# https://newyorkhandandnerve.com/ llms-full.txt ## Hand Surgery Specialists [Skip to main content](https://newyorkhandandnerve.com/#skiptomaincontent) ![INSTITUTE FOR HAND SURGERY - LOGO](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/header-logo-new.svg) # Put Your Hand & Upper Extremity Surgery in the Care of a **Specialized Plastic Surgeon** If a condition or injury is preventing you from participating in the activities you love, let our experts help you gain control of your symptoms. 8 Office Locations for Your Convenience - [Locations](https://newyorkhandandnerve.com/#mobile-map) ## Experience in State-of-the-Art Plastic and Reconstructive Surgery For the past 70 years, New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group, has offered state-of-the-art plastic and reconstructive procedures. At the Institute for Hand Surgery at NYPS Group, our mission is to provide comprehensive, cutting edge, patient-centered care for the treatment of injuries and disorders of the upper extremity and peripheral nerve throughout the body. [Meet our Doctors](https://newyorkhandandnerve.com/#) [Meet our Doctors ![right arrow](data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20width='0'%20height='0'%20viewBox='0%200%200%200'%3E%3C/svg%3E)](https://newyorkhandandnerve.com/about/) [Thomas A. Davenport, MD, FACS](https://newyorkhandandnerve.com/about#davenport) [Brian A. Pinsky, MD, FACS](https://newyorkhandandnerve.com/about#pinsky) [Haritha B. Veeramachaneni, MD](https://newyorkhandandnerve.com/about#veeramachaneni) [Michael R. Christy, MD, MA, FACS](https://newyorkhandandnerve.com/about#christy) [Paul Adenuga, MD](https://newyorkhandandnerve.com/about#adenuga) [Alexander B. Dagum, MD, FRCS(C), FACS](https://newyorkhandandnerve.com/about#dagum) ## Why Choose a Plastic Surgeon? Plastic surgeons receive extensive training on surgery all throughout the body, providing them with a more comprehensive view of the essential relationship between bone and soft tissue. In addition to completing six to eight years of primary training, plastic surgeons specializing in the hand spend an extra year of training devoted solely to hand surgery. Many people aren’t aware of this advanced level of expertise. With exposure to a vast array of conditions, plastic surgeons are highly proficient in treating conditions of the upper extremity and peripheral nervous system. Our team is composed of subspecialty-trained plastic surgeons who can treat all types of injuries and disorders. While some problems pertaining to the upper extremities require surgery, many can effectively be treated with non-surgical methods, such as medication, splints, therapy, or injections. Our mission goes beyond just putting you back together. The [hand surgeons](https://newyorkhandandnerve.com/about/) at NYPS Group focus on restoring optimal form as well as function by tending to our patients’ individual needs. Hand & Arm Conditions - [Hand](https://newyorkhandandnerve.com/services/hand-upper-extremity/) - [Wrist](https://newyorkhandandnerve.com/services/hand-upper-extremity/) - [Elbow](https://newyorkhandandnerve.com/services/hand-upper-extremity/) - [Body](https://newyorkhandandnerve.com/services/hand-upper-extremity/) Hand and Arm Conditions - Elbow Many of the structures that control the hand and wrist either cross the elbow joint or originate from the area around the elbow joint. Soft tissue problems around the elbow can affect the downstream, resulting in issues in the hand and/or wrist. Common syndromes related to the elbow include tennis elbow, cubital tunnel syndrome, and radial tunnel syndrome. If your symptoms prevent your elbow and/or wrist from moving properly, our specialists can help. **Conditions include:** - [Cubital Tunnel](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/) - [Tendonitis](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/) - [Tennis Elbow/Golfer’s Elbow](https://newyorkhandandnerve.com/services/hand-upper-extremity/tennis-elbow/) - [Radial Tunnel Syndrome](https://newyorkhandandnerve.com/services/nerve/radial-tunnel/) - Elbow Symptoms can include: - Stiffness - Reduced motion - Inability to turn hand - Wrist pain - Weakness - Elbow and forearm pain - Weakness - Numbness in the ring and small fingers - [Learn More](https://newyorkhandandnerve.com/services/hand-upper-extremity/) - Wrist The wrist controls the positioning of the hand. Injuries to the wrist can present themselves as pain, loss of motion, or weakness. Some of the most prevalent conditions that affect the wrist include common injuries, tendonitis, arthritis, and carpal tunnel syndrome. Our plastic surgeons will work to provide you with an accurate diagnosis and a comprehensive treatment plan to suit your needs. **Conditions include:** - [Broken Wrist](https://newyorkhandandnerve.com/services/hand-upper-extremity/fractures-broken/) - [Carpal Tunnel Syndrome](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/) - [Ligament Tears and Arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/ligament-tears-wrist-arthritis/) - [Tendonitis](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/) - [Tendon Injuries](https://newyorkhandandnerve.com/services/hand-upper-extremity/flexor-extensor-tendon-injuries/) - Wrist Symptoms can include: - Weakness - Pain - Difficulty grasping objects - Tingling in the fingers - Deformity - [Learn More](https://newyorkhandandnerve.com/services/hand-upper-extremity/) - Hand Whether you experience a trauma, like a fingertip injury or hand fracture, or suffer from a chronic disease, like thumb arthritis or carpal tunnel syndrome, our experienced hand specialists are dedicated to restoring your hand function through the most effective treatment options possible. Depending on your unique problem, this may include solutions like rest, splinting, steroid injections, or surgery. We’ll work closely with you to figure out which treatments are best for your condition and lifestyle, ensuring you obtain optimal long-term results. **Conditions include:** - [Broken Hand](https://newyorkhandandnerve.com/services/hand-upper-extremity/fractures-broken/) - [Congenital Hand Anomalies](https://newyorkhandandnerve.com/services/hand-upper-extremity/congenital-anomalies/) - [Dupuytren’s Contracture](https://newyorkhandandnerve.com/services/hand-upper-extremity/dupuytrens-contracture/) - [Fingertip Injuries](https://newyorkhandandnerve.com/services/hand-upper-extremity/fingertip-injuries/) - [Hand Rejuvenation](https://newyorkhandandnerve.com/services/hand-upper-extremity/rejuvenation/) - [Ligament Tears and Arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/ligament-tears-wrist-arthritis/) - [Pediatric Hand Injuries](https://newyorkhandandnerve.com/services/hand-upper-extremity/pediatric-injuries-surgery/) - [Skin Cancers](https://newyorkhandandnerve.com/services/hand-upper-extremity/skin-cancers/) - [Tendonitis (Trigger Finger, Intersection Syndrome, De Quervain’s, Other Wrist Tendinopothy)](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/) - [Tendon Injuries](https://newyorkhandandnerve.com/services/hand-upper-extremity/flexor-extensor-tendon-injuries/) - [Thumb Arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/) - Hand Symptoms can include: - Swelling - Numbness - Tenderness - Weakened grip strength - Inability to straighten fingers - [Learn More](https://newyorkhandandnerve.com/services/hand-upper-extremity/) - Ankle The peripheral nervous system is a network of nerves that controls your ability to sense and move. When peripheral nerve injuries and entrapment occur, this can lead to various sensory and motor symptoms throughout different parts of the body, such as the ankle. Our surgeons are experienced in treating a variety of nerve-related ankle conditions. They will create a customized treatment plan for your individual needs to ensure you regain as much of your body’s normal function as possible. **Conditions include:** - [Peroneal Nerve Entrapment](https://newyorkhandandnerve.com/peroneal-nerve-entrapment-foot-drop/) (foot drop) - [Tarsal Tunnel Syndrome](https://newyorkhandandnerve.com/services/nerve/tarsal-tunnel-syndrome/) - Ankle Symptoms can include: - Weakness - Loss of function - Numbness and tingling in the feet - Unexplained pains - [Learn More](https://newyorkhandandnerve.com/services/nerve/) - Head Nerve conditions in the head can cause symptoms that either stay localized to the area or spread to the entire body. Although discomfort like headaches are common and often harmless, more severe head symptoms can be completely debilitating for some people. From facial paralysis to migraines, chronic head problems can interrupt daily living and complicate our simple abilities, like talking or seeing clearly. Our reconstructive surgeons are highly experienced with treating nerve problems throughout various areas of the body, including the complex nature of the head. If you want to rid yourself of frequent pain, restore lost feeling, or address other symptoms, our doctors can help you find the best treatment for improving your specific condition. **Conditions include:** - [Migraines](https://newyorkhandandnerve.com/services/nerve/migraines/) - Head Symptoms can include: - Headache - Blurred vision - Numbness in the face - Dizziness - Difficulty speaking - [Learn More](https://newyorkhandandnerve.com/services/nerve/) - Knee The knee is often put under a significant amount of stress and pressure as we move throughout our daily activities. With a network of nerves running across this joint, trauma to the area can lead to problems with normal function in the lower leg, ankle, and foot. Since the knee acts as an intersection for tendons, bones, and nerves, these structures can be at-risk from conditions such as trauma and arthritis. We perform routine and complex procedures to correct nerve injuries. Our goal is to provide long-term relief so you can get back to doing what you love. **Conditions include:** - [Peroneal Nerve Entrapment](https://newyorkhandandnerve.com/peroneal-nerve-entrapment-foot-drop/) (foot drop) - Knee Symptoms can include: - Weakness - Numbness in the foot and lower leg - Leg pain - Inability to flex the ankle - [Learn More](https://newyorkhandandnerve.com/services/nerve/) - Thigh Nerves running through the thigh can become irritated due to factors like tight clothing, weight gain, sudden trauma, or an underlying condition. Symptoms of nerve issues in the thigh are often most noticeable after sitting or standing. While some problems can go away with conservative treatments, others may need more in-depth solutions. Our surgeons specialize in the peripheral nervous system to help you find relief from the symptoms that are causing you discomfort and preventing you from moving normally. **Conditions include:** - [Meralgia Paresthetica](https://newyorkhandandnerve.com/services/nerve/meralgia-paresthetic/) - Thigh Symptoms can include: - Tingling - Numbness - Pain - Difficulty moving the legs - [Learn More](https://newyorkhandandnerve.com/services/nerve/) - Hand & Wrist When the nerves in the upper extremity become compressed, stretched, or detached, this can have a significant effect on how the hand and wrist feel, move, and function. These areas tend to suffer from nerve injuries and overuse-related syndromes, due to being manipulated continuously in different ways for various activities. Since the hand and wrist are responsible for carrying out so many of our daily functions, our reconstructive surgeons are committed to finding which treatment options can provide the best improvement for your long-term function. **Conditions include:** - [Carpal Tunnel](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/) - [Nerve Injuries](https://newyorkhandandnerve.com/services/nerve/injury-secondary-reconstruction/) - [Ulnar Tunnel](https://newyorkhandandnerve.com/services/hand-upper-extremity/ulnar-tunnel/) - Hand & Wrist  Symptoms can include: - Weakness - Burning pain - Tingling - Numbness - Difficulty pinching or grasping objects - [Learn More](https://newyorkhandandnerve.com/services/nerve/) - Elbow The elbow is used in some of our most basic daily activities. When the nerves in this area becomes injured or otherwise impaired, this can limit our ability to perform routine motions. In addition, nerve conditions in the elbow can affect the function of the wrist and hand leading to permanent weakness and numbness in the hand. Nerve-related elbow conditions are most often caused by pressure, stretching, overuse, or sudden injuries. By determining the most appropriate treatments and therapies, our reconstructive surgeons can help relieve your chronic symptoms and restore optimal use of your elbow and arm. **Conditions include:** - [Cubital Tunnel](https://newyorkhandandnerve.com/services/nerve/cubital-tunnel/) - [Pronator Syndrome](https://newyorkhandandnerve.com/services/nerve/pronator-syndrome/) - [Radial Tunnel Syndrome](https://newyorkhandandnerve.com/services/nerve/radial-tunnel/) - Elbow Symptoms can include: - Pain - Numbness - Pins and needles sensation - Weak grip - Difficulty sleeping - Dropping objects - [Learn More](https://newyorkhandandnerve.com/services/nerve/) - Shoulder Nerve injuries or disorders in the shoulder area can be devastating and can severely impact our ability to live and work. When the shoulder is strained or injured during a fall, sports, or motor vehicle accident, the nerves can be stretched or torn. This can lead to irreversible loss of feeling to all or part of the arm and hand. Depending on the severity of the injury, your nerves may recover on their own with time. In some severe cases, the loss of function is permanent and requires surgery to improve the outcome. To ensure you receive as much return of function as possible, our surgeons will dedicate the time to provide accurate diagnoses so you receive the most effective treatment for your individual needs. **Conditions include:** - [Brachial Plexus and Other Complex Neurologic Trauma of Upper Extremity](https://newyorkhandandnerve.com/services/nerve/brachial-plexus-complex-neurologic-trauma/) - Shoulder Symptoms can include: - Numbness - Burning sensation or pain - Weakness - Difficulty moving the hand, wrist, or arm - [Learn More](https://newyorkhandandnerve.com/services/nerve/) Nerve Conditions - [Nerve Conditions / Treatments](https://www.newyorkhandandnerve.com/services/nerve/) Hand and Arm Conditions Nerve Conditions - Elbow Many of the structures that control the hand and wrist either cross the elbow joint or originate from the area around the elbow joint. Soft tissue problems around the elbow can affect the downstream, resulting in issues in the hand and/or wrist. Common syndromes related to the elbow include tennis elbow, cubital tunnel syndrome, and radial tunnel syndrome. If your symptoms prevent your elbow and/or wrist from moving properly, our specialists can help. **Conditions include:** - [Cubital Tunnel](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/) - [Tendonitis](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/) - [Tennis Elbow/Golfer’s Elbow](https://newyorkhandandnerve.com/services/hand-upper-extremity/tennis-elbow/) - [Radial Tunnel Syndrome](https://newyorkhandandnerve.com/services/nerve/radial-tunnel/) - Elbow Symptoms can include: - Stiffness - Reduced motion - Inability to turn hand - Wrist pain - Weakness - Elbow and forearm pain - Weakness - Numbness in the ring and small fingers - [Learn More](https://newyorkhandandnerve.com/services/hand-upper-extremity/) - Wrist The wrist controls the positioning of the hand. Injuries to the wrist can present themselves as pain, loss of motion, or weakness. Some of the most prevalent conditions that affect the wrist include common injuries, tendonitis, arthritis, and carpal tunnel syndrome. Our plastic surgeons will work to provide you with an accurate diagnosis and a comprehensive treatment plan to suit your needs. **Conditions include:** - [Broken Wrist](https://newyorkhandandnerve.com/services/hand-upper-extremity/fractures-broken/) - [Carpal Tunnel Syndrome](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/) - [Ligament Tears and Arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/ligament-tears-wrist-arthritis/) - [Tendonitis](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/) - [Tendon Injuries](https://newyorkhandandnerve.com/services/hand-upper-extremity/flexor-extensor-tendon-injuries/) - Wrist Symptoms can include: - Weakness - Pain - Difficulty grasping objects - Tingling in the fingers - Deformity - [Learn More](https://newyorkhandandnerve.com/services/hand-upper-extremity/) - Hand Whether you experience a trauma, like a fingertip injury or hand fracture, or suffer from a chronic disease, like thumb arthritis or carpal tunnel syndrome, our experienced hand specialists are dedicated to restoring your hand function through the most effective treatment options possible. Depending on your unique problem, this may include solutions like rest, splinting, steroid injections, or surgery. We’ll work closely with you to figure out which treatments are best for your condition and lifestyle, ensuring you obtain optimal long-term results. **Conditions include:** - [Broken Hand](https://newyorkhandandnerve.com/services/hand-upper-extremity/fractures-broken/) - [Congenital Hand Anomalies](https://newyorkhandandnerve.com/services/hand-upper-extremity/congenital-anomalies/) - [Dupuytren’s Contracture](https://newyorkhandandnerve.com/services/hand-upper-extremity/dupuytrens-contracture/) - [Fingertip Injuries](https://newyorkhandandnerve.com/services/hand-upper-extremity/fingertip-injuries/) - [Hand Rejuvenation](https://newyorkhandandnerve.com/services/hand-upper-extremity/rejuvenation/) - [Ligament Tears and Arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/ligament-tears-wrist-arthritis/) - [Pediatric Hand Injuries](https://newyorkhandandnerve.com/services/hand-upper-extremity/pediatric-injuries-surgery/) - [Skin Cancers](https://newyorkhandandnerve.com/services/hand-upper-extremity/skin-cancers/) - [Tendonitis (Trigger Finger, Intersection Syndrome, De Quervain’s, Other Wrist Tendinopothy)](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/) - [Tendon Injuries](https://newyorkhandandnerve.com/services/hand-upper-extremity/flexor-extensor-tendon-injuries/) - [Thumb Arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/) - Hand Symptoms can include: - Swelling - Numbness - Tenderness - Weakened grip strength - Inability to straighten fingers - [Learn More](https://newyorkhandandnerve.com/services/hand-upper-extremity/) - Ankle The peripheral nervous system is a network of nerves that controls your ability to sense and move. When peripheral nerve injuries and entrapment occur, this can lead to various sensory and motor symptoms throughout different parts of the body, such as the ankle. Our surgeons are experienced in treating a variety of nerve-related ankle conditions. They will create a customized treatment plan for your individual needs to ensure you regain as much of your body’s normal function as possible. **Conditions include:** - [Peroneal Nerve Entrapment](https://newyorkhandandnerve.com/peroneal-nerve-entrapment-foot-drop/) (foot drop) - [Tarsal Tunnel Syndrome](https://newyorkhandandnerve.com/services/nerve/tarsal-tunnel-syndrome/) - Ankle Symptoms can include: - Weakness - Loss of function - Numbness and tingling in the feet - Unexplained pains - [Learn More](https://newyorkhandandnerve.com/services/nerve/) - Head Nerve conditions in the head can cause symptoms that either stay localized to the area or spread to the entire body. Although discomfort like headaches are common and often harmless, more severe head symptoms can be completely debilitating for some people. From facial paralysis to migraines, chronic head problems can interrupt daily living and complicate our simple abilities, like talking or seeing clearly. Our reconstructive surgeons are highly experienced with treating nerve problems throughout various areas of the body, including the complex nature of the head. If you want to rid yourself of frequent pain, restore lost feeling, or address other symptoms, our doctors can help you find the best treatment for improving your specific condition. **Conditions include:** - [Migraines](https://newyorkhandandnerve.com/services/nerve/migraines/) - Head Symptoms can include: - Headache - Blurred vision - Numbness in the face - Dizziness - Difficulty speaking - [Learn More](https://newyorkhandandnerve.com/services/nerve/) - Knee The knee is often put under a significant amount of stress and pressure as we move throughout our daily activities. With a network of nerves running across this joint, trauma to the area can lead to problems with normal function in the lower leg, ankle, and foot. Since the knee acts as an intersection for tendons, bones, and nerves, these structures can be at-risk from conditions such as trauma and arthritis. We perform routine and complex procedures to correct nerve injuries. Our goal is to provide long-term relief so you can get back to doing what you love. **Conditions include:** - [Peroneal Nerve Entrapment](https://newyorkhandandnerve.com/peroneal-nerve-entrapment-foot-drop/) (foot drop) - Knee Symptoms can include: - Weakness - Numbness in the foot and lower leg - Leg pain - Inability to flex the ankle - [Learn More](https://newyorkhandandnerve.com/services/nerve/) - Thigh Nerves running through the thigh can become irritated due to factors like tight clothing, weight gain, sudden trauma, or an underlying condition. Symptoms of nerve issues in the thigh are often most noticeable after sitting or standing. While some problems can go away with conservative treatments, others may need more in-depth solutions. Our surgeons specialize in the peripheral nervous system to help you find relief from the symptoms that are causing you discomfort and preventing you from moving normally. **Conditions