome, Dupuytren’s Disease) and are interested in learning how Dr. Yalif can help, or would like information on the surgical options available at Y Plastic and Reconstructive Surgery, we encourage you to contact us today for an initial consultation. We look forward to hearing from you!