Considering Hand Surgery? Four Common Misconceptions

 If you injured your hand or suffer from persistent hand or wrist pain that has not responded to treatment, surgery may be an option. Surgical hand and wrist procedures are safe and effective for a range of hand injuries and conditions, and many of these surgeries will not significantly disrupt your everyday life.

“One of the most fulfilling things about being a hand surgeon is that people are typically satisfied with the outcomes,” says Keith Crivello, MD, an orthopedic hand surgeon with Hunterdon Health. “We really feel like we can improve people’s quality of life.” Surgery can treat painful hand conditions ranging from arthritis, fractures, and carpal tunnel syndrome, to trigger finger (abnormal finger bending and stiffness) and ganglion cysts (non-cancerous fluid-filled sacs on the wrist or hand).

If your doctor recommends hand surgery and you’re not sure what to expect, here are the facts that dispel four common misconceptions about hand surgery:

My hand/wrist really hurts, so I probably need surgery.

Fact: Hand surgery may be necessary after a sudden traumatic injury, but most hand conditions may respond to non-surgical treatments such as RICE (rest, ice, compression, and elevation), pain medication, massaging, splinting, bracing or casting, physical or occupational therapy, steroid or collagenase injections, or other technologically advanced treatments. “When we see conditions that may be treated electively, we try to exhaust all non-surgical treatments before going to surgery,” Dr. Crivello says.

I’m too old and frail for surgery.

Fact: There are no age limits on hand surgery, says Dr. Crivello, who adds that hand procedures can be safely performed on elderly patients. “A number of procedures can be performed safely under local or regional anesthesia,” he notes. “For surgeries that do require additional anesthesia, we ensure that patients are properly prepared before proceeding.”

It will take me months to get back to normal after surgery.

Fact: Advances in hand surgery allow surgeons to address the affected area in a manner that minimizes recovery time. For example, Dr. Crivello explains that today’s hand joint implants have a “lower profile” compared with traditional implants.  This means that the newer implants don’t impinge on surrounding structures—they fit more accurately and can be inserted with smaller incisions, improving range of motion while avoiding soft tissue impact and shortening recovery time.

Other advances in surgical techniques can also speed recovery, Dr. Crivello adds. For instance, many fractures can be fixed with screws that are inserted completely inside the bone with minimal impact on the soft tissues, causing less stiffness. Several newer procedures, such as those for hand and wrist arthritis, do not require joint replacements or fusions but instead can alleviate pain and dysfunction with minimal invasiveness, according to  Dr. Crivello.

With shorter recovery times patients can return to their regular routines faster and get back to what they enjoy most.  “When people prepare for hand surgery, they expect to have significant restrictions that limit their activities of daily living for extended periods,” Dr. Crivello says. “Of course, some complex hand injuries may have a more extensive recovery period. But many patients are surprised at how they can type, drive and do other fine-motor activities soon afterward, depending on the surgery.”

I’ll suffer painful side effects after surgery.

Fact: “Any treatment carries a risk of side effects,” Dr. Crivello says. “Luckily, we don’t encounter these issues often. The most common side effect we see in hand surgery is stiffness, which is why we are excited about new techniques and implants that limit this issue.”  If post-surgical hand stiffness occurs, the patient can be referred to an occupational therapist, who will prescribe an exercise regimen to rebuild fine motor strength, Dr. Crivello notes.

To learn more about Dr. Crivello and the joint care services he provides, call MidJersey Orthopaedics at 908-782-0600, or visit www.midjerseyortho.com.