include:** - [Meralgia Paresthetica](https://newyorkhandandnerve.com/services/nerve/meralgia-paresthetic/) - Thigh Symptoms can include: - Tingling - Numbness - Pain - Difficulty moving the legs - [Learn More](https://newyorkhandandnerve.com/services/nerve/) - Hand & Wrist When the nerves in the upper extremity become compressed, stretched, or detached, this can have a significant effect on how the hand and wrist feel, move, and function. These areas tend to suffer from nerve injuries and overuse-related syndromes, due to being manipulated continuously in different ways for various activities. Since the hand and wrist are responsible for carrying out so many of our daily functions, our reconstructive surgeons are committed to finding which treatment options can provide the best improvement for your long-term function. **Conditions include:** - [Carpal Tunnel](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/) - [Nerve Injuries](https://newyorkhandandnerve.com/services/nerve/injury-secondary-reconstruction/) - [Ulnar Tunnel](https://newyorkhandandnerve.com/services/hand-upper-extremity/ulnar-tunnel/) - Hand & Wrist  Symptoms can include: - Weakness - Burning pain - Tingling - Numbness - Difficulty pinching or grasping objects - [Learn More](https://newyorkhandandnerve.com/services/nerve/) - Elbow The elbow is used in some of our most basic daily activities. When the nerves in this area becomes injured or otherwise impaired, this can limit our ability to perform routine motions. In addition, nerve conditions in the elbow can affect the function of the wrist and hand leading to permanent weakness and numbness in the hand. Nerve-related elbow conditions are most often caused by pressure, stretching, overuse, or sudden injuries. By determining the most appropriate treatments and therapies, our reconstructive surgeons can help relieve your chronic symptoms and restore optimal use of your elbow and arm. **Conditions include:** - [Cubital Tunnel](https://newyorkhandandnerve.com/services/nerve/cubital-tunnel/) - [Pronator Syndrome](https://newyorkhandandnerve.com/services/nerve/pronator-syndrome/) - [Radial Tunnel Syndrome](https://newyorkhandandnerve.com/services/nerve/radial-tunnel/) - Elbow Symptoms can include: - Pain - Numbness - Pins and needles sensation - Weak grip - Difficulty sleeping - Dropping objects - [Learn More](https://newyorkhandandnerve.com/services/nerve/) - Shoulder Nerve injuries or disorders in the shoulder area can be devastating and can severely impact our ability to live and work. When the shoulder is strained or injured during a fall, sports, or motor vehicle accident, the nerves can be stretched or torn. This can lead to irreversible loss of feeling to all or part of the arm and hand. Depending on the severity of the injury, your nerves may recover on their own with time. In some severe cases, the loss of function is permanent and requires surgery to improve the outcome. To ensure you receive as much return of function as possible, our surgeons will dedicate the time to provide accurate diagnoses so you receive the most effective treatment for your individual needs. **Conditions include:** - [Brachial Plexus and Other Complex Neurologic Trauma of Upper Extremity](https://newyorkhandandnerve.com/services/nerve/brachial-plexus-complex-neurologic-trauma/) - Shoulder Symptoms can include: - Numbness - Burning sensation or pain - Weakness - Difficulty moving the hand, wrist, or arm - [Learn More](https://newyorkhandandnerve.com/services/nerve/) ## Schedule Your Appointment with One of Our Plastic Surgeons Home Form First Name \* Last Name \* Email \* Phone \* Comments I agree to the Terms of Use \* I agree to the Terms of Use\* \*By submitting this form you consent to receive phone calls, text messages and emails from New York Plastic Surgical Group. It is not a condition of purchasing any goods or services. You can opt out at any time, message/data rates may apply, and opting-in includes acceptance of the [Privacy Policy](https://newyorkhandandnerve.com/privacy-policy/) and [Terms of Use](https://newyorkhandandnerve.com/terms-of-use/). Communications through this website or via email are not encrypted and are not necessarily secure. Use of the internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use. Captcha Submit If you are human, leave this field blank. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Hand and Nerve Services [Skip to main content](https://newyorkhandandnerve.com/services/#skiptomaincontent) **The hand and upper extremity are essential for carrying out many of our daily activities and interacting with the world around us. Since we rely so heavily on our hands for everyday life, the upper extremity can be prone to a number of problems. These issues can be caused by a congenital deformity, injury, overuse, or other condition. Depending on the nature of the issue, injury to the upper extremity can significantly affect how you go about your daily routine, possibly even limiting you from doing the activities you love.** **At the Institute for Hand Surgery at New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group, our reconstructive [hand surgeons](https://newyorkhandandnerve.com/about/) have undergone advanced training in disorders related to the upper extremity and peripheral nerve system. They are highly experienced in treating conditions related to the skin, bones, tendons, nerves, and other soft tissues. To provide the most beneficial and effective procedures, our doctors utilize the latest surgical techniques to improve your symptoms and help you get back to living your ideal lifestyle.** ## Hand and Upper Extremity The upper extremity can be affected by injuries or chronic conditions of the hand, wrist, arm, or shoulder. When one or more of these areas is damaged, you may find it difficult or painful to perform even the most basic daily tasks. Our doctors offer a wide range of treatment options, ranging from non-invasive methods to surgical reconstruction. Treatment can include options such as immobilizing the area, taking medications, receiving injections, hand therapy, or undergoing surgery. If surgery is recommended for your individual situation, we will optimize the plan of care to meet your needs and get you back to top form as quickly as possible. Learn about [hand and upper extremity conditions](https://newyorkhandandnerve.com/services/hand-upper-extremity/). ## Nerve The peripheral nervous system is a network of nerves that act like cables and send signals all throughout the body. These nerves communicate with the skin and muscles of the face, trunk, upper extremity, and lower extremity, and provide the entire body with movement and sensation. When a peripheral nerve is damaged—such as in a nerve compression or traumatic injury—this can cause weakness, pain, or numbness in the surrounding areas. Getting prompt treatment for nerve conditions is crucial for making an optimal recovery, which is why our doctors recommend patients seek medical care without delay. Nerve surgery is a delicate and highly specialized area, but with the help of our extensively trained surgeons, even the most complex nerve conditions can be treated to help you regain optimal function. Learn about [peripheral nerve conditions](https://newyorkhandandnerve.com/services/nerve/). Common Questions Regarding Carpal Tunnel and Nerve Testing with Dr. Brian Pinsky - YouTube New York Plastic Surgical Group 832 subscribers [Common Questions Regarding Carpal Tunnel and Nerve Testing with Dr. Brian Pinsky](https://www.youtube.com/watch?v=qKGBq9ckWHM) New York Plastic Surgical Group Search Watch later Share Copy link Info Shopping Tap to unmute If playback doesn't begin shortly, try restarting your device. More videos ## More videos You're signed out Videos you watch may be added to the TV's watch history and influence TV recommendations. To avoid this, cancel and sign in to YouTube on your computer. CancelConfirm Share Include playlist An error occurred while retrieving sharing information. Please try again later. 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In addition to their six to eight years of primary training, our plastic surgeons specializing in [hand surgery](https://newyorkhandandnerve.com/) have completed an additional year of training dedicated solely to upper extremity surgery. This advanced expertise sets them apart as unique experts in the field, and it provides them with a deeper understanding of the relationship between bone and soft tissue. Our doctors have undergone advanced training in plastic and reconstructive surgery, and we are proud to offer expert treatment for all conditions of the hand and upper extremity.** Our doctors are committed to helping patients restore both the appearance and function of the affected area with optimal results. By utilizing the most current and innovative surgical techniques, and evaluating patients in a timely manner, they are able to provide effective solutions that can improve patients’ overall quality of life. As a division of Long Island Plastic Surgical Group—the longest running plastic surgery group practice in North America—the Institute for Hand Surgery is a name you can trust. To learn about each of our highly trained hand surgeons, please read their biographies below. If you have any questions, or would like to know about your options for treatment, contact us to schedule an appointment. ## Thomas A. Davenport, MD, FACS ![Davenport webp](https://newyorkhandandnerve.com/wp-content/uploads/2024/12/Thomas-A.-Davenport.webp)Dr. Thomas A. Davenport has been a partner at NYPS Group since 2006. He performs a wide variety of cosmetic and reconstructive procedures and specializes in wound care and burn reconstruction. Dr. Davenport earned his medical degree from Yale University, and continued his training in a General Surgery residency and Plastic Surgery fellowship in the Harvard University Program at the Massachusetts General Hospital. Dr. Davenport then completed a fellowship in Cancer Reconstruction and Cosmetic Surgery at the Memorial Sloan-Kettering Cancer Center, during which he was selected for the Webster Fellowship in Pediatric Plastic Surgery award. He also completed advanced training in a fellowship at the Shriner Burn Hospital for Children through Harvard University, where he trained in burn and accident reconstruction. In addition to treating patients at NYPS Group, Dr. Davenport is the Director of Microsurgery and the Director of Surgical Wound Care at Winthrop-University Hospital. He stays active in the medical community through his involvement in several organizations, including his Fellow status in the American College of Surgeons. He is also a member of societies such as the American Society of Plastic Surgery, the American Society for Reconstructive Microsurgery, the American Association of Hand Surgery, and the American Professional Wound Care Association. ## Brian A. Pinsky, MD, FACS ![Pinsky](https://newyorkhandandnerve.com/wp-content/uploads/2021/11/LIPSG-Dr-Pinksy.jpg)Dr. Brian A. Pinsky is a board-certified plastic surgeon who performs a range of plastic and reconstructive procedures. He has a specialty in complex hand and wrist injuries, rheumatoid arthritis, [nerve injury](https://newyorkhandandnerve.com/services/nerve/injury-secondary-reconstruction/) repair, nerve compression, and treating [Dupuytren’s contracture](https://newyorkhandandnerve.com/services/hand-upper-extremity/dupuytrens-contracture/). Dr. Pinsky earned his medical degree from Case Western Reserve University School of Medicine in Ohio. He then completed his residency training in Plastic and Reconstructive Surgery at Mount Sinai Hospital as well as a fellowship in Hand and Microsurgery at the UCLA Medical Center in Los Angeles. Dr. Pinsky has also earned a subspecialty certificate in Surgery of the Hand. Dr. Pinsky has been with NYPS Group since 2012 and also acts as Assistant Clinical Professor in Plastic Surgery at Stony Brook University. Dr. Pinsky is active in many professional societies including the American Society for Surgery of the Hand, American Association for Hand Surgery, the New York Society of Plastic Surgeons, and the American College of Surgeons. Dr. Pinsky is a consultant peer reviewer for the Journal of Hand Surgery and the journal Hand. Additionally, he has been involved with volunteer opportunities to help those in need throughout the world. This has included traveling abroad with the non-profit Komedyplast as a volunteer pediatric surgeon for children with complex craniofacial deformities. ## Haritha B. Veeramachaneni, MD ![Dr. Veeramachaneni](https://newyorkhandandnerve.com/wp-content/uploads/2024/12/Haritha-B.-Veeramachaneni.webp)Dr. Haritha B. Veeramachaneni specializes in complex hand and wrist injuries, arthritis treatment, nerve repair, and treatment for nerve compression conditions, such as [carpal tunnel syndrome](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/). She also performs a wide range of cosmetic procedures at NYPS Group, such as breast augmentation, abdominoplasty, liposuction, and eyelid lift surgery. Dr. Veeramachaneni is board-certified by the American Board of Plastic Surgery. After completing her undergraduate education from Duke University, where she graduated Magna Cum Laude, Dr. Veeramachaneni earned her medical degree from Vanderbilt University School of Medicine under the prestigious merit-based Canby Robinson Society Scholarship. She completed her residency training in Plastic & Reconstructive Surgery at the University of Southern California in Los Angeles, followed by a fellowship in Hand and Microsurgery at the C.M. Kleinert Institute in Louisville. ## Michael R. Christy, MD, MA, FACS ![Dr. Christy](https://newyorkhandandnerve.com/wp-content/uploads/2024/12/Michael-R.-Christy.webp)Dr. Michael R. Christy is experienced in the full breadth of cosmetic, plastic, and reconstructive surgery. He is a board-certified plastic surgeon with advanced expertise in facial plastic surgery and craniomaxillofacial trauma and reconstruction. Dr. Christy earned his master’s and medical degrees from Boston University School of Medicine. He then studied in a combined residency at the Mount Sinai Medical Center in New York, training in General Surgery and Plastic & Reconstructive Surgery. Dr. Christy continued to train in a fellowship in Hand and Microsurgery at Los Angeles County Hospital through the University of Southern California. Dr. Christy was previously a faculty member at Johns Hopkins/University of Maryland in the combined Plastic & Reconstructive Surgery Residency program and the R Adams Cowley Shock Trauma Center in Baltimore. Throughout this time, he earned several honors and awards for his work. Dr. Christy stays active in the surgical community through his involvement in various professional organizations. He is a Diplomate of the American Board of Plastic Surgery, a Fellow of the American College of Surgeons, and a member of multiple organizations, including the American Society of Plastic Surgeons, International Hand and Composite Tissue Allotransplantation Society, and American Society of Reconstructive Transplantation. ## Alexander B. Dagum, MD, FRCS(C), FACS ![Alexander B. Dagum, MD, FRCS(C), FACS](https://newyorkhandandnerve.com/wp-content/uploads/2024/11/dagum-adenuga-200x300dagum-200x300-1.jpg)Dr. Alex Dagum is a highly respected plastic surgeon with a distinguished career spanning reconstructive, craniofacial, and cosmetic surgery. He received his medical degree from the University of Ottawa, graduating first in his class, and completed his plastic surgery residency at the University of Toronto. Dr. Dagum went on to complete advanced fellowships in microsurgery and hand surgery, gaining expertise in head and neck reconstruction. After several years as a faculty member at the University of Toronto, he joined Stony Brook University, where he rose to the rank of tenured Professor of Surgery and served as Chief of the Division of Plastic Surgery. In addition to his academic roles, Dr. Dagum is deeply committed to volunteer work and global health. He has led surgical teams in groundbreaking procedures, including one of the world’s first double hand replantations. Dr. Dagum also sponsors and performs complex craniofacial surgeries for children from overseas, providing them with life-changing treatments. His contributions to plastic surgery extend to research and innovation, holding patents for methods to treat cellulite and optimize BOTOX® use. ## Paul Adenuga, MD ![Paul Adenuga, MD](https://newyorkhandandnerve.com/wp-content/uploads/2024/11/dagum-adenuga-200x300adenuga-200x300-1.jpg)Dr. Paul Adenuga is an accomplished plastic surgeon and hand surgeon specializing in facial rejuvenation, aesthetic breast and body contouring, and hand and peripheral nerve surgery. He earned his medical degree on a full merit scholarship from Case Western Reserve University and completed a general surgery residency at the Cleveland Clinic Foundation. Dr. Adenuga further refined his expertise through a plastic surgery residency at NYU Langone Health, one of the top plastic surgery training programs in the United States. His broad training, under the guidance of world-renowned experts, covered aesthetic and reconstructive surgery, microsurgery, and hand surgery. Dr. Adenuga recently completed a combined plastic and orthopedic hand surgery fellowship at Baylor College of Medicine. As an associate physician at New York Plastic Surgical Group, he is passionate about delivering exceptional patient care by blending a customized approach with his surgical skills to optimize both functional and aesthetic outcomes. His areas of focus include facelifts, neck lifts, rhinoplasties, and elective hand surgeries such as treating hand arthritis and nerve injuries. Outside of surgery, Dr. Adenuga enjoys weightlifting, exploring art, and spending time with family. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Hand and Nerve Blog [Skip to main content](https://newyorkhandandnerve.com/blog/#skiptomaincontent)[![Dr. Roger L. Simpson Speaks at International Conference in Greece](https://newyorkhandandnerve.com/wp-content/uploads/2023/08/simpson-greece-2.webp)](https://newyorkhandandnerve.com/in-the-news/dr-roger-l-simpson-speaks-at-international-conference-in-greece/) ## [Dr. Roger L. Simpson Speaks at International Conference in Greece](https://newyorkhandandnerve.com/in-the-news/dr-roger-l-simpson-speaks-at-international-conference-in-greece/) Posted on Aug 31, 2023 in [Hand & Upper Extremity](https://newyorkhandandnerve.com/category/hand-upper-extremity/), [In The News](https://newyorkhandandnerve.com/category/in-the-news/) Recently, board-certified plastic surgeon and practice partner, Dr. Roger L. Simpson, had the opportunity to speak at the international conference… [Continue Reading](https://newyorkhandandnerve.com/in-the-news/dr-roger-l-simpson-speaks-at-international-conference-in-greece/) [![FAQs About Fingertip Injuries by Dr. Brian A. Pinsky](https://newyorkhandandnerve.com/wp-content/uploads/2023/01/pinsky-blog-2023-handnerve.webp)](https://newyorkhandandnerve.com/hand-upper-extremity/faqs-about-fingertip-injuries/) ## [FAQs About Fingertip Injuries](https://newyorkhandandnerve.com/hand-upper-extremity/faqs-about-fingertip-injuries/) Posted on Jan 19, 2023 in [Hand & Upper Extremity](https://newyorkhandandnerve.com/category/hand-upper-extremity/) by Dr. Brian A. Pinsky Q: What are some common causes of fingertip injuries? A: Fingertip injuries can be caused… [Continue Reading](https://newyorkhandandnerve.com/hand-upper-extremity/faqs-about-fingertip-injuries/) [![woman showing her hand](https://newyorkhandandnerve.com/wp-content/uploads/2022/09/hand-model.webp)](https://newyorkhandandnerve.com/hand-upper-extremity/pigmented-nail-lesions/) ## [Pigmented Nail Lesions](https://newyorkhandandnerve.com/hand-upper-extremity/pigmented-nail-lesions/) Posted on Sep 28, 2022 in [Hand & Upper Extremity](https://newyorkhandandnerve.com/category/hand-upper-extremity/) By Dr. Brian A. Pinsky A pigmented nail lesion is a concern that comes up more often than you would… [Continue Reading](https://newyorkhandandnerve.com/hand-upper-extremity/pigmented-nail-lesions/) [![](https://newyorkhandandnerve.com/wp-content/uploads/2022/06/NA-HAND-BLOG.jpg)](https://newyorkhandandnerve.com/hand-upper-extremity/a-commitment-to-education-3/) ## [A Commitment to Education](https://newyorkhandandnerve.com/hand-upper-extremity/a-commitment-to-education-3/) Posted on Jun 8, 2022 in [Hand & Upper Extremity](https://newyorkhandandnerve.com/category/hand-upper-extremity/) In addition to completing six to eight years of primary training, plastic surgeons specializing in the hand spend an extra… [Continue Reading](https://newyorkhandandnerve.com/hand-upper-extremity/a-commitment-to-education-3/) [![](https://newyorkhandandnerve.com/wp-content/uploads/2022/05/avocado-hand.jpg)](https://newyorkhandandnerve.com/hand-upper-extremity/avocado-hand/) ## [Avocado Hand](https://newyorkhandandnerve.com/hand-upper-extremity/avocado-hand/) Posted on May 17, 2022 in [Hand & Upper Extremity](https://newyorkhandandnerve.com/category/hand-upper-extremity/) At the Institute for Hand Surgery at Long Island Plastic Surgical Group (LIPSG), our highly skilled plastic surgeons provide specialized… [Continue Reading](https://newyorkhandandnerve.com/hand-upper-extremity/avocado-hand/) [![Young man walking on the street texting with two thumbs](https://newyorkhandandnerve.com/wp-content/uploads/2022/02/texting-thumb-blog.jpg)](https://newyorkhandandnerve.com/hand-upper-extremity/how-to-avoid-texting-thumb/) ## [How to Avoid Texting Thumb](https://newyorkhandandnerve.com/hand-upper-extremity/how-to-avoid-texting-thumb/) Posted on Feb 3, 2022 in [Hand & Upper Extremity](https://newyorkhandandnerve.com/category/hand-upper-extremity/) These days, much of our communication is done