We diagnose and treat a wide range of hand conditions, including hand and upper extremity trauma, hand and wrist fractures as well as infections. We also have a large array of equipment that helps our doctors provide quality care for our patients. We have a dedicated Minor Surgical Procedure Room in our centre with comprehensive surgical capability and specialised filters to keep the air clean and infection rates low. We also have an 'in-house fluoroscopy' (portable x-ray) where we can perform ultrasound and dynamic assessments of bone and joint problems. In essence, our centre is set up to take care of majority of the conditions that can affect the hand and upper limb.
Post-traumatic Deformity
Post-traumatic Deformity from inadequate treatment of acute trauma is another area of surgery that we look into. These patients present with deviation of their fingers or scissoring on making a fist and are mostly to have malunion of a previous fracture. After appropriate imaging, corrective osteotomies are performed to improve the alignment and function of the fingers.
Figure 1: The above depicts the result of corrective surgery in a mal-united fracture of the phalanx of the middle finger.
Congenital Hand Problems
Congenital Hand Problems are a group of conditions where the hands of children are different in form in terms of shape, number or length of the digits. Examples would include syndactyly and thumb duplication. These patients often require a thorough examination to ensure that other organ systems are not also compromised, as is the case in a small proportion of these patients. Patients usually have an X-ray taken of their hands and corrective procedures planned after a detailed consultation with the child’s parents to understand their expectations.
Corrective surgery for thumb duplication.
Hand & Upper Extremity Trauma
Hand & Upper Extremity Trauma includes the strains and sprains as well as fractures and dislocations of hand and wrist. Treatment for these conditions entails diagnosis of the injuries by clinical examination, confirmation with imaging studies and treatment with splints or surgery.
Open reduction and internal fixation of multiple fractures.
Hand Infections
Hand Infections are another common type of problem we treat. These take the form of paronychia, felon, or more serious conditions such as necrotising fasciitis. We treat these infections with antibiotics and excisional debridement when necessary.
Pulp abscess (left) and post-operative infection (right).
Tendinopathies
Tendinopathies usually present with pain over the metacarpal head and radial styloid called trigger finger and DeQuervain’s tenosynovitis respectively. These conditions are diagnosed clinically and respond well to local injections of steroid. For those cases where symptoms recur, surgical release of the A1 pulley (for trigger) and first extensor compartment (for DeQuervain’s tenosynovitis) may be performed.
Typical bent posture observed in a trigger finger.