Common Types of Hand Surgery at Fort Worth Hand Center

Our first goal is to advise patients on beneficial conservative treatments. However, for those in which hand surgery is the best course of action, the Fort Worth Hand Center utilizes the most up-to-date technologies with a minimally invasive approach. This helps patients heal faster and with a less painful recovery period.

Who Needs Hand Surgery?

Many patients with musculoskeletal and arthritis-related problems in their hands or wrists won’t need surgery. A conservative approach is typically the first option. The decision to operate will depend on:

  • Patient needs
  • Patient response to other treatments, including drugs, splinting and exercise
  • How bad patient’s symptoms are, such as pain or loss of hand function

Typical conditions that require hand surgery include:

  • Congenital deformities or birth defects, which cause hands to have a different structure or appearance than normal.
  • Degenerative conditions such as arthritis and carpal tunnel syndrome, which occur gradually because of age and other factors, cause pain, and change how the hands function.
  • Infections such as those that lead to the formation of fluid-filled cysts or ganglions.
  • Injuries like fractures, dislocations or deep cuts, bruises, which change the aesthetics and function of hands. Severed fingers can also be re-attached or re-constructed with hand surgery procedures.

What Are Common Types of Hand Surgery Procedures?

Arthritis Surgery for Thumb and Digit

Arthritis in the thumb and digits can cause stiffness, swelling, deformity and inflammation, thus affected hand and finger function. The need for hand surgery depends on the severity of the arthritis and pain. Possible surgical options include:

  • Synovectomy, in which the inflamed tissue lining the joint is removed.
  • Arthroplasty, in which the affected joint is replaced with an artificial joint.
  • Arthrodesis, in which the joints are removed, and the finger bones are fused together.
  • Osteotomy, in which damaged joints and bones are cut and reshaped.

Artificial Finger Joint Replacement

Damaged joints in the finger can be surgically replaced by artificial plastic or metal joints. In severe cases that do not improve with other therapies, artificial finger joint replacement will alleviate pain, realign bones, and improve finger function.

Carpal Tunnel Release Surgery

Carpal Tunnel is a common condition in which the median nerve becomes pressed or squeezed, causing numbness, weakness and pain in the hand, wrist, and forearm. When conservative measures such as rest, anti-inflammatory medications and splinting fail, carpal tunnel release surgery reduces pressure on the median nerve by surgically releasing the band of tissue around the wrist.

Closed Reduction and Fixation

When bones in the hand, wrist or elbow dislocate or fracture, the bone needs to be placed back in the proper position. In closed reduction, the orthopedic surgeon physically moves the bone back into place without surgical exposure of the bone. Internal fixation is the surgical reconnection of the broken bones, utilizing screws, plates, or other methods to help the bone heal correctly.

Dupuytren’s Contracture Surgery

Dupuytren’s Contracture is a hand deformity caused by knots forming in the tissue of the palm. These knots eventually create a thick cord that pulls on the fingers, causing them to remain bent. As the condition advances, hand surgery is needed to remove the knotted tissue, allowing more hand movement and function.

Elective Emergency Hand Surgery

When accidents and traumas occur to the hands, there may be an immediate need to perform hand surgery to save hand function. Other times, the need for surgical intervention can be elective not urgent. A board-certified orthopedic surgeon will advise the patient on surgical requirements to allow the best outcome.


Swelling and fluid buildup within the compartments of the fascia can build up pressure to the area and lead to permanent damage. This condition, called compartment syndrome, can be happen suddenly (acute) or gradually (chronic). A surgical intervention called a fasciotomy is required to cut open the fascia to relieve the pressure, restore blood flow, and prevent damage to the hand, forearm, or other extremity. 

Finger Joint Fusion

In this hand surgery, the damaged ends of finger joints are removed and replaced by a prosthesis. The prosthesis is then made stable by wrapping nearby ligaments around it. Joint finger fusion is most often performed on patients with severe arthritis pain, in which the cartilage between the finger bones wears out, thus causing pain, inflammation and stiffness.

Ganglion Removal

Ganglion cysts are fluid filled, non-cancerous lumps that develop on the hand or wrist. Not all ganglion cysts require treatment, and non-surgical treatments are tried before surgical removal. However, depending on the location, the cysts can restrict movement. Or they may be painful if pressing against a nerve. Ganglion removal surgery is a routine procedure that removes the ganglion cyst at its root.

Hand Joint Replacement (Arthroplasty)

Like wrist arthroscopy and finger joint replacement, a damaged or deteriorated hand joint is surgically replaced with an artificial joint.

Hand Nerve Repairs

See Microscopic nerve repair, specifically in the hand

Hand Tendon Repair

Hand tendons are cord-like tissue that connect the muscles to the bones. When torn, damaged or cut, hands cannot move normally. Hand tendon repair surgery, performed by an expert hand orthopedic surgeon, stitches the tendons back together to restore movement and function.

Hand Therapy

Therapeutic interventions performed by a specialized therapist to treat conditions and injuries of the hand, fingers, wrist, and elbow. The goal of hand therapy is to reduce pain and return high level functioning of the injured extremity.