through texting via smartphones. Anywhere you look, you can see people with… [Continue Reading](https://newyorkhandandnerve.com/hand-upper-extremity/how-to-avoid-texting-thumb/) [![](https://newyorkhandandnerve.com/wp-content/uploads/2021/10/hand-blog-seahawks-1.png)](https://newyorkhandandnerve.com/in-the-news/seahawks-qb-russell-wilson-undergoes-surgery-on-injured-finger/) ## [Seahawks QB Russell Wilson Undergoes Surgery On Injured Finger](https://newyorkhandandnerve.com/in-the-news/seahawks-qb-russell-wilson-undergoes-surgery-on-injured-finger/) Posted on Oct 13, 2021 in [In The News](https://newyorkhandandnerve.com/category/in-the-news/) In this article, the Seahawks shared that their quarterback, Russell Wilson, underwent surgery for an injury on the field. Wilson… [Continue Reading](https://newyorkhandandnerve.com/in-the-news/seahawks-qb-russell-wilson-undergoes-surgery-on-injured-finger/) [![](https://newyorkhandandnerve.com/wp-content/uploads/2021/09/hand-blog-sciencedailyfinal.png)](https://newyorkhandandnerve.com/in-the-news/researchers-discover-a-way-to-speed-up-tendon-healing/) ## [Researchers Discover a Way to Speed Up Tendon Healing](https://newyorkhandandnerve.com/in-the-news/researchers-discover-a-way-to-speed-up-tendon-healing/) Posted on Sep 14, 2021 in [In The News](https://newyorkhandandnerve.com/category/in-the-news/) ScienceDaily recently released information from the researchers at CÚRAM, the SFI Research Centre for Medical Devices based at NUI Galway,… [Continue Reading](https://newyorkhandandnerve.com/in-the-news/researchers-discover-a-way-to-speed-up-tendon-healing/) [![](https://newyorkhandandnerve.com/wp-content/uploads/2021/08/Hand-Blog-John-Stamos-Trigger-Finger-2.png)](https://newyorkhandandnerve.com/in-the-news/john-stamos-shares-hospital-selfie-after-surgery/) ## [John Stamos Shares Hospital Selfie After Surgery](https://newyorkhandandnerve.com/in-the-news/john-stamos-shares-hospital-selfie-after-surgery/) Posted on Aug 31, 2021 in [In The News](https://newyorkhandandnerve.com/category/in-the-news/) In an article by Page Six, “Full House” star John Stamos revealed he is recovering from surgery to fix his… [Continue Reading](https://newyorkhandandnerve.com/in-the-news/john-stamos-shares-hospital-selfie-after-surgery/) [![](https://newyorkhandandnerve.com/wp-content/uploads/2021/03/de-quervains-tnosynovitis-lipsg.jpg)](https://newyorkhandandnerve.com/hand-upper-extremity/de-quervains-tenosynovitis/) ## [De Quervain’s Tenosynovitis](https://newyorkhandandnerve.com/hand-upper-extremity/de-quervains-tenosynovitis/) Posted on Mar 24, 2021 in [Hand & Upper Extremity](https://newyorkhandandnerve.com/category/hand-upper-extremity/) By Haritha B. Veeramachaneni, MD Patients with De Quervain’s Tenosynovitis, commonly known as De Quervain’s Tendinosis, have painful tendons on… [Continue Reading](https://newyorkhandandnerve.com/hand-upper-extremity/de-quervains-tenosynovitis/) [next page](https://newyorkhandandnerve.com/blog/page/2/) [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Peripheral Nerve Services [Skip to main content](https://newyorkhandandnerve.com/services/nerve/#skiptomaincontent) **The peripheral nervous system is composed of the nerves that connect our brain and spinal cord to the rest of our body. These nerves give us the ability move and sense the world around us by sending and receiving signals from our skin, muscles, and other tissues. Common issues that can affect the function of the peripheral nerve include compression syndromes, stretching, crushing, and traumatic tears. When these sensory and motor nerves are injured, patients often experience symptoms such as pain, numbness, weakness, or paralysis.** Our reconstructive hand surgeons help patients with peripheral nerve problems by understanding the whole picture. Their goal is to restore the function that was impaired or lost as a result of the nerve problem. Our [doctors](https://newyorkhandandnerve.com/about/) specialize in the diagnosis and treatment of peripheral nerve conditions. To ensure optimal function is restored, our surgeons provide prompt treatment and utilize state-of-the-art techniques to offer the most effective procedures possible. Nerve conditions can often be improved with non-surgical therapies and treatments, but this will ultimately be determined during an appointment with one of our experienced physicians. Surgery will only be recommended if the nerve problem does not respond to more conservative treatment, or in situations where surgery offers the best possible outcome. To learn about common nerve-related conditions and the treatments our doctors may recommend for each, click on the links below. - [Brachial Plexus and Other Complex Neurologic Trauma of the Upper Extremity](https://newyorkhandandnerve.com/services/nerve/brachial-plexus-complex-neurologic-trauma/) - [Carpal Tunnel](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/) - [Cubital Tunnel](https://newyorkhandandnerve.com/services/nerve/cubital-tunnel/) - [Facial Paralysis](https://newyorkhandandnerve.com/services/nerve/facial-paralysis/) - [Meralgia Paresthetica](https://newyorkhandandnerve.com/services/nerve/meralgia-paresthetic/) - [Migraines](https://newyorkhandandnerve.com/services/nerve/migraines/) - [Nerve Injuries & Secondary Reconstructions](https://newyorkhandandnerve.com/services/nerve/injury-secondary-reconstruction/) - [Pronator Syndrome](https://newyorkhandandnerve.com/services/nerve/pronator-syndrome/) - [Peroneal Nerve Entrapment](https://newyorkhandandnerve.com/peroneal-nerve-entrapment-foot-drop/) - [Radial Tunnel](https://newyorkhandandnerve.com/services/nerve/radial-tunnel/) - [Tarsal Tunnel Syndrome](https://newyorkhandandnerve.com/services/nerve/tarsal-tunnel-syndrome/) - [Ulnar Tunnel](https://newyorkhandandnerve.com/services/hand-upper-extremity/ulnar-tunnel/) [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Contact New York Hand [Skip to main content](https://newyorkhandandnerve.com/contact-us/#skiptomaincontent) Contact Name\* Email\* Phone\* Comments I agree to the Terms of Use\* I agree to the Terms of Use\* \*By submitting this form you consent to receive phone calls, text messages and emails from New York Plastic Surgical Group. It is not a condition of purchasing any goods or services. You can opt out at any time, message/data rates may apply, and opting-in includes acceptance of the [Privacy Policy](https://newyorkhandandnerve.com/privacy-policy/) and [Terms of Use](https://newyorkhandandnerve.com/terms-of-use/). Communications through this website or via email are not encrypted and are not necessarily secure. Use of the internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use. Captcha Submit If you are human, leave this field blank. ## Locations Babylon 200 W. Main Street Building A Suite 101 Babylon, NY 11702 ![map phone](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/map-phone.svg)833-469-4263 [Directions](https://www.google.com/maps/place/Long+Island+Plastic+Surgical+Group,+PC/@40.695134,-73.327739,17z/data=!3m1!4b1!4m2!3m1!1s0x89e9d2cd348613e5:0xab2fe616a9efbf05) East Hills 2200 Northern Blvd Suite 201 East Hills, NY, 11548 ![map phone](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/map-phone.svg)833-469-4263 [Directions](https://www.google.com/maps/place/Long+Island+Plastic+Surgical+Group,+PC/@40.806157,-73.6372747,17z/data=!3m1!4b1!4m5!3m4!1s0x0:0x697f053ca7f734a4!8m2!3d40.806157!4d-73.635086?authuser=7) Garden City 999 Franklin Ave Garden City, NY 11530 ![map phone](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/map-phone.svg)833-469-4263 [Directions](https://www.google.com/maps/place/Long+Island+Plastic+Surgical+Group,+PC/@40.729495,-73.6374357,17z/data=!3m1!4b1!4m5!3m4!1s0x89c27d4151320f6b:0x422cf77d0b68e9ab!8m2!3d40.729495!4d-73.635247?hl=en) Huntington 206 E. Jericho Turnpike Huntington Station, NY 11746 ![map phone](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/map-phone.svg)833-469-4263 [Directions](https://www.google.com/url?q=https://www.google.com/maps/place/Long%2BIsland%2BPlastic%2BSurgical%2BGroup,%2BPC/@40.8280128,-73.4040685,17z/data%3D!3m1!4b1!4m5!3m4!1s0x0:0x8a68354ad97dc338!8m2!3d40.8280128!4d-73.4018798?authuser%3D7&sa=D&ust=1607490972182000&usg=AOvVaw3FGK5XLL4lYpytbVlgqklK) Brooklyn 86 Saint Felix Street 11th Floor Brooklyn, NY 11217 ![map phone](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/map-phone.svg)833-469-4263 [Directions](https://maps.app.goo.gl/77Unv8jLm2dXViK68) Manhattan 1040 Park Avenue Suite 1BC New York, NY 10028 ![map phone](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/map-phone.svg)833-469-4263 [Directions](https://maps.app.goo.gl/qTdMS4cSxTytkS7p7) Manhattan 5 Columbus Circle 8th Floor New York, NY 10019 ![map phone](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/map-phone.svg)833-469-4263 [Directions](https://maps.app.goo.gl/3uDLvnsgJ8ixKakz5) Port Jefferson Station 316 Nesconset Highway Suite 100 Port Jefferson Station, NY 11776 ![map phone](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/map-phone.svg)833-469-4263 [Directions](https://maps.app.goo.gl/Y3cBREieHvn7myM1A) [![Schedule An Appointment](data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20width='0'%20height='0'%20viewBox='0%200%200%200'%3E%3C/svg%3E)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Password Recovery [Skip to main content](https://newyorkhandandnerve.com/lost-password/#skiptomaincontent) [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Privacy Policy Overview [Skip to main content](https://newyorkhandandnerve.com/privacy-policy/#skiptomaincontent) ## Introduction This website is operated by New York Plastic Surgical Group (collectively the “Company”, “We” or “Us”) respect your privacy and the Company is committed to protecting it through our compliance with this policy. This policy describes the types of information we may collect from you or that you may provide when you visit this website (our “Website”) and our practices for collecting, using, maintaining, protecting and disclosing that information. This policy applies to information we collect: - On this Website - In email, text, phone and other electronic messages between you and this Website. - Through mobile and desktop applications you download from this Website, which provide dedicated non-browser-based interaction between you and this Website. It does not apply to information collected by: - Us offline or through any other means, including on any other website operated by Company or any third party (including our affiliates and subsidiaries) that may link to or be accessible from or on the Website. Note that patient health information will be governed by a separate HIPAA Notice of Privacy Practices provided by your healthcare provider at the time of services. Please read this policy carefully to understand our policies and practices regarding your information and how we will treat it. This policy is incorporated into our [Terms of Use](https://newyorkhandandnerve.com/terms-of-use/) and creates a contract between the Company and you. If you do not agree with our policies and practices, your sole choice is not to use our Website. By accessing or using this Website, you agree to this privacy policy and the Terms. This policy may change from time to time. All changes are effective immediately when we post them, and apply to all access to and use of the Website thereafter. Your continued use of this Website after we make changes is deemed to be acceptance of those changes, so please check the policy periodically for updates. ## Children Under the Age of 16 Our Website is not intended for children under 16 years of age. No one under age 16 may provide any personal information to or on the Website. We do not knowingly collect personal information from children under 16. If you are under 16, do not use or provide any information on this Website or on or through any of its features/register on the Website, make any purchases through the Website, use any of the interactive or public comment features of this Website or provide any information about yourself to us, including your name, address, telephone number, email address or any screen name or username you may use. If you are aware that we have inadvertently collected personal information from a child under the age of 16, please write to us using the information on our contact page to request deletion of that information. ## Information We Collect About You and How We Collect It We collect several types of Personal Information from and about users of our Website, including information: - By which you may be personally identified, such as name, postal address, email address, and telephone number. - Consumer information, like your preferences or a consumer profile based on your use of the website. - Insurance information. - General health information, like your gender, height, weight or generalized medical conditions that you may be seeking information about. - Social media information, such as social media handles, content and other data shared with us through third-party features that you use on our Site and other services (such as apps, tools, payment services, widgets and plug-ins offered by social media services, like Facebook, Instagram and LinkedIn, that may have referred you to our Site). - Information about your device, your internet connection, the equipment you use to access our Website, and usage details. We collect this information: - Directly from you when you provide it to us. - Automatically as you navigate through the site. Information collected automatically may include usage details, IP addresses and information collected through cookies, pixels, web beacons and other tracking technologies. ## Information You Provide to Us The information we collect on or through our Website may include: - Information that you provide by filling in forms on our Website. This includes information provided at the time of registering to use our Website, subscribing to our service, posting material, or requesting further services. We may also ask you for information when you enter a contest or promotion sponsored by us, and when you report a problem with our Website. - Records and copies of your correspondence (including email addresses), if you contact us. - Your responses to surveys that we might ask you to complete for research purposes. - Details of transactions you carry out through our Website and of the fulfillment of your orders. You may be required to provide financial and personal information before placing an order through our Website. - Your search queries on the Website. ## Mobile Numbers and Text Messaging The user agrees any mobile phone number(s) provided by them to New York Plastic Surgical Group shall be unique to that user. The user agrees mobile number(s) provided are not shared with, or common to, other users. If a user changes their mobile phone number(s), it is the user’s responsibility to contact us to update their mobile phone number in a timely manner. - Message/data rates may apply per phone plan. - Message frequency varies. - Some carriers may not be supported. - Reply “Stop” to text message to opt-out. ## Information We Collect Through Automatic Data Collection Technologies As you navigate through and interact with our Website, we may use automatic data collection technologies to collect certain information about your equipment, browsing actions and patterns, including: - Details of your visits to our Website, including traffic data, location data, logs and other communication data and the resources that you access and use on the Website. - Information about your computer and internet connection, including your IP address, operating system and browser type. The information we collect automatically may include personal information, or we may maintain it or associate it with personal information we collect in other ways or receive from third parties. It helps us to improve our Website and to deliver a better and more personalized service, including by enabling us to: - Estimate our audience size and usage patterns. - Store information about your preferences, allowing us to customize our Website according to your individual interests. - Speed up your searches. - Recognize you when you return to our Website. The technologies we use for this automatic data collection may include: - Cookies (or browser cookies). A cookie is a small file placed on the hard drive of your computer. You may refuse to accept browser cookies by activating the appropriate setting on your browser. However, if you select this setting you may be unable to access certain parts of our Website. Unless you have adjusted your browser setting so that it will refuse cookies, our system will issue cookies when you direct your browser to our Website. - Flash Cookies. Certain features of our Website may use flash cookies to collect and store information about your preferences and navigation to, from and on our Website. Flash cookies are not managed by the same browser settings as are used for browser cookies. - Web Beacons. Pages of our Website and our emails may contain small electronic files known as web beacons (also referred to as clear gifs. pixel tags and single-pixel gifs) that permit the Company, for example, to count users who have visited those pages or opened an email and for other related website statistics (for example, recording the popularity of certain website content and verifying system and server integrity). - Javascript which uses third-party services to store data about activities and transactions. - Trackable telephone numbers which keep track of phone calls made to some phone numbers on this site. - Offline website data – including both local and remote storage of activities. - Geo-targeting information about your general location at the time of use of the site. We may tie this information to personal information about you that we collect from other sources or you provide to us. By using the Site, you consent to our use of these Tracking Technologies. You can decide if and how your computer will accept a cookie by configuring your preferences or options in your browser. However, if you choose to reject cookies, you may not be able to use certain online products, services or features on the Website. For example, we may not be able to recognize your computer or device, and you may need to log in every time you visit. You can get more information about Cookies and Tracking Technologies, and instructions on how to opt out of these items, you may visit [All About Cookies](http://www.allaboutcookies.org/). You may also learn more at the [Digital Advertising Alliance](https://optout.aboutads.info/?lang=EN&fbclid=IwY2xjawEWiFdleHRuA2FlbQIxMAABHWj6OMs0Y7K5X0H-8ZIE1fJcCG34_vKHLevMs-iM6We-rdaRkK4exZMVkA_aem_r2mHq5c_sCnYeL0MTmm_yQ&c=2) or the [NAI industry opt-out platform](https://optout.networkadvertising.org/?fbclid=IwY2xjawEWiERleHRuA2FlbQIxMAABHfpjF2VRt1YDbwm11cF_EKIb4JuiClER8CWjy6R0Jg0qZy9gB2aUCsgvZg_aem_qZJLOv7DHUw8tfJZnyx6GQ&c=1). ## How We Use Your Information We use information that we collect about you or that you provide to us, including any personal information: - To present our Website and its contents to you. - To provide you with information, products or services that you request from us. - To fulfill any other purpose for which you provide it. - To provide you with notices about your account/subscription, including expiration and renewal notices. - To carry out our obligations and enforce our rights arising from any contracts entered into between you and us, including for billing and collection. - To notify you about changes to our Website or any products or services we offer or provide through it. - To allow you to participate in interactive features on our Website. - In any other way we may describe when you provide the information. - For any other purpose with your consent. ## Your Access to and Control Over Information You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the email address or phone number given on our website. The jurisdiction in which you reside may dictate the rights available to you, but they may include the right to: - See what data we have about you, if any. - Change/correct any data we have about you. - Opt-out of our sharing of certain information. - Have us delete any data we have about you. - Express any concern you have about our use of your data. If applicable, you may exercise any of your rights by submitting a verifiable data subject request to us by using the information in the “Contact Us” section below. You may make a request related to your Personal Information or on behalf of someone for which you have authorization. You must include your full name and email address in your request. We may require you to confirm your identity and/or legal standing for the request as well as your residency to obtain the information. Please note that we will ask you to verify your identity before responding to such requests, and we may deny your request if we are unable to verify your identity or authority to make the request. ## Disclosure of Your Information We may disclose aggregated information about our users, and information that does not identify any individual, for any reason without restriction. We may disclose personal information that we collect or you provide as described in this privacy policy: - To fulfill the purpose for which you provide it. - To allow our service providers to complete a service we have contracted with them to provide. - For any other purpose disclosed by us when you provide the information. - With your consent. - To any potential acquirer, successor or assignee as part of any business transaction for the merger, sale, transfer, assignment or reorganization of our business or assets. - To comply with any court order, law or legal process, including to respond to any government or regulatory request. ## Privacy of Collected Data We will