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2001 Laurel Ave., Suite 402
Knoxville, TN 37916
865-632-5577 office
865-632-5589 fax

Basal Joint Surgery Finger Joint Fusion (DIP Joint)
De Quervain’s Release Ganglion Cyst Removal
Digital Mucous Cyst Excision Open Carpal Tunnel Release Surgery
Distal Radius Fracture Repair with Volar Plate Trigger Digit Release



Basal Joint Surgery

De Quervain’s Release

De Quervain's disease is a stenosing tendovaginitis of the first dorsal compartment of the wrist. Tendovaginitis refers to the inflamed and thickened retinacular sheath, which is characteristic of de Quervain's disease. De Quervain's disease classically affects those who are in their forties and fifties. The incidence in women may be up to six more times more common than in men. The process is aggravated by activities that require frequent and repetitive abduction and simultaneous ulnar deviation at the wrist. The diagnosis is usually easily made after eliciting a history of radial-sided wrist pain aggravated by thumb movement.

The pathophysiology and clinical presentation of de Quervain's disease are reviewed, and the nonsurgical and surgical management options are reviewed in detail, including the first dorsal compartment release.
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Digital Mucous Cyst Excision

Digital mucous cysts (DMCs) are benign ganglion cysts of the digits, typically located at the distal interphalangeal (DIP) joints or in the proximal nail fold. They usually occur on the hands, although they have also been noted on the toes. The etiology of these cysts is uncertain but may involve mucoid degeneration. Often, these cysts are asymptomatic and do not require treatment. When treatment is indicated, medical therapies and surgical interventions of varying magnitudes may be attempted. Recurrence is common.
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Distal Radius Fracture Repair with Volar Plate

The radius is the larger of the two bones of the forearm. The end toward the wrist is called the distal end. A fracture of the distal radius occurs when the area of the radius near the wrist breaks.
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Finger Joint Fusion (DIP Joint)

Arthritis of the finger joints may be surgically treated with a fusion procedure. This keeps the problem joints from moving so that pain is eliminated.

The finger joints work like hinges when the fingers bend and straighten. The main knuckle joint is the metacarpophalangeal joint (MCP joint). It is formed by the connection of the metacarpal bone in the palm of the hand with the finger bone, or phalange. Each finger has three phalanges, separated by two interphalangeal joints (IP joints).The one closest to the MCP joint (knuckle) is called the proximal IP joint (PIP joint). The joint near the end of the finger is called the distal IP joint (DIP joint).

Ligaments are tough bands of tissue that connect bones together. Several ligaments hold the joints together in the finger. These ligaments join to form the joint capsule of the finger joint, a watertight sac around the joint.

The joint surfaces are covered with a material called articular cartilage. This material is the slick, spongy covering that allows one side of a joint to slide against the other joint surface easily. When this material wears out, the joint develops a type of arthritis called osteoarthritis and becomes painful.
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Ganglion Cyst Removal

Ganglion cysts arise from the capsule of a joint or the sheath of a tendon. They can be found at different places on the wrist. A ganglion cyst that grows on the top of the wrist is called a dorsal ganglion. Others are found on the underside of the wrist between the thumb and your pulse point, at the end joint of a finger, or at the base of a finger. Most of the time, these are harmless and will often disappear in time.
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Open Carpal Tunnel Release Surgery

Carpal tunnel syndrome (CTS) is the most common compression neuropathy of the upper extremity. It describes a clinical syndrome commonly involving pain, weakness, paresthesias, and/or numbness caused by compression of the median nerve as it passes through the fibro-osseous carpal tunnel at the level of the wrist. The etiology of CTS is likely multifactorial, and diagnosis is made primarily on the basis of a thorough patient history and physical examination. For patients with mild symptoms, a variety of nonsurgical treatments have been shown to be effective in providing relief, including splinting, oral medications, and corticosteroid injection. When conservative treatment fails or a patient presents with advanced neuropathy, surgical intervention is recommended. 
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Trigger Digit Release

A common disorder of later adulthood characterized by catching, snapping or locking of the involved finger flexor tendon, associated with dysfunction and pain. A disparity in size between the flexor tendon and the surrounding retinacular pulley system, most commonly at the level of the first annular pulley, results in difficulty flexing or extending the finger and the “triggering” phenomenon. The label of trigger finger is used because when the finger unlocks, it pops back suddenly, as if releasing a trigger on a gun.
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