Intricate Hand and Microscopic Surgery

Used for injuries, deformities, traumas and more, microscopic hand surgery enables the surgeon to repair damage to the minute, complex structures of the hand. Using state-of-the-art instruments under a microscope, the orthopedic surgeon utilizes advanced techniques to repair nerves, blood vessels, tissue, etc. to restore hand function.

Knuckle (MCP Joint) Replacement

Like other joint replacement surgery, the metacarpophalangeal joint, or knuckle joint, is surgically replaced with an artificial joint.

Microscopic Nerve Repair

Nerves in the hand, wrist or arm can become pinched, severed, stretched, or compressed. Whether due to injury, deformity, disease or condition, these damaged nerves may require highly specialized microscopic surgery to repair them. Microscopic nerve repair will restore feeling to the nerve and improve functioning of the extremity.

Realignment and Fixation

When bones in the upper extremities are broken, they need to be restored to the proper placement. If the bones are shifted out of alignment, or displaced, fixation is performed to realign the bones. Pins and/or other hardware are applied to keep the bones in the correct position as they heal. 


When a finger, hand or arm has been completely cut off from the body, replantation can surgically reattach the extremity. This is a highly specialized procedure requiring state-of-the-art techniques and equipment. The goal is to restore as much function as much as possible without the possibility of pain with movement. However, sometimes there is too much damage to the body part, and revision amputation is a better option for the patient’s recovery.

Skin Flaps

Like skin grafts, skin flaps use healthy tissue to replace damaged tissue. Skin flaps, however, are still attached to the original donor site and used to cover a nearby wound.  

Skin Grafts

Infections, cancers, burns, deep wounds, and skin diseases may damage the skin on the upper extremity to unsafe levels. In these cases, surgically replacing damaged skin with healthy skin from another area of the body is a last resort treatment. Skin grafts may be split-thickness, meaning the epidermis and part of the dermis are used, or full-thickness, replacing both the entire epidermis and dermis.

Sports Injury Management of Hand, Wrist and Elbow

Sports injuries often need specialized medical attention. After rest, ice, compression, and elevation (RICE), the orthopedic surgeon may recommend additional treatments, such as medication, rehabilitation exercises and surgery to manage pain and facilitate healing.

Surgery for Arthritis: Synovectomy, Osteotomy, Joint fusion, Arthroplasty

See Arthritis Surgery for Thumb and Digit

Surgical Drainage and/or Debridement

These methods are used to fight bone or joint infections and abscesses. In surgical drainage, the abscess is drained of any pus, thoroughly cleaned, and treated with any needed antibiotics. The wound is allowed to heal without sutures and requires expert care. In debridement, infected and diseased tissue is surgically removed to promote healing.

Thumb CMC (Basal) Joint Reconstruction

The thumb joint, known as the carpometacarpal (CMC) joint, can deteriorate and break down due to arthritis. Pain occurs when the bones in the area do not glide smoothly and rub against each other. In thumb joint reconstruction, the expert orthopedic surgeon removes damage and reconstructs the CMC joint with a prosthetic implant or small ceramic ball.

Total Wrist Arthrodesis

Trauma, deformity, and degeneration can cause severe wrist pain. When more conservative treatments fail to relieve the pain, the orthopedic surgeon may advise a total wrist arthrodesis. In this hand surgery, the wrist joint is stabilized by fusing the small wrist bones to the forearm bone using a metal plate.

Trapeziectomy (removal of the trapezium)

When arthritis at the base of the thumb becomes debilitating, a trapeziectomy can restore movement and reduce stiffness to the area. Surgically removing the trapezium bone, the small bone at the base of the thumb, gives the thumb more space to move so that inflamed, arthritic bones are not rubbing against each other. 

Trigger Finger Release

When trigger finger does not respond to nonsurgical treatments, trigger finger release surgery (also called tenolysis) can restore movement. The procedure releases the inflamed A1 pulley that is prohibiting the tendons from moving smoothly through the tendon sheath.  

Wrist Arthroscopy

Also called wrist joint replacement, wrist arthroscopy is a surgical procedure in which a damaged wrist joint is replaced with a prosthetic joint. Damage requiring wrist arthroscopy can occur from inflammation and degeneration from various types of arthritis, infections and/or injuries.

Wrist Joint Replacement

See Wrist Arthroscopy

Wrist Ligament Reconstruction

When the ligaments in the wrist are severely torn, stretched or injured, wrists are unable to function without pain. Wrist ligament reconstruction, a minimally invasive and arthroscopic procedure, repairs the ligament to enable smooth movement in the wrist.

Learn More About Hand Surgery

For all these procedures, your orthopedic surgeon will first perform a thorough physical examination to determine the best treatment recommendations for your situation. Risks, benefits, post-surgical rehabilitation and required after care of hand surgery will be discussed.

At Fort Worth Hand Center, our physicians are experienced board certified, fellowship-trained orthopedic surgeons. We create a custom plan for all patients, designed to get them back to their life activities more quickly and with less pain. If you are experiencing symptoms in your hand, fingers, or wrist, contact hand surgery specialists at Fort Worth Hand Center to determine if you require one of these procedures.

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