never use the statistical analytics tool to track or to collect any names or email addresses of visitors to our site. Google will not associate your IP address or device ID with any other data held by Google. Neither we nor Google will link, or seek to link, an IP address or a device ID with the identity of a computer user. ## Information About Remarketing We specifically share your information with Google (including YouTube, Google Analytics, Google AdSense, Google Business Profiles) and Meta (including Facebook and Instagram). We use Google Analytics to help us understand how our customers use the Site. Read more about how [Google uses your Personal Information](https://policies.google.com/privacy?hl=en) or [opt-out of Google Analytics](https://tools.google.com/dlpage/gaoptout). You have the option to manage Google’s personalized ads by visiting the [Google advertising center](https://myadcenter.google.com/?ref=privacy-policy). You can read more about how [Meta uses your Personal Information](https://www.facebook.com/privacy/policy/?entry_point=data_policy_redirect&entry=0) and how to [manage your Meta ad preferences](https://accountscenter.facebook.com/ads/). You can read [Vimeo’s privacy policy](https://vimeo.com/privacy) and information on [Vimeo’s video privacy settings](https://help.vimeo.com/hc/en-us/articles/12426199699985-Overview-of-video-privacy-settings). Please note that depending on your settings, the next time you access our Services the analytics may be reactivated, so you may have to disable the technology each time. This website uses Google remarketing to advertise online using text or image ads on the Google Display Network. Remarketing is a feature that lets us reach people who have previously visited our site, and show them relevant ads when they visit other sites on the Google Display Network. For websites using remarketing, a third-party DoubleClick cookie is used to enable remarketing for products like AdWords on the Google Display Network. When someone visits our website, a few lines of code will drop an anonymous browser cookie. This cookie is a small file that stores information. The cookie will store the site visit, but does not store any sensitive information, such as visitor name, address or any other piece of information that might personally identify the visitor. The cookie will be enabled for a set period of time, such as 30 or 60 days, at which time, the cookie expires. ### What is the Google Display Network? A group of more than a million websites, videos, and apps where ads can appear. Sites in this network have partnered with Google to show relevant ads. ### Opting out of Remarketing Visitors may opt out of Google’s use of cookies by visiting the [Ads Preferences Manager](https://www.google.com/ads/preferences/). Visitors may opt out of a third-party vendor’s use of cookies by visiting the [Network Advertising Initiative opt-out page](http://www.networkadvertising.org/managing/opt_out.asp). ## Do Not Track Signals Our Site currently does not respond to Do Not Track (“DNT”) signals and operates as described in this Policy, whether or not a DNT signal is received. ## Global Privacy Control Some browsers and browser extensions support the [Global Privacy Control (“GPC”)](https://globalprivacycontrol.org/) that can send a signal to the websites you visit indicating your choice to opt-out from certain types of data processing, including data sales. GPC is a web-browser level setting, maintained by either a browser or a browser extension, that is typically set by the user, not the website. In certain regions, when we detect such a signal, we will make reasonable efforts to respect your choices indicated by a GPC setting as required by applicable law. ## Changes to Our Privacy Policy Our Privacy Policy may change from time to time and all updates will be posted on this page. If you feel that we are not abiding by this privacy policy, you should contact us immediately via the email address or phone number given on our website. ## Contact Information To ask questions or comment about this privacy policy and our privacy practices, please write to or call us using the information provided on the contact page of our website. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Migraine Treatment Solutions [Skip to main content](https://newyorkhandandnerve.com/services/nerve/migraines/#skiptomaincontent) ## What Are Migraines? **Migraines are an extremely common problem that can be described as debilitating headaches. They can last for a few hours or multiple days, and are often accompanied by symptoms such as:** - Pain - Nausea - Dizziness - Light sensitivity - Other sensory issues Due to their severity, migraines can prevent individuals from living their daily lives and, consequently, tend to affect their overall quality of life. To help relieve this pain and reduce, if not completely eliminate, migraine recurrence, our [reconstructive surgeons](https://newyorkhandandnerve.com/about/) provide innovative solutions for lasting results. ## Treatment for Migraines The best candidates for migraine surgery are typically those who see improvement from treatment with injectables. Our surgeons are extensively trained in migraine surgery and perform innovative techniques that have successfully helped eliminate migraine symptoms for many patients. The procedure works by releasing the compressed muscles that put pressure on the nerves and cause migraine pain. The muscles most often connected to migraines include the following areas: - Forehead - Temple - Back of the head - Deviated septum in the nose Depending on the area being treated, a small portion of the muscle or nerve tissue may be removed or detached. Following surgery, some patients may feel relief right away. The procedure takes one to two hours to complete for each muscle area that is triggering migraines. Patients will often be screened for surgery by injecting BOTOX® to the affected nerves to see the amount of improvement in their symptoms. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Tendon Injury Treatment Course [Skip to main content](https://newyorkhandandnerve.com/all-things-tendon/#skiptomaincontent) ## **_Evalution and Treatment of_** **_Common Tendon Injuries of the Hand and Wrist_** _**Program Overview:** This half-day course was targeted for family practitioners, doctors of internal medicine, neurologists, rheumatologists, orthopedic surgeons, sports medicine specialists, emergency medicine physicians, physiatrists, PAs, nurses, NPs, and hand therapists._ _The goal of the program was to educate providers on the latest methods of diagnosis and treatment for common conditions of the hand, upper extremity, and peripheral nerves. This can help streamline patient care by ensuring that the appropriate tests are done and recognizing which patients need urgent evaluation and treatment._ ## PRESENTERS Roger L. Simpson, MD, MBA, FACS Laurence T. Glickman, MD, MSc, FRCS(C), FACS Thomas A. Davenport, MD, FACS Brian A. Pinsky, MD, FACS Haritha B. Veeramachaneni, MD Michael R. Christy, MD, MA, FACS Robert S. Wilutis, MS, OTR, CHT ## Wednesday, June 19 2019 8:00 a.m. — 1:00 p.m. Melville Marriott Long Island 1350 Walt Whitman Road Melville, New York 11747 _4 AMA PRA Category 1 Credits_ * * * ## AGENDA 8:00 a.m. Registration \| Continental Breakfast \| Vendor Expo Open 8:30 a.m. Program Overview 9:00 a.m. Anatomy, Tendon Biology 9:20 a.m. Flexor Tendon Injuries 9:40 a.m. Extensor Tendon Injuries 10:00 a.m. Flexor Tendon Reconstruction 10:20 a.m. Managing Complications of Tendon Repairs 10:40 a.m. Coffee Break/Questions 11:00 a.m. Tendon Transfers 11:20 a.m. Tendon Rehabilitation 11:40 a.m. Tendon Imbalance in the Fingers – Boutonniere and Swan-Neck 12:00 p.m. Infectious Tenosynovitis 12:20 p.m. Stenosing Tenosynovitis 12:40 p.m. Tendinopathy of the Wrist and Forearm 1:00 p.m. Closing Statements \| Vendor Expo Open ## Thank you for your interest, videos of full presentations to come soon. _**Questions?** Contact Lisa Munier 516.629.3824 • [lmunier@lipsg.com](mailto:lmunier@lipsg.com)_ [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Website Terms of Use [Skip to main content](https://newyorkhandandnerve.com/terms-of-use/#skiptomaincontent) ## Introduction This website is operated by New York Plastic Surgical Group (collectively the “Company”, “We” or “Us”). The use of our website is subject to the following terms and conditions of use, as amended from time to time (the “Terms”). The Terms are to be read together by you with any terms, conditions or disclaimers provided in the pages of our website. Please review the Terms carefully. They constitute a legal contract between you and the Company. The Terms apply to all users of our website, including without limitation, users who are browsers, customers, merchants, vendors and/or contributors of content. If you access and use this website, you accept and agree to be bound by and comply with the Terms and our [Privacy Policy](https://newyorkhandandnerve.com/privacy-policy/). If you do not agree to the Terms or our Privacy Policy, you are not authorized to access our website, use any of our website’s services or place an order on our website. ## Use of Our Website The information on this Site is for information or educational purposes only. It is not intended to provide medical advice or diagnose any condition. You agree to use our website for legitimate purposes and not for any illegal or unauthorized purpose, including without limitation, in violation of any intellectual property or privacy law. By agreeing to the Terms, you represent and warrant that you are at least the age of majority in your state or province of residence and are legally capable of entering into a binding contract. You agree to not use our website to conduct any activity that would constitute a civil or criminal offense or violate any law. You agree not to attempt to interfere with our website’s network or security features or to gain unauthorized access to our systems. You agree to provide us with accurate personal information, such as your email address, mailing address and other contact details in order to complete your order or contact you as needed. You authorize us to collect and use this information to contact you in accordance with our Privacy Policy. ## General Conditions We reserve the right to refuse service to anyone, at any time, for any reason. We reserve the right to make any modifications to the website, including terminating, changing, suspending or discontinuing any aspect of the website at any time, without notice. We may impose additional rules or limits on the use of our website. You agree to review the Terms regularly and your continued access or use of our website will mean that you agree to any changes. You agree that we will not be liable to you or any third party for any modification, suspension or discontinuance of our website or for any service, content, feature or product offered through our website. ## Consent to Electronic Communications You agree that we may communicate with you electronically regarding your use of the website or the services and that any notices, agreements, disclosures or other communications that we send to you electronically will satisfy any legal communication requirements including any requirement that the communications be in writing. To withdraw your consent to receiving electronic notices, please notify us at the information on the Contact page of our website. ## Products or Services All purchases through our website are subject to product availability. We may, in our sole discretion, limit or cancel the quantities offered on our website or limit the sales of our products or services to any person, household, geographic region or jurisdiction. Prices for our products are subject to change, without notice. Unless otherwise indicated, prices displayed on our website are quoted in U.S. dollars. We reserve the right, in our sole discretion, to refuse orders, including without limitation, orders that appear to be placed by distributors or resellers. If we believe that you have made a false or fraudulent order, we will be entitled to cancel the order and inform the relevant authorities. ## Links to Third-Party Websites Links from or to websites outside our website are meant for convenience only. We do not review, endorse, approve or control, and are not responsible for any sites linked from or to our website, the content of those sites, the third parties named therein, or their products and services. Linking to any other site is at your sole risk and we will not be responsible or liable for any damages in connection with linking. Links to downloadable software sites are for convenience only and we are not responsible or liable for any difficulties or consequences associated with downloading the software. Use of any downloaded software is governed by the terms of the license agreement, if any, which accompanies or is provided with the software. ## Use Comments, Feedback, and Other Submissions You acknowledge that you are responsible for the information, profiles, opinions, messages, comments and any other content (collectively, the “Content”) that you post, distribute or share on or through our website or services available in connection with our website, including our social media sites. You further acknowledge that you have full responsibility for the Content, including but limited to, with respect to its legality, and its trademark, copyright and other intellectual property ownership. We do not wish to receive any confidential, proprietary or sensitive information from you via the website or your comments. 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We will use it to accommodate all our customers and improve our overall accessibility policies. ## Questions or Concerns Please send all questions, comments and feedback to us using the information provided on the contact page of our website. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Patient Information [Skip to main content](https://newyorkhandandnerve.com/contact-us/patient-information/#skiptomaincontent) **Injuries to the upper extremity may involve a variety of bones, tendons, nerves, or other tissues in the area. While some conditions or injuries may heal on their own, treatment is often necessary to regain optimal function of the area. Before recommending surgery, your [reconstructive hand surgeon](https://newyorkhandandnerve.com/about/) will first consider more conservative treatment options, but if these do not provide enough improvement, surgery may be necessary.** **To help you prepare for your hand or arm surgery, we have provided information about the consultation process as well as what you can expect during the post-operative period.** - [What to Bring to Your Consultation](https://newyorkhandandnerve.com/contact-us/patient-information/#consultation) - [Post-Op Care Instructions](https://newyorkhandandnerve.com/contact-us/patient-information/#instructions) - [Pain Management](https://newyorkhandandnerve.com/contact-us/patient-information/#pain) - [Hand Therapy](https://newyorkhandandnerve.com/contact-us/patient-information/#hand) Open communication between you and your doctor is essential for achieving the best possible outcome. If you have any questions about your upper extremity procedure, please feel free to contact us. ## What to Bring to Your Consultation Depending on your injury or condition, you may have tests such as EMGs or imaging studies such as x-rays or MRIs that were ordered by other doctors or from the Emergency Room. You should obtain copies of the IMAGES as well as any reports that are available whenever possible. This will assist your surgeon in evaluating you in a timely manner. If you have any difficulty getting these records, please call the office and we will help. You should also be aware of your medical history to ensure you are a good candidate for the procedure and nothing will interfere with your recovery. This includes current medications, other conditions, treatments, and allergies to any medications. The consultation is the best time to ask any questions you may have so your doctor can help you understand what to expect throughout your surgical treatment. It can also help to bring a friend or family member for support. ## Post-Op Care Instructions Recovery from upper extremity surgery will vary based on the specifics of your procedure. However, the following details and instructions are common in many of our hand surgeries. - For the first day following surgery, it can be helpful to have someone with you for help. - A cast or splint may need to be worn for several weeks to immobilize the area as it heals. This dressing should stay clean and dry to make sure there are no complications with wound healing. - Swelling is normal. Elevating and icing the area can help reduce post-operative swelling as well as inflammation. - Refrain from smoking before and after your surgery. This affects your body’s ability heal properly, as it limits blood flow to the area. - You will have restricted use of the area as you recover. It is important that you do not bear weight on the affected area until your doctor advises that you can do so. - You may be instructed on certain exercises, like making a tight fist or moving your wrist and elbow several times each day to avoid stiffness. - If stitches are preset, they will usually be removed in 10-14 days after surgery. ## Pain Management To keep you as comfortable as possible, you will be prescribed pain medication to help control any pain or discomfort you have after surgery. We usually recommend a combination of over-the-counter pain medication and prescription medication to maximize your pain control and minimize any potential side effects. Before your surgery, your doctor will make sure you understand how often and the amount of the medication that is safe to take. Please take your prescription as directed. While you are taking the medication, you should refrain from driving, drinking alcohol, making big decisions, or taking other pain medications, unless otherwise told by your doctor. ## Hand Therapy After your hand surgery, you will most likely need to limit movement of the treated area for weeks. Once the hand or arm has healed enough to begin therapy, your doctor will refer you to a certified hand therapist to begin regular therapy. The area may feel stiff and weak at first, but with therapy you should regain strength and proper function of the hand. This is often a critical step in your recovery, and your final post-operative results will ultimately depend on your commitment to therapy. We look forward to your visit at the Institute for Hand Surgery. Please feel free to [contact us](https://newyorkhandandnerve.com/contact-us/) anytime. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Hand and Upper Extremity [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/#skiptomaincontent) **The upper extremity is composed of the hand, wrist, forearm, elbow, upper arm, and shoulder. We use these areas in almost all of our daily routines without even realizing it. When the upper extremity becomes injured, even just a fingertip, this can make it difficult to function like normal. Daily activities such as work, sports, and driving put your extremities at risk for a variety of common and not-so-common injuries and overuse syndromes. The upper extremity is made up of multiple tendons, bones, nerves, muscles, and other soft tissues, making it a delicate and intricate area that can require complex treatment when injured.** Our surgeons have advanced training in the diagnosis and treatment of the upper extremity. Depending on the nature of the condition, they may recommend care such as resting the area, wearing a splint, injections, therapy, or surgery. Our [doctors](https://newyorkhandandnerve.com/about/) always consider the most conservative treatment options first before advising surgical intervention. Should a patient need surgery to regain full function and appearance of their upper extremity, our surgeons utilize the most innovative, state-of-the-art techniques available to provide the best outcome possible. To learn more about common hand and upper extremity conditions, as well as potential treatment options we may recommend, please visit the pages below: - [Carpal Tunnel](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/) - [Congenital Hand Anomalies](https://newyorkhandandnerve.com/services/hand-upper-extremity/congenital-anomalies/) - [Cubital Tunnel](https://newyorkhandandnerve.com/services/nerve/cubital-tunnel/) - [Dupuytren’s Contracture](https://newyorkhandandnerve.com/services/hand-upper-extremity/dupuytrens-contracture/) - [Fingertip Injuries](https://newyorkhandandnerve.com/services/hand-upper-extremity/fingertip-injuries/) - [Flexor Tendon Injuries and Extensive Tendon Injuries](https://newyorkhandandnerve.com/services/hand-upper-extremity/flexor-extensor-tendon-injuries/) - [Forearm, Wrist, and Hand Fractures](https://newyorkhandandnerve.com/services/hand-upper-extremity/fractures-broken/) - [Hand Rejuvenation](https://newyorkhandandnerve.com/services/hand-upper-extremity/rejuvenation/) - [Hand and Finger Joint Replacement](https://newyorkhandandnerve.com/services/hand-upper-extremity/hand-finger-joint-replacement/) - [Hand Sprains and Strains](https://newyorkhandandnerve.com/services/hand-upper-extremity/hand-sprains-strains/) - [Kienbock’s Disease](https://newyorkhandandnerve.com/services/hand-upper-extremity/kienbocks-disease/) - [Ligament Tears and Wrist Arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/ligament-tears-wrist-arthritis/) - [Mallet Finger](https://newyorkhandandnerve.com/services/hand-upper-extremity/mallet-finger/) - [Pediatric Hand Injuries](https://newyorkhandandnerve.com/services/hand-upper-extremity/pediatric-injuries-surgery/) - [Skin Cancers](https://newyorkhandandnerve.com/services/hand-upper-extremity/skin-cancers/) - [Tendonitis (Trigger Finger, Intersection Syndrome, De Quervain’s, other Wrist Tendinopothy)](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/) - [Tennis Elbow/Golfers Elbow](https://newyorkhandandnerve.com/services/hand-upper-extremity/tennis-elbow/) - [Thumb Arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/) - [Ulnar Tunnel](https://newyorkhandandnerve.com/services/hand-upper-extremity/ulnar-tunnel/) [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Meralgia Paresthetica Overview [Skip to main content](https://newyorkhandandnerve.com/services/nerve/meralgia-paresthetica/#skiptomaincontent) ## What Is Meralgia Paresthetica? **Meralgia paresthetica is caused when the nerve that provides skin sensation to the thigh is pinched. Common symptoms of the [nerve condition](https://newyorkhandandnerve.com/services/nerve/) affect the outer thigh and include:** - Tingling - Burning pain - Numbness The condition often results when patients wear tight-fitting clothes, gain weight, or are pregnant; however, it can also develop from trauma to the area or a chronic disease, such as diabetes. Meralgia paresthetica often happens to one side of the body, and symptoms may be more intense after walking or standing. ## Treatment for Meralgia Paresthetica Non-invasive treatments are typically enough to relieve the compressed nerve that causes meralgia paresthetica. This may include wearing loose-fitting clothes or losing weight. If the condition is severe enough, patients may benefit from medications to help reduce pain, such as the following: - Corticosteroid injections - Tricyclic antidepressants - Anti-seizure medications Those who can benefit from surgery are typically those with severe symptoms that have not responded to more conservative forms of treatment. