Core Orthopedics provides expert treatment for injuries and problems to the hand, wrist, and forearm. The hand is a complex and unique part of the body, composed of delicate tissues and a network of bones, muscles, and nerves. It is an amazing balance of both power and finesse, with the ability to generate great force, but also having fine dexterity. We offer treatments for the following common hand conditions, as well as many others.
Artificial Joint Replacement of the Finger: In this procedure, the surgeon replaces a diseased or damage joint in the finger with a joint implant made of silicone rubber or pyrocarbon, a ceramic material. The joint replacement can be for a damaged PIP joint, at the middle of the finger, or for a damaged MCP joint, at the base of the finger. Local or regional anesthesia is administered before a single-joint incision is created along the back of the joint. The soft tissues are then spread, to expose the joint and the damaged ends of the bones are cut away, preparing the surface for the implant. The implant is then inserted into the bone end. The soft tissues around the joint are repaired, to stabilize the joint and implant. After the incision is closed and bandaged, the hand is placed in a splint to heal.
Digital Nerve Repair: This is a microsurgery performed to reconnect severed ends of the nerves in the hand, allowing the nerve to heal and reducing the risk of a neuroma formation. Using a microscope, the surgeon identifies the damaged nerve ends. The surgeon reconnects the Epineurium (nerve sheath), allowing the nerve fascicles (nerve fibers) to rejoin. The ends of the nerve are trimmed, exposing healthy tissue. The nerve ends are then sewn together with sutures placed in the Epineurium. Sometimes the surgeon may also align the fascicles and sew them together as well. However, if there is too much tension to pull the nerve ends together, a nerve conduit will be used to bridge the gap between the nerve ends. The conduit is a soft tube made from absorbable material, silicone, or a piece of vein from the patient’s body. There are some cases, for exceptionally large nerves, where the surgeon will have to repair the nerve with a nerve graft. The graft is a segment of a large sensory nerve from a less critical place on the patient’s body, most commonly from the back of the leg. After the procedure, the incision is closed and bandaged and the finger is usually put into a splint for healing. After a month, the nerve fibers will begin to grow and heal.
Endoscopic Carpal Tunnel Release: This outpatient procedure is performed to alleviate the pain of carpal tunnel syndrome by relieving pressure from the median nerve. It also helps to restore normal sensations to the hand and fingers. A small incision is created in the wrist. A guide is inserted between the transverse carpal ligament and the median nerve, protecting the median nerve during the surgery. An endoscope is inserted through the incision, beneath the transverse carpal ligament, sending images to a TV monitor in the operating room. Using these images as a guide, the surgeon cuts the constricting transverse carpal ligament, relieving pressure on the median nerve. After the procedure, a splint may be applied to the hand to restrict movement while the transverse carpal ligament and the median nerve heal.
Because of the endoscopic technique and that this is an outpatient procedure, less pain and scarring occur than with traditional open surgery and there is a much quicker recovery time.
Limited Palmar Fasciectomy for Dupuytren’s Contracture: This surgical procedure is performed to treat fingers that have become flexed by Dupuytren’s contracture. In this procedure, the fascia, the thickened tissue just below the layer of skin, is removed. The patient is anesthetized before the surgery begins. One of several types of incisions is made to access to fascia of the palm and the involved fingers. Digital nerves and arteries are first identified and protected, before the surgeon carefully removes the thickened cords of the fascia. This allows the skin to move more normally. After the incision is closed with sutures, the hand is bandaged and put into a splint. Most patients are able to go home the same day.
Needle Aponeurotomy for Dupuytren’s Contracture: This is a minimally invasive, non-surgical procedure performed to straighten fingers that have become bent from Dupuytren’s contracture. A small needle is used to cut the cords that caused the contracture. Before the procedure, some local anesthesia is injected into the skin to numb each point where the needle will be inserted. However, the nerves and surrounding tissues are not anesthetized, making the procedure safer. The sharp edge of the needle is used to gently cut across the contracted tissue at several places, allowing the finger to straighten as much as possible. After the contractions released, the finger is stretched to break any remaining fibers and an anti-inflammatory steroid is injected at the needle marks and the surrounding tissues. Patients are usually able to get back to normal activities within 10 days of the procedure.
Please explore these pages to learn more from our doctors about your hand condition and the treatment options that may apply.
Dr. Raymond Metz, Jr. is a board certified, fellowship trained Orthopedic Hand surgeon. He practices as Core’s leading Orthopedic Hand Surgeon in Elk Grove Village and Hoffman Estates.
His clinical practice focus includes adult and pediatric hand disorders, such as fractures, nerve disorders, arthritis, and Dupuytren’s disease. He is also interested in endoscopic nerve decompression and arthroscopic surgery for the elbow, wrist, and hand. He has written chapters on pediatric finger injuries as well as adult tendon transfers for orthopaedic text-books. Dr. Metz’s goal is to provide an individualized treatment plan, expedited care, and a multidisciplinary approach in order to get patients back to enjoying life as quickly as possible.
555 Biesterfield Road Elk Grove Village, Illinois 60007-3306 Phone : (847) 690-1776
2380 Lakewood Blvd. Hoffman Estates, Illinois 60192 Phone : (847) 690-1776
800 Biesterfield Rd. Elk Grove Village, Illinois 60007
Phone : 847-437-5500
1555 Barrington Road Hoffman Estates, Illinois 60169
Phone : 847-843-2000
450 West Highway 22, Barrington, IL 60010
Phone : 847-381-0123