FAQ

Since a while it seems to me that a hard module is forming under the skin at the level of the palm and sometimes it is hard to completely extend my finger

This condition is know as Dupuytren's desease. It is a gradual thickening of the palmar fascia that, in its advanced cases, can retract tendons and bent the fingers. It is a benign condition, usually painful, and there is no conservative treatment to avoid its development. When it is no longer possible to extend the finger on a table, the surgery may be needed. It consists in removing the tissue around the tendons and can be performed in day surgery regimen.

It happens during the night that my fingers go numb and I often have to wake up and shake my hand to make numbness go away

The situation described could be the typical presentation of the so called carpal tunnel syndrome. Because of the compression of the median nerve at the level of the wrist, numbness and tingling are present. The diagnosis and severity is confirmed by electromyography.
Treatment can be conservative at early stages while in advanced one surgery is indicated; it consists usually, in opening the ligament that compresses the nerve through and endoscopic procedure that allow immediate use of the hand.

I've noticed a bump at the level of the wrist on its dorsal aspect. Sometimes it hurts especially after repetitive movements

According to your description should be a ganglion cyst rising from the wrist. It is a benign cyst full of liquid coming from the wrist joint. An ecography will help to confirm the diagnosis.Surgery is indicated only when it hurts, it causes limitation of daily functions or its dimension are important. Surgery can be performed arthroscopically in selected cases in day surgery regimen.

Sometimes it happens that in the morning my ring finger is hard to extend, after forcing it a snap can be heard. Sometimes it is also painful

This condition may be referred as trigger finger; it is an inflammation of the tendons that make the finger bend. In its early stages a splint associated to anti-inflammatory medication can be useful. In advanced cases surgery is the treatment of choice; it consists in opening the pulley (the structure under which the tendon passes) through an endoscopic approach. Dressing is kept for few days and immediate mobilization is allowed.

When I open jars or turn the key I feel a deep aching pain at the base of the thumb

Pain at the base of the thumb, especially in women, is often caused by degenerative changes of the joint (the so called arthritis of the base of the thumb). Most common symptoms are pain, limitation of motion and deformity in advanced stages. At the beginning treatment can be conservative while in advanced cases surgery can relive pain. Many surgical procedure are available; the surgeon should help the patient in choosing the proper one for his particular condition.

I have been diagnosed a lesion of the fibrocartilage complex at the wrist; the surgeon proposed me an arthroscopy. Is it really necessary before repair of it?

Arthroscopy is a surgical procedure that allows to make 100% sure diagnosis of lesion of the structures inside the wrist such as ligaments, cartilage and bones. It is performed under brachial plexus anaesthesia (of the upper limb). The technique utilizes small incision to allow a video camera to enter the wrist. It can be used only to make diagnosis or to definitely treat some kind of conditions. In most cases after an arthroscopy mobilization is allowed earlier then with classical approaches.

I felt and broke my wrist. The surgeon proposed me an operation; is it really necessary?

Some fractures do need an operation to stabilize the bony fragments especially if the normal anatomical pattern has been lost. In other cases the union of the fragment can be achieved both with an operation or conservative treatment. The difference is made by patient's needs. The use of stabilizing elements, such as plates or screws, allows in most cases an immediate mobilization. An hand therapy program is mandatory after surgery.