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Cubital Tunnel Syndrome [Skip to main content](https://newyorkhandandnerve.com/services/nerve/cubital-tunnel/#skiptomaincontent) ## What Is Cubital Tunnel Syndrome? **Cubital tunnel syndrome is caused by increased pressure or stretching of the ulnar nerve at the elbow, also known as the “funny bone.” This condition is characterized by tingling or numbness in the ring and small fingers, pain in the forearm, and/or general weakness in the hand. These symptoms frequently happen during activities where the elbow is bent, such as talking on the phone or driving a car. Over time, this can make it difficult to grasp or pinch objects, make a tight fist, or do simple tasks like buttoning clothes. In later stages, patients may notice complete wasting of the small muscles in the hand. Fortunately, many symptoms of cubital tunnel syndrome can be minimized or eliminated with treatments guided by our team of reconstructive [hand surgeons in Long Island and New York City](https://newyorkhandandnerve.com/about/). The condition is often initially addressed with nonsurgical treatments, such as therapy and activity modification. No matter the severity of your symptoms, we aim to provide you with the expert care that can help you find relief and regain hand and finger function.** ## Signs & Symptoms Cubital tunnel syndrome characteristically affects the ring finger and small finger (pinky), but symptoms can also extend to the hand, forearm, and elbow. Signs of the condition may include: - Tingling, pins and needles sensations, electric shocks - Dull or burning pain - Loss of sensation - Inability to pinch - A weak grip or general feeling of weakness These symptoms can arise during certain movements, especially activities where the elbow is bent. The symptoms will initially come and go, but will eventually be felt at all times as the condition worsens. The diagnosis of cubital tunnel is clinical, based on your medical history and physical exam findings. Our reconstructive hand surgeons can examine your symptoms and utilize an array of approaches to determine the most effective course of treatment for your case. ## Causes The ulnar nerve is one of the three main nerves of the arm, supplying feeling to the ring and pinky fingers, as well as controlling the movement of the small muscles of the hand. The ulnar nerve is located close to the skin’s surface and runs behind the inner elbow in a tight compartment called the cubital tunnel. Certain stressors that impact this nerve over a long period of time can lead to cubital tunnel syndrome. In general, causes may include: - **Pressure**: Because this nerve has little padding over it, certain movements can create tension on the nerve and cause the affected areas to experience a pins-and-needles sensation, or “fall asleep.” Leaning the elbow on a hard surface or bending the elbow for an extended length of time are common motions that can eventually cause symptoms associated with cubital tunnel syndrome. - **Stretching**: Keeping the elbow bent during sleep, while talking on the phone, or during other activities can stretch the ulnar nerve, causing increased pressure and leading to cubital tunnel syndrome if these actions are consistently repeated. - **Anatomy**: A person’s natural anatomy can sometimes prevent the ulnar nerve from working properly. For some individuals, moving the elbow forces the nerve to snap across a bony bump and the repeated snapping can cause inflammation or irritability over time. For others, abnormal bone growth or intense physical activity can trigger symptoms. ## Treatment Many treatments may first involve refraining from the motions that are likely to cause symptoms. This may involve: - **Activity modification**—Patients are instructed to avoid elbow-flexing activities, such as talking on the phone, typing on a computer with the elbows bent, or resting the elbow in the center console while driving. - **Wearing an elbow pad or splint**—Using a splint, especially while sleeping, can limit elbow flexion and decrease stress to the nerve. An elbow pad may also be utilized during daytime hours to similarly immobilize  the elbow and avoid direct pressure on the ulnar nerve. - **Surgery**—When conservative treatment proves to be ineffective or patients present with muscle loss, the recommended treatment is surgery. Surgery involves a small incision at the inner elbow with release of the nerve at multiple points of compression. Usually, the nerve can be left in its native position. This is known as an “in situ” decompression. Occasionally, the nerve is not stable in this position and requires relocation from behind the elbow to the front of the elbow. The nerve can be placed under the skin or under the forearm muscles, depending on the specific case. Recovery from surgery averages three to six weeks. Most patients are given a home exercise program and some will benefit from supervised hand therapy. At the Institute for Hand Surgery at New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group, we can develop a personalized treatment plan to determine the most beneficial course of action for your unique condition. While recovery may be gradual, our reconstructive hand surgeons can take the necessary steps to help you regain maximum function of the affected areas. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Nerve Compression Syndrome [Skip to main content](https://newyorkhandandnerve.com/nerve/nerve-compression-syndrome/#skiptomaincontent) February 3, 2021 By Laurence T. Glickman, MD, MSC, FRCS(C), FACS Nerve compression syndrome (NCS) is also known as nerve entrapment syndrome, compression neuropathy, entrapment neuropathy, or simply a trapped nerve. There are many types of NCS. Each affects a different nerve that may arise in the upper extremity, the neck, torso, trunk, or in the lower extremity. The most common type of NCS is **carpal tunnel syndrome**. This occurs when the median nerve is compressed at the level of the wrist. The symptoms include numbness and tingling, weakness, and pain in the wrist and fingers of the hand. The second most common NCS is **cubital tunnel syndrome** which occurs when the ulnar nerve is compressed at the elbow. The ulnar nerve provides sensation to the pinky finger and half of the ring finger, as well as power to the muscles within the hand. Other types of NCS can occur in any nerve in the body where nerves can be compressed as they pass through a tight tunnel. These include the occiput (back of the head), the neck, axilla, the buttock, the groin, the knee, and the ankle. ## Causes NCS can be caused by repetitive injuries in the workplace, overextension of the wrist while typing a keyboard, or even the use of cell phones to take selfies. Injuries such as sprains or fractures can also lead to nerve compression. Benign as well as malignant tumors can also result in NCS. Certain systemic conditions also make you more susceptible to NCS. These include diabetes, high blood pressure, rheumatoid arthritis, and obesity. ## Symptoms Symptoms of NCS are numerous but include swelling, redness, inflammation, numbness and tingling, muscle weakness, as well as pain. ## Diagnosis Patients will often see a neurologist who may require a specific nerve conduction test or electromyography to test the nerves. Nonsurgical management is the mainstay of treatment. This includes a change in lifestyle, a change in job description, losing weight, the use of splinting, the use of nonsteroidal anti-inflammatory medication such as Motrin, as well as cortisone injections. Most patients respond to nonsurgical treatment, but outcomes are dependent on many factors such as comorbidities, age, and how long you have had the compression. ## Surgical treatment Should you be referred to a plastic surgeon, he or she might suggest a nerve decompression. The surgery can be quite simple or complex depending on the severity of the compression and the location. Outcomes are generally excellent but of course, are dependent on many factors. Almost all the surgeries are outpatient and recovery takes about 10 days or so following the surgical procedure. [Previous Post](https://newyorkhandandnerve.com/arthritis/my-fingers-hurt-do-i-have-arthritis/) [Next Post](https://newyorkhandandnerve.com/hand-upper-extremity/de-quervains-tenosynovitis/) [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Carpal Tunnel Syndrome Overview [Skip to main content](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/#skiptomaincontent) ## What Is Carpal Tunnel Syndrome? **Carpal tunnel syndrome is one of the most common [nerve conditions](https://newyorkhandandnerve.com/services/nerve/). Patients will often report burning pain, tingling, or numbing sensations in the thumb, index, and middle fingers that emerge at night or throughout the day. The numbness and tingling will generally affect the hand and wrist, but can also radiate up or down the arm. Difficulty sleeping is a common issue, and a patient’s quality of life can be significantly affected. The symptoms will often come and go in the beginning, but will often progress to permanent numbness and weakness over time. This condition develops when swelling around the nerve or tendons causes increased pressure on the median nerve as it crosses the wrist in the tight carpal tunnel. The pressure results in decreased blood flow to the median nerve and nerve damage.** **Individuals who have suffered wrist injuries, or make repetitive and forceful hand and wrist motions for work or sports-related activities, are usually at a higher risk of developing carpal tunnel syndrome. This condition may improve with conservative, non-surgical treatment; however, long-term carpal tunnel syndrome can cause permanent loss of sensation and coordination. Left untreated, the condition can also result in permanent muscle weakness of the thumb and base of the palm. While carpal tunnel syndrome is difficult to live with, our experienced [reconstructive hand surgeons](https://newyorkhandandnerve.com/about/) can recommend the most beneficial treatment to help alleviate your painful symptoms and restore hand function.** Understand.com Player # Step 1: Introduction Carpal tunnel syndrome is a condition in the hand and wrist caused by excessive pressure on the median nerve in the wrist. Compression of the nerve typically causes numbness and tingling in the thumb, index finger, middle finger, and ring finger. Pain in the hand and wrist may also occur. Carpal tunnel release is a surgical procedure that reduces the pressure on the median nerve to alleviate symptoms. # Step 2: What Causes Carpal Tunnel Syndrome The median nerve controls thumb movement and provides sensation from the palm side of the thumb to half of the ring finger. This nerve runs from the forearm into the hand, along with flexor tendons, through the carpal tunnel, which is a narrow tunnel formed by the transverse carpal ligament and carpal bones in the wrist. If the median nerve is compressed or pinched, numbness and tingling in the thumb, index, middle, and ring finger are typically present. Pain in the wrist may also occur and may even radiate up the forearm. In severe cases of carpal tunnel syndrome, the muscles of the thumb may become weak and decrease in size. Compression of the nerve may be the result of any number of factors that narrow the carpal tunnel or cause changes in the median nerve. Fluid retention or swelling at the wrist, such as occurs during pregnancy or after trauma or injury; flexor tendon irritation from excessive or repetitive hand use; nerve changes resulting from diabetes, hypothyroidism, or alcoholism; wrist inflammation due to rheumatoid and other forms of inflammatory arthritis; bone changes from arthritis or an overactive pituitary gland; and cysts or tumors may all lead to carpal tunnel syndrome. # Step 3: Surgery Options and Preparation Carpal tunnel release may be performed either as an open procedure or an endoscopic procedure. The open procedure typically involves a small incision on the palm of your hand to expose the carpal ligament. Alternatively, the procedure may be performed endoscopically, which involves one or two small incisions and the use of a special surgical camera and instruments to perform the surgery beneath the tissues. Both procedures are described in this animation. Each procedure may be done under local, regional, or general anesthesia. The type chosen will be determined by your surgeon based on a variety of factors. If local anesthesia is used, the surgeon will inject medication into your wrist or hand to numb the incision area. Prior to this injection you are often given medication so you are relaxed during the procedure. Regional anesthesia with IV sedation involves injecting medication into an IV in your arm to numb your entire arm and hand, and you may be relaxed but not entirely asleep. If general anesthesia is used, you will be given medication so that you are asleep during the procedure. Prior to the procedure, a tourniquet will be carefully placed on your arm. This will temporarily stop blood flow to the hand so that the surgeon can clearly visualize the nerve in the hand and wrist area during the short surgical procedure. # Step 4: Open Procedure To begin the open procedure, an incision is made at the base of the palm of the hand in line with the ring finger. Instruments known as retractors are used to pull the skin and fat apart and expose the underlying tissue, called the superficial palmar fascia. Another incision is made through the fascia to expose the transverse carpal ligament. The ligament is then carefully cut to relieve the pressure on the median nerve. The fascia that is connected to the carpal ligament is then loosened and cut to further open the carpal tunnel. The surgeon will inspect the carpal tunnel, nerve, and flexor tendons. If a cyst or other mass is present, or if significant tendon inflammation is present, the surgeon may extend the original incision to address these problems. Once the carpal tunnel is completely released, the tourniquet is removed and the incision is closed with sutures or special wound tape. A medication is typically injected to numb the area for several hours after surgery and a bandage is placed over the wound. A splint may be applied to limit wrist motion after surgery. # Step 5: Endoscopic Procedure To begin the endoscopic procedure in a single incision technique, a small incision is made in the wrist. In a double incision technique, which is described in this animation, incisions are made in the wrist and in the palm of the hand. A thin tube with a camera attached, called an endoscope, is gently guided through the incision in the wrist, allowing the surgeon to visualize the tissues beneath the skin. A special surgical knife is inserted into the incision under the transverse carpal ligament which is then cut to relieve the pressure on the median nerve. The instruments are withdrawn and reinserted in the opposite direction. This allows visualization of the fascia that is connected to the carpal ligament. The fascia is loosened and cut to further open the carpal tunnel. Once the carpal tunnel is completely released, the tourniquet is removed and the incision is closed with sutures or special wound tape. A medication is typically injected to numb the area for several hours after surgery and a bandage is placed over the wound. A splint may be applied to limit wrist motion after surgery. # Step 6: Recovery Immediately following the procedure, you can expect to have some pain, swelling, and possibly stiffness around the wrist and hand that may last for several weeks. You will likely be advised to keep your hand elevated for a few weeks after the surgery to reduce swelling. Sutures will typically be removed between 10 days and two weeks. Your surgeon will likely suggest hand and finger exercises after surgery and may also recommend hand therapy if necessary. You will consult with your surgeon about when to resume other activities. Carpal tunnel release provides complete or nearly complete relief of numbness, tingling, and pain depending on your age, the severity of your condition, and other medical conditions. menu Carpal Tunnel Release Content provided by **NYPlasticSurgical** together with ![Carpal Tunnel Release](https://content-files.understand.com/73d4da0b-9dcc-4b96-92bf-ed7d924bf6e7.jpg) 0:00 0:00 /6:14 3.7K views 7 likes ## Signs & Symptoms of Carpal Tunnel Symptoms of carpal tunnel syndrome usually arise in the thumb, index, middle, and ring fingers. They may include: - Burning pain - Tingling - Numbness - Trouble pinching, grasping, or holding onto objects - Difficulty using the thumb (inability to open a jar, use a screwdriver, etc.) In severe cases, carpal tunnel syndrome can cause a complete loss of strength in the thumb muscles. Because the median nerve typically does not affect the little finger (pinky), symptoms experienced in this finger may indicate another condition. A [ligament tear](https://newyorkhandandnerve.com/services/hand-upper-extremity/ligament-tears-wrist-arthritis/), [thumb arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/), or tendonitis may occur at the same time as carpal tunnel syndrome, and our hand surgeons have a wide array of treatments designed for these and other conditions. ## Diagnosis of Carpal Tunnel Syndrome The diagnosis of carpal tunnel syndrome is clinical and based on a person’s symptoms, history, and physical exam findings. Patients may be recommended to have a nerve test performed by a neurologist which can help determine the severity of the nerve compression and rule out other potential causes of nerve symptoms, including  nerve compression at the neck and diabetic neuropathy. What to expect during a Carpal Tunnel exam with Brian A. Pinsky, MD, FACS - YouTube New York Plastic Surgical Group 832 subscribers [What to expect during a Carpal Tunnel exam with Brian A. Pinsky, MD, FACS](https://www.youtube.com/watch?v=5p1nSV-AUBM) New York Plastic Surgical Group Search Watch later Share Copy link Info Shopping Tap to unmute If playback doesn't begin shortly, try restarting your device. More videos ## More videos You're signed out Videos you watch may be added to the TV's watch history and influence TV recommendations. To avoid this, cancel and sign in to YouTube on your computer. CancelConfirm Share Include playlist An error occurred while retrieving sharing information. Please try again later. [Watch on](https://www.youtube.com/watch?v=5p1nSV-AUBM&embeds_referring_euri=https%3A%2F%2Fnewyorkhandandnerve.com%2F) 0:00 0:00 / 4:32•Live • [Watch on YouTube](https://www.youtube.com/watch?v=5p1nSV-AUBM "Watch on YouTube") ## Causes of Carpal Tunnel Syndrome Increased pressure to the median nerve, as it crosses the wrist with the tendons of the fingers, is the main cause of carpal tunnel syndrome. This pressure can come from a number of influences. Work-related duties involving vibration or repetitive, forceful motion over a long period of time may lead to the development of this condition. Other factors that can cause undue pressure on the median nerve include: - A history of fractures or arthritis - Joint dislocations - Fluid build-up during pregnancy - Thyroid conditions, diabetes, or obesity ## Carpal Tunnel Syndrome Treatment Carpal tunnel syndrome can be treated by both surgical and non-surgical remedies. Our experienced hand surgeons can create a treatment plan personalized to address your unique condition, but in general, your symptoms may be relieved by: - Steroid injections to help decrease swelling around the median nerve - Physical and occupational therapy to change patterns of motion - Wearing a wrist splint to limit movement of the affected area - Surgery to decrease pressure on the median nerve While conservative treatments are often utilized first, surgery may be required if your symptoms do not improve. Our expert hand surgeons can help determine the most effective surgical approach to improve the mechanisms causing your carpal tunnel syndrome. Our expert surgeons offer the most state-of-the-art surgical solutions to carpal tunnel syndrome. Should surgery prove necessary, patients may experience temporary soreness around the treated area after the operation. Recovery from this condition will happen gradually, but taking measures to reduce pressure on the median nerve can help minimize the symptoms and burdens presented by carpal tunnel syndrome. ## Carpal Tunnel Overview with Expert Hand Surgeon Dr. Brian Pinsky In this video, Dr. Pinsky provides an overview of Carpal Tunnel Syndrome including causes, symptoms, and treatment options. Carpal Tunnel Overview with Expert Hand Surgeon Dr. Brian Pinsky - YouTube New York Plastic Surgical Group 832 subscribers [Carpal Tunnel Overview with Expert Hand Surgeon Dr. Brian Pinsky](https://www.youtube.com/watch?v=ofb_I5LliTs) New York Plastic Surgical Group Search Watch later Share Copy link Info Shopping Tap to unmute If playback doesn't begin shortly, try restarting your device. More videos ## More videos You're signed out Videos you watch may be added to the TV's watch history and influence TV recommendations. To avoid this, cancel and sign in to YouTube on your computer. CancelConfirm Share Include playlist An error occurred while retrieving sharing information. Please try again later. [Watch on](https://www.youtube.com/watch?v=ofb_I5LliTs&embeds_referring_euri=https%3A%2F%2Fnewyorkhandandnerve.com%2F) 0:00 0:00 / 1:30•Live • [Watch on YouTube](https://www.youtube.com/watch?v=ofb_I5LliTs "Watch on YouTube") [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Radial Tunnel Syndrome [Skip to main content](https://newyorkhandandnerve.com/services/nerve/radial-tunnel/#skiptomaincontent) ## What Is Radial Tunnel Syndrome? **Radial tunnel syndrome is a condition caused by sustained pressure on the radial nerve — a nerve that extends across the bones and muscles in the forearm and elbow. This nerve controls movement of the muscles on the back forearm that extend the wrist and fingers, and also provides sensation to the skin covering the forearm and the back of the hand. Increased pressure on a branch of the radial nerve, known as the posterior interosseous nerve, causes deep aching pain in the forearm just beyond the outer elbow. This area can be very tender to the touch and patients can experience weakness from the pain. The symptoms can be very similar to [tennis elbow](https://newyorkhandandnerve.com/services/hand-upper-extremity/tennis-elbow/). While living with radial tunnel syndrome can be very challenging and limit everyday movements, our [reconstructive hand surgeons](https://newyorkhandandnerve.com/about/) offer an array of treatments designed to give you relief from painful symptoms and recover the full range of motion.