Conditions & Treatments

Conditions affecting the hand can have a major impact on our life. We rely on our hands to perform many day-to-day activities, from work to leisure.

Injuries, diseases or pain can mean we are no longer able to do the things we have always done and this, in turn, can lead to frustration, anxiety and depression. If you rely on your hands for work – whether that is using a computer or working as a carpenter – loss of function can, potentially, lead to loss of income and a drop in living standards. Over time, the impact of this can be immense.

What to expect

We specialise in treating chronic (long-term) conditions of the hand and upper limb.

Lead consultant, Alok Misra routinely manages emergency hand surgery cases at Wexham Park Hospital, supported by a team of dedicated nurses, hand therapists and imaging specialists.

Privately, we work with patients with a vast range of different hand and upper limb conditions, including those referred by GPs.

Among the conditions we work with and treatments we provide are

Acute hand injuries – we work with all types of hand injuries, including open wounds or closed injuries with underlying damage to bone or joint dislocations, tendon, nerve or sprains. The treatment offered will depend on the type and extent of the problem.

Dupuytren’s disease – also called Dupuytren’s contracture, this causes one or more of the fingers to bend in towards the palm of the hand. It can affect one or both hands. We offer:

  • Xiapex (collagenase) injections
  • Needle fasciotomy
  • Fasciectomy (digital / palmar)

Nerve compression – such as Carpal Tunnel Syndrome, which is pressure on the nerve in your wrist. This causes tingling, numbness and pain in your hands and fingers. We offer treatments for the following nerve compression conditions:

  • Carpal tunnel syndrome (median nerve)
  • Cubital tunnel syndrome (ulnar nerve)
  • Radial tunnel syndrome (radial nerve)

Hand and finger osteoarthritis – Hand osteoarthritis often runs in families. It mainly affects women and can start in your 40s and 50s, around the time of the menopause. It causes joints to become swollen and tender. We offer:

  • Injection (steroid, filler)
  • Trapeziectomy
  • Joint replacement / fusion

Ageing – like the rest of our bodies, our hands are subject to the effects of ageing. They may lose their smoothness and firmness, and become more knobbly, with wrinkled skin. They may also develop age spots. We offer:

  • Hand rejuvenation treatments (dermal filler or fat transfer)

Conditions in children – there are a number of different conditions of the hand and upper limbs that can affect children. We are able to help with:

  • Syndactyly (fused fingers / toes)
  • Trigger thumb
  • Hand injuries
  • Polydactyly (extra digits) / duplicate thumb
  • Ingrown toe-nails

Other hand and upper limb conditions – many other conditions of the hand and upper limb can be treated effectively, including:

  • Tennis elbow, Golfer’s elbow
  • Trigger digit
  • De Quervain’s tenosynovitis
  • Lumps (ganglion or other)
  • Infection
  • Hyperhidrosis (excessive sweating)

What results can be achieved?

The results will depend on a range of different factors including: the type and extent of the problem; how quickly it was diagnosed and treated; the treatment chosen; the age and overall health of the patient; how well the patient followed post-treatment advice and so on. Overall, we are highly effective at treating hand and upper arm conditions and have an excellent success rate. Regaining lost function in your hands and upper arms can help you to get back to work and doing the activities you love once more. This, in turn, can make you feel happier and more fulfilled.

Possible risks

All surgery and treatment carries potential risks, which will vary according to the type of treatment provided. Among the potential risks of surgery are: infection, swelling and bruising, bleeding, pain, adverse effects of anaesthetic. Your surgeon will offer you personalised advice based on the treatment you are having, your age, lifestyle and general state of health. Always follow this advice to ensure the best chance of making a full recovery.

After surgery

After surgery you will be given specific advice on what to do or not do and when to return to the clinic for a follow-up appointment. In general, it is a good idea to avoid doing anything too strenuous immediately after treatment and to avoid getting any sutures (stitches) wet immediately after surgery. Most treatments are performed in the clinic or outpatients so you will be able to go home the same day.

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