Hand Surgery

As we age, degeneration or overwork take a toll of our hands which may need medical attention.

As a thourougly trained professional in Hand surgery, Dr Mahadik had performed thousands of hand surgeries to achieve function and appearance.

A detailed consultation will decide whether you would need just a splint, a steroid injection into your joints or a surgery.

HAND SURGERY IN BRIEF

Duration of procedure	½ to 1 hr
Hospital	Most of the hand procedures can be safely done under regional block in the rooms
Magic blocks	Dr Mahadik has an expensive experience in local anaesthetic blocks. This is a specific technique used by Dr Mahadik for regional and local anaesthesia using; 1-2% Lignocaine ( Quick numbing effect ) Bupivacaine ( long lasting for post- op pain Relief) Adrenaline ( less bleeding and prolongs effect of the former 2 ) Adrenaline is not used in finger anaesthesia. Nerve blocks also can selectively numb target nerves with just 1-2 cc solution. A patch of Emla ( local anaesthetic creme ) is applied to numb the needle prick.in sensitive patients. A tiny 27 guaze needle ( tiny needle equivalent to a botox needle ) is used to create a bleb of anaesthetic under the numbed skin. 3-5 cc of anaesthetic infiltration is slowly carried out with minimal discomfort. The surgery is then performed under sterile conditions in a bloodless field.
Cost	Claiming medicare rebates is getting increasingly harder and not worth the time wasted. You cannot claim these rebates through our clinic. We however have chosen to incorporate them in our pricing model so you don’t miss out on anything.
Carpal tunnel	$ AUD 800 for one side
Trigger finger	$ AUD 500
De quervain’s	$ AUD 650 each side
Ganglion	$ AUD 750-1000 depending on the complexity
Fat Grafting rejuvenation	$ AUD 1000 each hand

CARPAL TUNNEL SYNDROME

The carpal tunnel is a tight space at the front of your wrist, which the tendons and one of the major nerves (median nerve) to the hand pass through. If the pressure within this space increases due to conditions such as disease (such as rheumatoid arthritis), injury, fluid retention during pregnancy, or repetitive motions it may causes a tingling sensation in the hand, often accompanied by numbness and aching. This is known as carpal tunnel syndrome . The symptoms are often worse at night and may be relieved by shaking or dangling the hand out of the bed

Neglected cases may cause loss of function due to irreversible loss of nerve function.

Treatment includes, activity modification, splint at night, steroid injection ( first 6-8 wks ) . If symptoms persist, then surgery may be required.

During the operation, an incision is made in the middle of the palm/wrist to decompress the median nerve. The results of the surgery will depend in part on how long the condition has existed and how much damage has already been done to the nerve. For that reason, it’s a good idea to see a doctor early if you think you may have carpal tunnel syndrome.

DEQUERVAIN’S TENDONITIS

De Quervain’s Tendonitis is brought on by irritation of tendons across the wrist at the base of the thumb. It causes pain on movement of the thumb and wrist leading to difficulty with pinch activities. The pain may come on gradually or suddenly and may radiate down the thumb or up the forearm. Other symptoms include swelling at the site of pain, ‘clicking’ or ‘snapping’ and numbness on the back of the thumb.

Treatment includes splinting, anti-inflammatory medication, and steroid injection around the tendons, which may help reduce swelling and pain. In some cases, simply stopping the aggravating activities may relieve symptoms.

When symptoms are severe or do not improve, surgery is often recommended. The tight fibrous tissue around the tendons is released to make room for the irritated tendons, which prevents irritation occurring.

TRIGGER FINGER

Trigger finger is a common condition affecting the fingers. The fingers may ‘click or lock’ due to catching or irritation of tendons on the pulleys that hold the tendons in place. Swelling can develop in the tendon, which causes more irritation and further swelling

Treatment includes with rest, anti-inflammatory medication and steroid injection around the inflamed tendon, which can relieve symptoms and sometimes ‘cure’ the condition. If symptoms persist or recur, then surgery is usually recommended.

DUPUYTREN’S DISEASE

Dupuytren’s contracture is an abnormal thickening of the underlying tissue on the palm side of the hands. Thick, scar-like tissue forms beneath the skin on the palm and extend into the fingers, pulling them toward the palm and restricting movement and normal activities. The progression of the condition is unpredictable; it usually develops in mid-life and has no known cause (although may have strong family history) While surgery is the only treatment for Dupuytren’s contraction, treatment is not required for simple nodules or cords. Surgery aims to straighten the fingers and improve function. The operation must be done precisely, since the nerves and arteries that supply the fingers are often tightly bound up in the abnormal tissue. The results of the surgery will depend on the severity of the disease and sometimes skin grafts or flaps may be required. You can usually expect significant improvement in function, however requires extensive hand therapy and splinting in the recovery period.

GANGLIONS

Ganglion cysts are common lumps that appear around the wrist, base of the fingers or over the joints on the back of the fingers. These lumps are generally not painful but may be of concern due to their appearance. They may fluctuate in size and may disappear spontaneously.

Those ganglions that disappear spontaneously require no treatment and for those that are persisting but are not causing problems require no more than simple reassurance. They however may be removed due to discomfort or concern with the appearance of the lump. Surgery aims to remove the ganglion and a small cuff of joint capsule from which the ganglion arises, performed through an incision directly over the swelling.

HAND REJUVENATION ( FAT GRAFTING )

Fat grafting for hand rejuvenation is relatively new . Thin and arthritic hands can make you look older than you are . The fullness of the hand is lost with advancing age.

Layered fat grafts laid on the back of the hand fill in the hollowed spaces to give it a youthful look and feel.

Fat is injected through 6-8 entry points to give a uniform fatty layer to hide the tendons and joints only partially. With time, the skin quality and texture gets better.