** ## Signs & Symptoms The type and location of symptoms experienced is often used to diagnose radial tunnel syndrome. Signs of the condition are typically indicated by: - Dull or aching pain at the top of the forearm, elbow, or back of the hand - Sharp pain when straightening the wrist or fingers - Fatigue in the forearm muscles - Weakness in the wrist and forearm muscles ## Causes Painful symptoms can arise whenever the radial nerve is pinched across its length. While the nerve extends from the neck all the way to the forearm and hand, this pinching occurs most often at a narrow passageway through the elbow called the radial tunnel. Common motions that can squeeze and irritate the radial nerve include: - Overuse of the arm by pushing or pulling - Repetitive gripping or pinching - Continual bending or twisting of the wrist Over time, such stressors can cause radial tunnel syndrome. Those who suffer an arm injury, or have a tumor or lump in their arm, can also be placed at a higher risk for developing the condition. Although diagnosing the condition can be difficult, our reconstructive hand surgeons can examine the location and nature of your pain to determine the most appropriate medical treatment to minimize your symptoms. ## Treatment In many circumstances, medical treatment combined with limitation of the movements that are likely to cause pain can minimize the everyday symptoms of radial tunnel syndrome. Depending on your unique needs, the condition can be treated by conservative approaches, such as: - Over-the-counter medications - Steroid injections to reduce inflammation - Wearing a splint to limit movement of the wrist and/or elbow - Occupational hand therapy to decrease repetitive motion stress Should these methods prove ineffective, surgery may be required to create more space for the radial nerve. This may involve making the radial tunnel bigger in order to allow more room for the nerve. After surgery, it is common for patients to temporarily wear a splint, or undergo some degree of physical therapy. Our experienced hand surgeons are committed to creating a personalized treatment plan for your unique condition to help you regain any lost function, and prevent symptoms from returning. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Facial Paralysis Services [Skip to main content](https://newyorkhandandnerve.com/services/nerve/facial-paralysis/#skiptomaincontent) ## What Is Facial Paralysis? **Facial paralysis can occur suddenly or develop gradually, affecting one side of the face or both. Depending on the case, the patient may have muscles that are weakened or completely unable to move. This can cause a variety of symptoms, such as:** - Drooping of the face - Inability to smile - Drooling - Inability to close eyelids - Facial asymmetry The [nerve condition](https://newyorkhandandnerve.com/services/nerve/) can result due to trauma, a tumor, infection, surgery, stroke, or Bell’s Palsy. Receiving a diagnosis of facial paralysis can be extremely upsetting and confusing. While it can be difficult to treat, our skilled [surgeons](https://newyorkhandandnerve.com/about/) can help restore basic function to many patients suffering from the condition. ### Treatment for Facial Paralysis To determine if treatment will help your condition, and which is the best method, your doctor will consider how long you have had symptoms, the cause of your facial paralysis, the extent of the damage, and the likelihood of a recovery. Not all patients need facial reanimation treatment—some cases will gradually improve on their own with time. Those who qualify for surgery typically have permanent facial paralysis and have already tried conservative forms of treatment without seeing improvement. Common treatments that can help improve problems caused by the paralysis as well as the overall facial appearance include: - Muscle transfer - Neural treatment techniques - Nerve-grafting techniques - Surgical lift procedure, such as an eyelid lift, brow lift, or facelift - Tear duct surgery to improve dry eye, gold weight placement to restore eyelid closure [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Pronator Syndrome Overview [Skip to main content](https://newyorkhandandnerve.com/services/nerve/pronator-syndrome/#skiptomaincontent) ## What Is Pronator Syndrome? **Pronator syndrome, also known as pronator teres syndrome (PST), occurs when the median nerve is compressed in the upper forearm. The median nerve is one of the three nerves that allows our upper extremity to sense and move—it begins in the upper arms and its branches extend into the fingers. When this nerve becomes entrapped at the elbow, a number of symptoms can present themselves. These are typically most noticeable and bothersome when trying to rotate the palms from facing upward to turning down towards the floor.** ## Signs & Symptoms The symptoms of pronator syndrome are similar to those of [carpal tunnel syndrome](https://newyorkhandandnerve.com/services/nerve/cubital-tunnel/), which occurs when the median nerve is compressed at the wrist. However, with pronator syndrome these symptoms tend to affect both the hand and the forearm. Common signs that the median nerve is being entrapped at the elbow include the following: - Aching pain in the forearm - Tingling in the thumb and index finger - Numbness in the hand - Weakness in the thumb and index finger ## Causes Pronator syndrome can occur in both men and women, but it is most common in women over the age of 40. The condition is caused by compression of the median nerve, usually by swollen and inflamed structures around the elbow. Certain underlying conditions such as hypothyroidism and diabetes are considered risk factors of pronator syndrome. Pronator syndrome is most prevalent in those who regularly take part in activities that require repetitive pronation (turning the palm to face the floor) while flexing the fingers, such as when grasping an object. Common job roles that are especially prone to developing pronator syndrome include carpenters and mechanics. Sports like weight lifting, rowing, and those that use rackets are also susceptible to the condition. In addition, pronator syndrome can be caused by other factors such as forearm trauma, tumors, and bony abnormalities. ## Treatment To make a diagnosis, one of our [reconstructive hand surgeons](https://newyorkhandandnerve.com/about/) will perform a physical examination and take imaging tests to thoroughly evaluate what may be causing your symptoms. Pronator syndrome is most often determined based on the physical exam, but imaging tests, such as an X-ray or MRI, or nerve conduction studies may help your doctor better understand the structure of the area and if another problem may be contributing. For mild to moderate cases of pronator syndrome, our surgeons will first recommend conservative treatments to attempt resolution of the condition. These non-surgical methods may include one or more of the following: - Rest from the activity causing symptoms - Splinting to prevent the forearm from rotating - Anti-inflammatory pain medications - Hand therapy Your progress will be monitored over the course of three to six months; most of the time the symptoms will resolve. If these methods are not enough to improve the condition—or your initial symptoms include difficulty moving the arm or hand—surgery may be recommended to relieve the pressure on the median nerve. This typically entails a minimally invasive procedure designed to decompress the nerve at the elbow to restore optimal function. The most beneficial treatment option for your condition will be determined once your surgeon has had the opportunity to assess your symptoms as well as the results of your imaging tests. If you have any questions about pronator syndrome, or would like to schedule an appointment with one of our experienced surgeons, please contact the Institute for Hand Surgery at New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Tarsal Tunnel Syndrome [Skip to main content](https://newyorkhandandnerve.com/services/nerve/tarsal-tunnel-syndrome/#skiptomaincontent) ## What Is Tarsal Tunnel Syndrome? **The tarsal tunnel is a small space on the inner side of the ankle that includes veins, arteries, tendons, and nerves. In tarsal tunnel syndrome, the posterior tibial nerve located within the tarsal tunnel is the main area affected. The condition occurs when the nerve is compressed, similar to [carpal tunnel syndrome](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/), and can be caused by a number of factors, such as strain from flat feet, inflammation from an injury, and swelling from a disease. Symptoms of the condition typically include:** - Tingling or burning sensation - Numbness - Pain These symptoms may be sudden or develop with time. They are most commonly felt on the inside of the ankle or on the bottom of the foot. ## Treatment for Tarsal Tunnel Syndrome Early treatment is important for preventing permanent nerve damage from tarsal tunnel syndrome. A physical exam will be performed to assess the area and determine if there is any numbness. Once the cause and severity of the syndrome have been established, the most appropriate treatment options will be discussed with you. Non-surgical treatment can often improve tarsal tunnel syndrome, and may include the following options: - Immobilizing the ankle with a cast to encourage healing - Physical therapy to improve symptoms - Injections for pain relief and to reduce inflammation - Orthotic devices or supportive shoes - Wearing a brace to reduce pressure Depending on the cause of your tarsal tunnel syndrome, surgery may be recommended for long-term relief. More details about your personalized treatment plan will be discussed during your consultation. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Hand Rejuvenation Services [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/rejuvenation/#skiptomaincontent) ## What Is Hand Rejuvenation? **The hands are one of the areas of the body that give away our age—and can start to show signs of aging even before our faces. As we age, our hands lose elasticity, and lost collagen can make veins, bones, and tendons appear more pronounced, while sun exposure can cause unsightly age spots or dark spots to develop.** ## What Is Hand Rejuvenation? Hand rejuvenation procedures are a popular way to correct common signs of aging in the hands. For men and women who want to maintain young-looking hands, the clinical team at the [Institute for Hand Surgery](https://newyorkhandandnerve.com/) at New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group is proud to offer a variety of advanced age-defying treatment options. Our treatments are designed to refresh and restore aging hands to achieve a more youthful appearance. During your consultation, we’ll discuss your concerns, evaluate your hands, and develop a custom hand rejuvenation treatment plan to achieve your cosmetic goals. ## Laser Treatment A common method of treatment that may be recommended to improve the skin of your hands is laser treatment. This can correct pigmentation and texture issues that develop over time from sun damage and the aging process, such as freckles, sun spots, brown spots, scars, and wrinkles. Our team offers both Intense Pulsed Light (IPL) therapy and Fraxel® laser skin resurfacing. - **Intensive Pulsed Light (IPL):** During an IPL treatment session, a handpiece sends pulses of light energy to the target area on the back of the hands. This energy passes through the skin and is absorbed by abnormal cells. Any blemishes on your skin should gradually begin to fade, improving skin tone. IPL also helps promote collagen growth and skin texture. - **Fraxel® Laser Resurfacing:** The Fraxel re:store™ laser uses fractional technology that sends laser energy beneath the skin’s surface. Damaged skin cells are destroyed, triggering your body’s reaction to heal the area and replace old cells with new, healthier tissue. Minimal downtime is typically needed after our laser treatments. Multiple sessions may be necessary to achieve the best possible outcome ## Fat Grafting & Injectable Fillers Injectable fillers formulated with hyaluronic acid or calcium hydroxyapatite are an effective way to plump the back of the hands and restore lost volume. In addition to dermal fillers like Radiesse® and Restylane® Lyft, our team also offers a more natural alternative known as fat grafting. Both of these options can provide very natural-looking results. - **RADIESSE®**: The first filler of its kind, Radiesse is FDA-approved to restore lost volume in the back of the hands. By placing small injections under the skin, the hands achieve a more supple appearance. Results from Radiesse have been shown to last for about 1-2 years. In addition to its immediate effects, the injectable stimulates collagen production for continued improvement. - **Restylane Lyft**: This hyaluronic acid (HA) gel injectable is used to add volume to the back of the hands. This dermal filler is designed to fill wrinkles and add fullness to aging hands for a more youthful appearance. Results from Restylane Lyft injections in the hands typically last about 6 months. - **Fat Grafting:** A more natural alternative, fat grafting, also referred to as fat transfer, involves taking a small amount of excess fat from one area of your body and transferring it into the back of your hands to correct the loss of volume. These fat injections help plump the hands where the skin has begun to thin, creating a natural-looking rejuvenation. Extra fatty tissue may be injected to help make up for the small amount that is naturally absorbed by the body over the first weeks. While results from injectable fillers can last for a year or longer, patients can choose to schedule follow-up treatments to maintain their soft, plump hand appearance. ## Schedule A Consultation For Hand Rejuvenation If you’d like to learn more about hand rejuvenation or other cosmetic treatments, including Botox, and more, please [contact us](https://newyorkhandandnerve.com/contact-us/) today. Our specialized plastic surgeons, along with the expert aesthetic team at The [Institute for Hand Surgery](https://newyorkhandandnerve.com/), are dedicated to superlative care and achieving the best individual results for each patient. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Tendonitis Overview [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/#skiptomaincontent) ## What Is Tendonitis? **Tendonitis is a condition in which the tissue that connects the bone to the muscle becomes inflamed or irritated. The stress on this tissue—called the tendon—can cause severe pain and make movement and function difficult or impossible. Tendonitis is commonly experienced in the hand, wrist, and forearm, making movements like grabbing and reaching difficult. Because these extremities are responsible for many necessary functions, living with tendinotis can prevent you from completing simple daily tasks and diminish your overall quality of life.** - [Hand (Trigger Finger)](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/#hand) - [Wrist (De Quervain’s Tendinosis)](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/#wrist) - [Forearm (Intersection Syndrome)](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/#forearm) ## Hand (Trigger Finger) Tendonitis of the hand is commonly referred to as “trigger finger” or “trigger thumb”—a condition marked by difficulty bending and straightening the fingers. This occurs when the tendon connecting the base of your finger and palm becomes swollen. While the exact cause of trigger finger is unknown, repetitive motions and forceful gripping has been known to cause tendon swelling in this area. Activities like playing an instrument, carpentry, gardening, or playing sports can increase the risk of tendinotis in the hand. Understand.com Player # Step 1: Introduction Trigger finger, also known as stenosing tenosynovitis, occurs when one of the tendons responsible for bending a finger or the thumb develops a thickening, known as a nodule, and inflammation in the tendon sheath. The thickened tendon and inflamed sheath can prevent smooth gliding during motion, resulting in a popping or catching sensation while attempting to extend the finger from the palm. The name trigger finger stems from the observation that the bent finger may suddenly release, similar to the trigger motion when firing a gun in which the pulled trigger tightens and suddenly releases right before firing. In severe cases, the finger may lock in a bent position and remain stuck in the palm despite attempts at straightening the finger. In some people, the finger becomes stuck firmly and requires using the opposite hand to straighten it. Trigger finger is a common hand condition among adults between 40 and 60 years of age and repetitive gripping and grasping is often the underlying cause of the condition. While the condition can occur throughout the day, it is often worse in the morning. Trigger finger occurs more frequently in women than men and in patients with diabetes, gout, kidney disease, and rheumatoid arthritis or other inflammatory conditions. # Step 2: Hand Anatomy and Trigger Finger The main force for the ability to bend, or flex, the fingers is provided by muscles in the forearm that connect to the finger bones with tough bands of tissue called tendons. Each finger has two flexor tendons and the thumb has one. The flexor digitorum superficialis flexes the middle finger joint. The flexor digitorum profundis controls flexion of the entire finger. The flexor pollicis longus controls thumb flexion. These tendons are enclosed in sheaths lubricated with synovial fluid. This allows the tendons to freely glide while holding them next to the bones of the finger. Normally the tendons glide smoothly through the sheaths as the fingers flex and extend. Thickenings of the sheath in five areas are referred to as annular pulleys, which are numbered A1 through A5. Trigger finger results from a widening of the flexor tendons from forceful gripping or finger flexion that causes bunching of the tendon fibers at the A1 tendon sheath pulley. Inflammation develops, causing the pulley to narrow, and the tendon catching worsens. The difference between the diameter of the tendon and the A1 pulley opening causes the tendon to catch, preventing smooth motion of the tendon pulling into the sheath during finger extension. # Step 3: Trigger Finger Symptoms, Diagnosis, and Treatment Trigger finger can vary in severity and duration. Milder cases may come and go, and may present only a minor annoyance from the catching sensation. However, in more severe cases, and in those that worsen over time, the condition may be painful and can cause difficulty releasing objects. The tendon may become stuck and won’t move through the pulley without effort to free it. Tenderness and swelling are often present in the palm in line with the affected finger. In addition to catching and pain, a palpable nodule is often observed. If the trigger finger exists for a significant period of time, joint stiffness may also occur. Trigger finger is typically diagnosed based on patient history and physical exams. X-rays are often obtained to assess for other