Our Treatments

There is a fully air-conditioned operating theatre at the Cardiff Bay clinic which is equipped to accommodate some aspects of hand surgery and other surgery that lends itself to day case treatment under local and general anaesthetic.

Carpal Tunnel Syndrome

The carpal tunnel is a passageway through the wrist carrying muscle tendons and one of the hand's major nerves. Pressure can build up within the tunnel because of conditions like rheumatoid arthritis, wrist injury, repetitive strain injury and even fluid retention during pregnancy. The resulting pressure on the nerve within the tunnel can lead to a tingling sensation in the hand, often accompanied by numbness, aching, and difficulty using the hand. This is carpal tunnel syndrome.

In some cases (particularly early on), splinting of the hand and anti-inflammatory injections or medications can relieve the problem. If this doesn't work, however, surgery may be the answer.
During the operation, the surgeon makes an incision from the middle of the palm of the hand down to the wrist. He will then remove the tissue that is pressing on the nerve to release the pressure. A large pressure dressing and splint are used after surgery to keep the wound immobile and promote healing. The scar will gradually fade and become barely visible.

The results of the surgery will depend in part on how long the condition has existed and how much damage has been done to the nerve. For that reason, it is a good idea to see a doctor early if you think you may have carpal tunnel syndrome.

Dupuytren's Contracture


Dupuytren's contracture is a condition of the skin and the tissue underneath it on the palm side of the hand. Thick, scar-like tissue forms under the skin of the palm and may extend into the fingers. This causes the finger to tighten and gradually pull down towards the palm of the hand. As this ‘contracture develops, the finger becomes stiffer and less mobile. It often affects the little finger first but can affect all fingers and the thumb. The condition usually develops in mid-life and has no known cause (though it has a tendency to run in families).

Surgery is the long term solution for Dupuytren's contracture. Following the anaesthetic being given, the surgeon will make an incision in the skin. He will then cut and separate the bands of thickened tissue, freeing the tendons and allowing better finger movement. The wound will then be stitched but sometimes small areas left open to improve healing and in some cases, skin grafts may also be required to replace the tightened and puckered skin. After surgery, the hand will be dressed and bandaged tightly before being immobilised in a hand splint.

The results of the surgery will depend on the severity of the condition. You can usually expect significant improvement in function, particularly after physiotherapy and occupational therapy and a thin, fairly inconspicuous scar may be all that remains. Therapy can continue for a few weeks or several months to regain joint mobility, soften the scars and restore hand function.
 

Ganglion Removal

Ganglions or cysts are swellings near joints which are formed by thickened fluid leaking from a joint (due to an injury or arthritic changes) into a small sack which can grow or shrink, can be painful or not and may or may not cause problems with movement. The ganglions may respond to anti-inflammatory medication but they may cause sufficient problems to require draining or surgical removal.

The most reliable method of treating a ganglion is by surgical removal. Ganglions in the finger can usually be removed using a local anesthetic while those in the wrist often require a regional or general anesthetic. An incision is made over the area that is swollen and the ganglion is removed. Sometimes it is necessary to remove a small amount of the surrounding tissue to prevent it recurring.

Following removal of the ganglion, a pressure bandage will be applied. The physiotherapist will initially teach you how to prevent post operative swelling and some simple exercises to prevent the possibility of developing stiffness. Usual recovery time following surgery for ganglions ranges from two to three weeks for small ganglions of the finger, and six to eight weeks for ganglions involving the wrist.
 

Local Anaesthesia

“Local anesthesia” typically means anesthesia for a small area, and may include injecting numbing medicine in the finger, or just at the site of surgery, such as for a trigger finger or removing a small lump. Sedative medications may be given to you, usually through an intravenous line (IV), to help you relax during your surgery, too.