joint conditions and lab tests may be ordered to check for underlying diseases such as rheumatoid arthritis, gout, or other inflammatory conditions. Rest, stretching, splinting, and anti-inflammatory medications may resolve the symptoms. For more significant triggering or pain, a steroid injection into the tendon sheath will often solve the problem. If one or two steroid injections do not resolve the problem, or if the triggering and pain return after a successful injection, the surgeon may recommend a procedure to release the tight A1 pulley. A procedure, commonly referred to as a Trigger finger release, is typically performed by making a small incision in the palm to access and release the A1 pulley by cutting it open. This allows the thickened tendon and nodule to move past the pulley without getting stuck. Because of the presence of the strong A2 pulley, releasing the A1 pulley has no negative effect on the motion or strength of your hand. An alternate method to release the A1 pulley is known as a percutaneous release. In this procedure either a small needle or small needle-like device is inserted into the skin and used to sever the A1 pulley. This method is not appropriate for all patients and your surgeon will recommend the procedure that is best suited for your specific condition. # Step 4: Trigger Finger Release Surgery Preparation Trigger finger release surgery, also known as an A1 Pulley Release, may be performed at a hospital, surgery center, or possibly in your surgeon's office. It is typically an outpatient procedure, so you will be allowed home after your surgery. Local, regional, or general anesthesia will be administered to prevent the sensation of pain. The hand will be cleansed and draped, and a tourniquet, which is similar to a blood pressure cuff, is applied to your arm or forearm to prevent bleeding during the procedure. Your hand will be positioned palm up and will be marked for the procedure. The incision location varies depending on the finger affected and the surgeon's preference. # Step 5: Open Trigger Finger Release Procedure A small incision is made in the skin. Regardless of the location and orientation of the incision, in most instances there is minimal scarring at the incision site. When possible, the surgeon may create the incision along a crease that will conceal the scar. After the incision is made, the tissues are gently spread down to the level of the flexor tendon sheath. The finger is flexed and extended to visualize the inflammation or nodule as it catches on the A1 pulley. The tissues are retracted away from the A1 pulley and it is carefully released by cutting it with either scissors or a knife. Once the pulley is opened, the surgeon will typically use an instrument to inspect the two flexor tendons by pulling them upwards out of the incision to confirm full finger flexion with no catching or locking. The surgeon may move the finger, or if you are awake during the procedure, ask you to move the finger to test that the tendons glide smoothly. To conclude, the wound is irrigated to remove any tissue residues and the tourniquet is released. A local anesthetic may be injected to minimize pain after the procedure and the incision is closed with a few sutures. Finally a bandage and dressing are applied. The open procedure takes roughly 15 minutes per affected finger to complete. # Step 6: Results and Recovery It may take several hours for the anesthetic to wear off and for feeling to return to your hand. Some pain following the procedure is normal but is often minimal due to the small incision and can usually be managed with over-the-counter pain relievers. You will likely be asked to keep the area clean and dry and to keep your hand elevated as much as possible for several days to minimize swelling. Bandages are generally removed after a few days and sutures are removed in one to two weeks based on healing. The incision will likely be pink or reddish in color as the tissues heal. It may also feel tender and firm for a few months after surgery. Your surgeon may encourage you to open and close the hand several times daily to avoid stiffness in the fingers. Trigger finger release surgery has a remarkably high success rate, and the majority of patients report excellent results with relieved pain and normal motion. menu Trigger Finger Release Content provided by **NYPlasticSurgical** together with 0:00 # NYPlasticSurgical's Note Step 1: Introduction Thank you for visiting our website and viewing our 3D Animation Library. These animations should assist you in better understanding your condition or procedure. We look forward to answering any additional questions you may have at our next appointment. 0:00 /8:24 5.0K views 2 likes Once the tendons in fingers become swollen, forcing the finger to flex will often cause a popping or snapping sound. Other symptoms of tendinotis in the hand may include: - Pain - Fingers “catching” when moved - Fingers locking - Restricted finger movement - Finger stiffness - Joint contractures ### Treatment With comprehensive treatment, painless movement of the fingers and thumbs can be achieved. Many times, swollen tendons in the hand can be addressed with non-surgical options, such as: - Night splints - Anti-inflammatory medication - Steroid injection - Limiting activities that trigger symptoms - Hand therapy If less invasive methods of treatment do not address your symptoms, a surgical procedure can be performed by one of our [New York hand surgeons](https://newyorkhandandnerve.com/about/) to open up the tendon sheath (layer covering the tendon), allowing for easier movement and helping the tendons in your hand glide more freely. While some stiffness may occur after surgery, physical hand therapy can help this area regain proper function. ## Wrist (De Quervain’s Tendinosis) When tendons on the thumb side of the wrist become swollen, the condition is commonly known as De Quervain’s tendinosis. The swelling of tendons in this area can make many thumb movements—such as grasping and twisting—very painful. While the cause of De Quervain’s tendinosis is generally unknown, the condition is often linked to overuse, repetitive motion, hormonal changes caused by pregnancy, and rheumatoid disease. Common symptoms may include: - Gradual or sudden pain in the thumb side of the wrist - Visible swelling in the area - The thumb “catching” or “snapping” when moved - Limited thumb mobility ### Treatment Treatment for tendinotis in the wrist can work to reduce the pain and irritation of the condition. Many non-surgical options have been known to address symptoms; however, in some cases, surgery may be necessary if there is no improvement or symptoms worsen. - **Non-surgical**—Wearing a splint can prevent you from moving your thumb and wrist, alleviating the pain of swollen tendons in that region. Anti-inflammatory pain medication can also effectively improve symptoms. The most common initial treatment for De Quervain’s is a steroid injection into the affected area. - **Surgical**—In some cases, surgery can open the thumb compartment to make more room for swollen tendons to pass through. If less invasive methods don’t help, your doctor can help you determine whether surgical treatment would benefit you. ## Forearm (Intersection Syndrome) Intersection syndrome is a condition commonly associated with tendinotis in the lower forearm, usually a few inches from the wrist. Swollen tendons in this area can no longer glide easily, causing pain when flexing, extending, and rotating the forearm. Any athletic or general activity that involves repetitive wrist flexing can cause intersection syndrome. Common symptoms of the condition may include: - Pain in the forearm - Tenderness in the area - Swelling - A squeaking or creaking sound when moving the wrist ### Treatment A physical examination or ultrasound may be necessary to distinguish intersection syndrome from De Quervain’s tendinosis, but the location of pain is usually a good indicator of your condition. In general, non-surgical treatment for tendon swelling in the forearm may include: - Wearing a splint to immobilize the lower thumb and wrist joints - Anti-inflammatory medication - Limiting activities that may aggravate symptoms - Steroid injection to decrease swelling If these methods fail to improve your symptoms, surgery may be recommended. Should this happen, our experienced reconstructive hand surgeons can determine the procedure that will most benefit you and create a treatment plan to address your unique needs. After surgery, physical hand therapy can help the area regain function, with full recovery generally expected in several weeks. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Nerve Injury Reconstruction [Skip to main content](https://newyorkhandandnerve.com/services/nerve/injury-secondary-reconstruction/#skiptomaincontent) ## What Is Nerve Injury? **Nerves are responsible for transmitting signals that control many vital functions, including touch, pain,  and movement. They are cable-like structures that send and receive messages between the brain to the rest of the body. Sensory nerves transmit signals from the skin, muscles, and other organs and relay them to the brain, where they are received and interpreted. Motor nerves travel from the brain to the muscles to control purposeful movements. Consequently, when a nerve is damaged or cut, the affected area can experience a partial or total loss of function and/or feeling. Left untreated, this can result in a complete inability to perform simple tasks or work-related duties, particularly if the injured nerves control hand or wrist motion. Living with an injured nerve can be very debilitating and lead to a diminished quality of life, making it crucial to seek proper care from a reconstructive hand surgeon as soon as symptoms begin to arise.** ## Signs & Symptoms The symptoms of an injured nerve vary depending on the type of nerve that was damaged and the severity of the injury. However, in general, common signs of a nerve injury include: - **Nerve Pain/Paresthesias**—A damaged nerve is often accompanied by sharp or aching pain at the point of injury. Burning pains, a pins and needles feeling, or electric shock-like sensations can travel anywhere up and down the length of the nerve. - **Numbness**—Because nerves provide sensory function, an injured nerve usually causes partial or complete numbness in the affected body part. - **Weakness**—Nerves also significantly impact motor function. When excessive pressure is placed on a nerve and it becomes injured, this stress disrupts the motor signals sent by the brain and the affected muscles can become weak. These symptoms can be felt constantly, intermittently, or solely when stretching the nerve or performing certain actions. Nerve-related symptoms can be vague and are often difficult to put into words. Ultimately, symptoms differ by patient and we offer many treatments to address each individual’s unique condition. ## Causes A nerve injury can result whenever there is too much pressure placed on the nerve, or the nerve is stretched or cut. This trauma disrupts the messages that are sent from the brain and can impede motion, function, and sensation. The amount of function that is lost, as well as the expected recovery, depends on the degree of injury to the individual nerve fibers. Penetrating injuries with a saw, knife, or glass anywhere in the arm can result in a nerve injury. Motor vehicle or motorcycle accidents can result in severe stretching of the nerves, or complete cutting of a nerve associated with a broken bone or broken glass. Crushing injuries can result in temporary or permanent nerve loss from pressure. Evidence is mixed about the association between nerve injury or dysfunction and some work-related activities, such as typing or light office work. Heavy vibrational activities or repetitive, stressful motions can result in chronic nerve compression like [carpal tunnel syndrome](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/). ## Treatment Some minor nerve damage will heal without intervention, but other more severe injuries—such as a cut nerve—typically require surgery. It is possible for damaged nerve fibers to regrow and allow for continued communication between the brain and body, but this process can take several months and will likely involve rehabilitative hand therapy or another form of supportive care. When a nerve is completely severed, surgery from one of our [reconstructive hand surgeons](https://newyorkhandandnerve.com/about/) will be utilized to carefully sew the nerve endings back together using special magnification and fine hair-like sutures to allow for regrowth to the muscle or skin. Depending on the details of your injury, this can help the area regain function and sensation. Nerve injuries have a varied potential for recovery based on the location, severity, and age of the patient. Our expert hand surgeons will take the time to educate you on the details of your injury and formulate a plan that will maximize your potential for recovery. ## Secondary Reconstruction Sometimes, the function lost with complex nerve injuries must be repaired or replaced by other means in order to truly restore lost function and/or sensation in a given region. This may involve replacing the damaged nerve with nerves from a less critical part of the body. For example, “donor nerves” can come from the side of the foot or another area that is deemed non-essential. Secondary reconstruction of a nerve can be accomplished in a variety of ways, including: - **Nerve grafting**: Nerve grafting is a surgical technique that uses a donor nerve from another part of the body to bridge or replace a gap in an injured nerve. The donor nerve is typically considered less important in its original location than the nerve that is being repaired. Processed cadaver nerves can also be used in many instances to eliminate any donor site problems. - **Nerve transfers**: A nerve transfer restores function by completely replacing an injured nerve with another nerve in close proximity to the target muscle or sensory area. The transferred nerve is “plugged” into the location of the injured nerve, and eventually the area is able to receive messages about sensation and function from the brain again. - **Tendon transfers**: When restoring the actual nerve input to an area is not possible, a tendon transfer is typically used to restore muscle function to a given area. It involves removing the end of a non-essential tendon, and transferring it to another location to perform another function. This technique is useful when the nerve can no longer be repaired, or the window for successfully repairing a nerve has passed. In some cases, an injury to a sensory nerve can cause a painful knot of nerve tissue to form — this is called a neuroma. Surgery can also be utilized to remove the nerve tissue and provide relief for painful symptoms caused by a neuroma. Nerve injuries are extremely complex and each case is different. The most beneficial approach to address your injury is typically chosen based on which technique offers the strongest chance of recovering function. Any surgery performed on the nerves is typically followed by a gradual recovery period while the damaged nerves regrow. Physical therapy after the operation can aid in the healing process and often helps individuals relearn new patterns of motion to minimize pressure on the treated nerve. While nerve injuries can be difficult to live with, our experienced hand surgeons can provide you with the necessary care to repair your injury and enhance your overall quality of life. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Sports Hand Injuries Q&A [Skip to main content](https://newyorkhandandnerve.com/sport-injuries/interview-brian-pinsky/#skiptomaincontent) April 26, 2018 ![](https://newyorkhandandnerve.com/wp-content/uploads/2018/04/LIPSG_Hand_Surgery_Sports_Injuries-1.jpg) ## Sports Related Hand Injuries: A Q&A With Dr. Brian A. Pinsky Brian A. Pinsky, MD, FACS [![](https://newyorkhandandnerve.com/wp-content/uploads/2018/04/Pinsky-thumb-144x150.png)](https://newyorkhandandnerve.com/about/#pinsky) is a board-certified plastic surgeon specializing in complex hand and wrist injuries at The Institute for Hand Surgery at Long Island Plastic Surgical Group. Dr. Pinsky also specializes in the treatment of rheumatoid arthritis, nerve injury, nerve compression, and Dupuytren’s contracture. In this discussion, Dr. Pinsky shares his knowledge and experience in the diagnosis and treatment of sports related hand injuries. #### What are some common sports injuries that you have seen involving the hand? Common sports injuries can be divided into acute traumatic injuries versus chronic overuse injuries. Injuries to the hand and wrist are common at any level of competition and at any age. Common sports injuries range from minor to more severe that require surgery. I just treated a 9 year old in the emergency room who had a broken finger from playing baseball. The most common traumatic injuries I see are broken bones, dislocation, sprains, ligament injuries, and things of that nature. #### How are sports hand injuries typically treated? With any injury, unless it’s obviously severe, basic first aid is the first step. This includes ice, compression, elevation, and splinting. A non-steroidal anti-inflammatory, such as Motrin or Aleve can be helpful with most musculoskeletal injuries. This can be done on scene by coaching staff and trainers. Athletes should seek proper follow up with their primary care physician, who can help triage the injury and refer to proper specialists if needed. Most minor sports injuries will resolve within 1-2 weeks – if the injury persists beyond that, be sure to seek advanced care. #### Any particular sports hand injury “case studies” you’d like to share? I often see patients who are hit on the tip of a finger with a line drive baseball, these types of hyperextension injuries often result in a broken bone. Cases like these are usually seen in the emergency room for proper and immediate treatment. Finger joint injuries are super common, also referred to as “stubbed” or jammed finger”. This injury occurs often in any type of contact sport that involves a ball. The injuries range from simple sprain to full dislocation in a more severe type of trauma. These injuries should also be treated with basic first aid. An obvious deformity would need immediate medical attention. However, if a finger is swollen and can move, it may resolve on its own over time. #### What advice do you have for athletes to avoid these types of hand injuries? Injuries are unavoidable, the important thing is that they are recognized and treated properly when they happen. Most of these injuries occur in childhood sports and adolescent activities. A professional competitive athlete has different demands, and needs different medical consideration. In general, there’s no harm in letting a 9 year old sit out of sports for 3 months while they heal. #### Any advice for parents or coaches? A lot of chronic overuse injuries occur specifically in pitchers and competitive gymnasts. If a chronic injury becomes severe enough, the health of the athlete should be the paramount consideration. Remember, athletics are supposed to be fun and fulfilling. The overwhelming majority of people who participate in sports will not likely pursue it as a professional career, so please don’t risk long-term consequences or disability by rushing recovery. ## Contact Us The highly experienced surgeons at The Institute for Hand Surgery at Long Island Plastic Surgical Group utilize advanced training and expertise to treat injuries and conditions of the hand, upper extremity, and peripheral nervous system. Contact us to learn more or schedule a consultation. [Next Post](https://newyorkhandandnerve.com/peripheral-nerve/studies-show-significant-effectiveness-of-migraine-surgery/) [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Peroneal Nerve Entrapment [Skip to main content](https://newyorkhandandnerve.com/peroneal-nerve-entrapment-foot-drop/#skiptomaincontent) ## What Is Peroneal Nerve Entrapment? **The peroneal nerve is a branch of the sciatic nerve in the posterior thigh that runs around the outside of the knee over the head of the fibula bone. The nerve has deep and superficial branches. These branches provide sensation to the front and lateral side of the lower leg and top of the foot, as well as control the muscles of the leg that lift the ankle and toes upward (dorsiflexion). Patients with damage or injury to the peroneal nerve will most commonly experience the inability to raise their foot and difficulty walking. Other symptoms may include:** - Pain - Numbness of the top of the foot or outer lower leg - Weakness of the foot or ankle - Foot drop - Loss of muscle mass in the leg - Toes drag while walking or “slapping” gate Peroneal nerve entrapment can develop with trauma or injury to the knee or fracture of the fibula bone. Other potential causes are tight casts or boots, pressure to the outer leg during sleep or surgery, and systemic conditions such as diabetes, Charcot-Marie-Tooth, and other autoimmune neuropathies. ## Treatment for Peroneal Nerve Entrapment Diagnosing peroneal nerve entrapment will begin with a physical exam and imaging tests such as an MRI or ultrasound. Most patients will require a nerve conduction study and EMG to confirm the diagnosis. To relieve pressure on the peroneal nerve, such options may include: - Avoiding pressure to the area with knee padding and avoid leg crossing - Physical therapy - Steroid injection to reduce inflammation - Prescription medication to help with nerve pain if present - Surgery to release the compressed nerve, especially when muscle weakness or difficulty walking is present Regardless of the cause, the [reconstructive surgeons](https://newyorkhandandnerve.com/about/) at our practice will develop an individualized treatment plan to help maximize your recovery. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Thumb Pain Treatment [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-pain/#skiptomaincontent) Thumb pain, which is often both uncomfortable and distracting, can be caused by a variety of conditions. To determine what’s causing your pain, we must first begin with where the discomfort is coming from, how often it hurts, and what type of pain you are experiencing. A treatment plan for thumb pain will often depend on the condition or cause of the pain. For some patients, consistent thumb pain may be an indication of an underlying condition like arthritis or tendonitis. During your consultation, our experts will determine which course of action will be needed to relieve your discomfort and best treat your symptoms. This can include a combination of therapy, injections, splinting, anti-inflammatory medication, or surgery. ## Treat Thumb Pain In Long Island and New York The Institute for Hand Surgery at New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group offers comprehensive clinical care for conditions affecting the hands, peripheral nervous system, and upper extremities. Our [surgeons](https://newyorkhandandnerve.com/about/) specialize in hand and upper extremity disorders and are dedicated to helping patients restore the function of their hands with the most advanced surgical techniques. If you’re experiencing pain in your thumb or have questions about treatment options, please [contact us](https://newyorkhandandnerve.com/contact-us/) to schedule an appointment. Keep reading to learn more about the most common types of thumb pain, the common causes of thumb pain, as well as how we diagnose and treat thumb pain to improve our patients’ overall quality of life. ## Types of Thumb Pain Pain in specific areas of the thumb often indicates different conditions. For example: ### Thumb Knuckle Pain Thumb knuckle pain may be caused by a jammed thumb, a sprained knuckle, [carpal tunnel syndrome](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/), [trigger thumb](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/#hand), or basal joint arthritis. Thumb knuckle, or joint pain has many different causes depending on which joint is involved. Pain in the base of the thumb, or CMC joint is most often caused by nasal joint arthritis but can be injured in trauma such as a bicycle accident or car accident. Other common causes of thumb pain are a sprained knuckle from a fall or [trigger thumb](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/#hand), also known as tenosynovitis. ### Thumb Pad Pain Thumb pad pain can often indicate arthritis (basal joint or other), carpal tunnel syndrome, or soft tissue injury. ### Thumb & Wrist Pain Thumb and wrist pain may be caused by carpal tunnel syndrome, [arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/) (basal joint or other), or [De Quervain’s tenosynovitis](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/#wrist). ## Common Causes of Thumb Pain ### Thumb Arthritis As we age, the cartilage that forms a cushion inside the thumb joint can break down resulting in arthritis in the thumb. Arthritis is often characterized by an aching, stabbing, or burning pain, tenderness, stiffness, and swelling.1 Other symptoms may include decreased range of motion and the loss of grip strength. Thumb arthritis may be indicative of rheumatoid arthritis, which is an autoimmune inflammatory condition, or osteoarthritis, which mechanically affects the bones and joints. ### De Quervain’s Tenosynovitis Inflammation located where the thumb meets the wrist over the styloid process of the radius bone can indicate De Quervain’s tenosynovitis.2 This condition affects the tendons running from the thumb to the wrist and can cause pain when grasping, making a fist, or turning the wrist. While the exact cause of tenosynovitis isn’t known, repetitive wrist and/or hand movements like holding a video game controller can make the condition worse. For this reason, it is often referred to as “gamer’s thumb”. ### Trigger Thumb Trigger thumb, or stenosing tenosynovitis, is a condition that may result in pain, clicking, locking, or minimal movement of the thumb tendon, and may affect people with pre-existing underlying conditions such as arthritis or diabetes. Trigger thumb is caused by inflammation of the tendon in the thumb and thick ending of the tendon sheath. There may be a sensation of catching or locking when straightening and bending the thumb, as well as stiffness, and pain. ### Break, Sprain or Injury An injury resulting in damage to the ligaments in your thumb can cause thumb sprains, “skier’s thumb,” or a jammed thumb. Typically caused during falls or contact sports, this type of injury often creates localized pain at the thumb joint, as well as stiffness, and swelling. Your thumb may also be in pain if it’s broken. If the thumb is broken, it’s common to experience an intense radiating pain from the location of the fracture. ## Thumb Pain Diagnosis The Institute for Hand Surgery at New York Plastic Surgical Group can diagnose the cause of thumb pain in a variety of ways, depending on your symptoms, medical history, and lifestyle. The most common methods we use to diagnose thumb pain include: - X-ray - Nerve test - Ultrasound - MRI ## Thumb Pain Treatment If thumb pain is affecting your life, we offer a range of medical treatments that can reduce or eliminate your discomfort. Depending on the condition that is causing thumb pain, treatment may include: - Steroid injections - Physical therapy - Pain relievers (such as topical analgesics or prescription medication) - Surgery ## Schedule A Consultation To Treat Thumb Pain If you are experiencing recurrent pain in your thumb, that limits your daily activities or otherwise affects your life, we can help. [Contact us](https://newyorkhandandnerve.com/contact-us/) today to schedule an appointment to speak with one of our hand and wrist specialists. We are dedicated to helping each patient live their best, pain-free life. 1 Mayo Clinic. Thumb arthritis. Available: [https://www.mayoclinic.org/diseases-conditions/thumb-arthritis/symptoms-causes/syc-20378339](https://www.mayoclinic.org/diseases-conditions/thumb-arthritis/symptoms-causes/syc-20378339). Accessed October 6, 2021. 2 Mayo Clinic. De Quervain’s tenosynovitis. Available: [https://www.mayoclinic.org/diseases-conditions/de-quervains-tenosynovitis/symptoms-causes/syc-20371332](https://www.mayoclinic.org/diseases-conditions/de-quervains-tenosynovitis/symptoms-causes/syc-20371332). Accessed October 6, 2021. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Vascular Malformations Overview [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/vascular-malformation/#skiptomaincontent) ## What Are Vascular Malformations? A vascular malformation is a non-cancerous growth caused by abnormalities in the blood vessels. Vascular malformations are often congenital, meaning they are present at birth, but they can also be acquired, meaning that they develop later in life, often as the result of an injury or trauma. Successful treatment of vascular malformations involves multidisciplinary care; when they occur in the upper extremities, hand and arm surgeons need the diagnostic resources and specialized experience to choose the best treatment option for each individual patient. The highly skilled surgeons at The Institute for Hand Surgery at New York Plastic Surgical Group, a division of Long Island Plastic Surgical Group are experienced in treating vascular malformations. Their extensive training gives them the unique knowledge needed to restore form and function for patients with vascular malformations.1 ## Types of Vascular Malformations Vascular malformations are categorized based on the component type of involved structures, as well as the type of blood flow. Types of vascular malformations include: - Capillary malformations involve capillary vessels and are commonly called port wine stains. They affect approximately .5% of the population.2 - Venous malformations are fairly common growths of veins that may have a bluish color and are usually present at birth and continue to grow if left untreated. - Arteriovenous malformations involve arteries and veins without capillaries. - Lymphatic malformations are relatively rare abnormalities which involve only lymph vessels. - Veno-lymphatic malformations involve both veins and lymph vessels. - Hemangiomas These benign vascular tumors are red bumps caused by a clump of abnormal blood vessels that grow rapidly in the first three months. They are common in young children and infantile hemangiomas are the most common congenital vascular malformation.3 ## Causes of Vascular Malformations Many vascular malformations are congenital and do not have a known cause. Some types, such as hemorrhagic telangiectasia, are hereditary. Other types may be associated with rare genetic conditions, such as Klippel-Trenaunay syndrome, Parkes-Weber syndrome, Maffucci’s syndrome, CLOVES syndrome, and Kasabach-Merritt phenomenon (KMP).456 Occasionally, a vascular malformation may be the result of an injury. ## Symptoms of Vascular Malformations Vascular malformations can vary greatly in symptoms, depending on the location, size and type of the growth. Some common symptoms include: - Abnormally enlarged digit or extremity - Cold intolerance - Increased temperature and hair growth - Infection - Numbness or paresthesias from nerve compression - Pain - Swelling - Visibly enlarged blood vessels - Ulceration - Bleeding ## Diagnosing Vascular Malformations Some types of vascular malformations can be diagnosed upon sight, but most require testing to confirm a diagnosis. Tests such as ultrasound, X-ray, MRI with or without contrast, and angiogram or CT angiogram may be used. ## Treating Vascular Malformations There is no one-size-fits-all treatment for vascular malformations. Treatment plans must be tailored to appropriately address the type of growth, as well as the location and the severity of symptoms. Small or early stage vascular malformations may be treated with a compression garment. Other treatment methods include surgical removal, surgical debulking, or partial excision. Sclerotherapy, an injectable treatment, may be used alone or in combination with surgical excision. In rare and severe cases, amputation may be necessary. Our team is committed to restoring function and providing aesthetic improvement through the most advanced and minimally invasive treatment options. [Contact us](https://newyorkhandandnerve.com/contact-us/) with any questions about vascular malformations of the hand, arm, and upper extremities. ### Vascular Malformation of the Hand—One LIPSG Patient’s Story When a young woman came to the The Institute for Hand Surgery at NYPS Group with a painful mass growing in her hand, our surgeons were ready to help her. Her vascular malformation had been recognized several years earlier, but had ballooned in size and scope while left untreated. Her NYPS Group surgeon was able to remove the mass and she recovered full function and returned to work within a year of surgery. ### **Surgical Photos** _WARNING these photos are graphic, if you are squeamish, do not click_ [View Photos](https://newyorkhandandnerve.com/services/hand-upper-extremity/vascular-malformation/#) ![](data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20width='300'%20height='225'%20viewBox='0%200%20300%20225'%3E%3C/svg%3E)![](data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20width='300'%20height='225'%20viewBox='0%200%20300%20225'%3E%3C/svg%3E)![](data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20width='300'%20height='225'%20viewBox='0%200%20300%20225'%3E%3C/svg%3E)![](data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20width='300'%20height='225'%20viewBox='0%200%20300%20225'%3E%3C/svg%3E) 1 Balakrishnan G. Vascular anomalies of the upper limb. Indian J Plast Surg. 2011;44(2):276-282. doi:10.4103/0970-0358.85349 2 Cox JA, Bartlett E, Lee EI. Vascular malformations: a review. _Semin Plast Surg_. 2014;28(2):58-63. doi:10.1055/s-0034-1376263 3 Richter GT, Friedman AB. Hemangiomas and vascular malformations: current theory and management. Int J Pediatr. 2012;2012:645678. doi:10.1155/2012/645678 4 Mahajan P, Margolin J, Iacobas I. Kasabach-Merritt Phenomenon: Classic Presentation and Management Options. Clin Med Insights Blood Disord. 2017;10:1179545X17699849. Published 2017 Mar 16. doi:10.1177/1179545X17699849 5 Asilian A, Kamali AS, Riahi NT, Adibi N, Mokhtari F. Proteus Syndrome with Arteriovenous Malformation. Adv Biomed Res. 2017;6:27. Published 2017 Mar 7. doi:10.4103/2277-9175.201684 6 Jacobs BJ, Anzarut A, Guerra S, Gordillo G, Imbriglia JE. Vascular anomalies of the upper extremity \[published correction appears in J Hand Surg Am. 2011 Jan;36(1):183. Guerra, Sara \[added\]; Gordillo, Gayle \[added\]\]. J Hand Surg Am. 2010;35(10):1703-1709. doi:10.1016/j.jhsa.2010.08.005 [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Dupuytren's Contracture Overview [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/dupuytrens-contracture/#skiptomaincontent) ## What Is Dupuytren’s Contracture? **Dupuytren’s contracture occurs when the tissue below the skin of the palm begins to thicken. If you suffer from this [hand condition](https://newyorkhandandnerve.com/services/hand-upper-extremity/), you will most likely notice bumps, thick cords, and indentations in your palm. Dupuytren’s contracture can also cause the fingers to bend towards the palm, as well as affect the knuckles and bottoms of the feet.** ## Signs & Symptoms Those living with Dupuytren’s contracture often have it in both hands, which may have slightly different symptoms. One of the first signs that people notice are lumps and bumps in the palm. As the condition becomes more advanced, patients lose the ability to place their hand flat on a table due to the fingers being pulled into the palms. Other signs of the condition can be seen below: - Deep creases in the palm of the hand - Hard, uncomfortable bumps that are stuck under the skin of the palm - Curling fingers (especially the small and ring fingers) - Weakened hand grip Every case of Dupuytren’s contracture varies and progresses at a different rate. Some people only experience small bumps and cords on their hands, which may never worsen. Others have severe curling of their fingers and find everyday activities to be difficult, like washing the hands, shaking hands with others, and putting on gloves. ## Causes Dupuytren’s disease is a genetic condition, but the exact cause for developing Dupuytren’s contracture is unknown. However, if you identify with one of the following, you may be have a higher risk of developing it in the future: - Family history of the disease - Male - 40 years or older - Northern European descent While there are different theories as to what actually leads to Dupuytren’s contracture, there is no definitive evidence of these claims. There is likely an interaction between your genetic history and environmental exposure such as trauma or surgery to the hands. ## Treatment Treatment for Dupuytren’s contracture can range from simple observation to surgery, depending on how severe the case is. Since pain is rare, the main goal of treatment is to help the hand function like normal again. In mild cases, the disease may only need to be monitored, and it may not end up worsening. In more severe cases, treatment may include one of the following options to help straighten the fingers: - Needles - Injected medicines - Surgery When you visit the Institute for Hand Surgery at New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group, one of our experienced surgeons will recommend the best solution for your condition, taking into account the stage of your Dupuytren’s contracture and the joints affected. We will develop a personalized treatment plan that best suits your individual goals. We will help you understand what to realistically expect, including possible risks associated with the treatment. After your treatment, you may need to wear a splint and undergo hand therapy to maintain the improved function of your fingers. Unfortunately, even with treatment, Dupuytren’s contracture may come back. Should this happen, your [reconstructive hand surgeon](https://newyorkhandandnerve.com/about/) will create a new treatment plan to increase your chances of proper hand and finger function in the long run. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Skin Cancer Overview [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/skin-cancers/#skiptomaincontent) ## What Is Skin Cancer? **Skin cancer is the most common type of cancer, with millions of people in the U.S. being diagnosed each year. The hands are especially vulnerable since they are frequently exposed to  the sun’s harmful UV rays—a leading cause of skin cancer. By taking the proper precautions to prevent the disease, catching it early, and seeking treatment right away, you are taking an important step towards protecting your overall health. If you have noticed an abnormal growth or mole developing on skin of your hand(s) or upper extremities, schedule a consultation with one of our [New York hand surgeons](https://newyorkhandandnerve.com/about/) to learn if it may need to be removed.** ## Types of Skin Cancer Skin cancer is present when the skin cells begin to change and continue to grow in an abnormal way. This leads to a dangerous tumor developing, and if left untreated, these cells can spread across your skin and eventually into your organs (metastasis). The most common types of skin cancer include: - Squamous cell carcinoma - Basal cell carcinoma - Melanoma More rare types can include Kaposi’s sarcoma, dermatofibrosarcoma protuberans, sweat gland tumors, and Merkel cell carcinoma. ## Signs & Symptoms Depending on the type of skin cancer you have, your hands may exhibit slightly different symptoms. **Squamous cell carcinoma (SCC):** In SCC the affected area typically looks brown or tan and has a scaly, crusty texture. This rough top layer of skin can create a cone-like bump (cutaneous horn) and lead to bleeding and ulcers. This skin cancer type is often mistaken for a harmless wound that won’t heal. In some patients, the cancer can grow into a large, mushroom-like patch. Those with SCC have a risk of their cancer spreading to their lymph nodes and other areas of the body. **Basal cell carcinoma:** These cancerous growths look like a small, defined bump that has a clear, shiny border. They can be flesh-colored, pink, red, or blue. Just like SCC, basal cell carcinomas can turn into an ulcer that won’t heal. However, this type of skin cancer tends to get worse at a slower rate, and rarely spreads throughout the body. **Melanoma:** Melanomas look like moles or dark spots and have five main characteristics, also known as the ABCDEs. A is for irregular shape or _asymmetry_. B is for irregular _border._ C is for a variety of _colors._ D is for a _diameter_ larger than 6mm, and E is for an _evolving_ appearance. If you notice a mole having any of these qualities or changing in size, color, or shape with time, you should contact your doctor or dermatologist to schedule a physical exam. ## Causes The three main types of skin cancer—squamous cell carcinoma, basal cell carcinoma, and melanoma—have been linked to a number of potential causes. - Frequent exposure to the sun - Fair or light skin - Immune system that doesn’t work properly - Having been exposed to radiation - Coming in contact with certain chemicals - Certain genetic conditions You are at a higher risk of melanoma, specifically, if you have a family history of the condition, certain types of moles, actinic keratosis, cutaneous horns, or Bowen’s disease. ## Prevention Being proactive with skin cancer prevention is the best possible way to avoid its dangerous effects. You should wear sunscreen and protective clothes when in the sun, avoid dangerous chemicals (like arsenic), regularly check your skin with a doctor, and monitor any abnormal changes. ## Treatment The best treatment for your skin cancer will depend on where it’s located, how large it is, and the nature of the growth. To learn if you have skin cancer, you must first schedule an appointment with your doctor to get your skin inspected. **Skin Exam:** During this visit, your doctor will go over your history and perform a skin exam. If any areas look abnormal, a sample of the tissue may be taken (biopsy) to get tested for abnormal cells. Should there be any concern over a cancerous growth spreading in the body (metastasis), your doctor may recommend a CT or PET scan. **Surgical Removal:** If you receive a skin cancer diagnosis, you will be recommended the best form of treatment for your specific type of skin cancer. Wide excision with removal of the cancer and a margin of normal skin surrounding the area is usually the main part of treatment for any type of skin cancer. If it is a small lesion, this can often be removed with little to no scarring. If it is a larger concern that extends under the skin, a more involved surgery may be needed. Depending on the extent of your condition, radiation and/or chemotherapy may also be recommended. Melanomas often require a lymph node biopsy at the time of cancer removal. **Reconstruction:** Although cancerous skin cells can often be completely removed, additional care may be needed to improve the appearance and function of the area, or close wounds related to cancer removal. Our expert plastic and reconstructive hand surgeons can perform additional treatment to help fade significant scars and restore the structure of the area with a skin flap or skin graft as needed. We offer comprehensive treatment of skin cancer and work with other expert dermatologists, pathologist, medical and surgical oncologists to develop a comprehensive treatment plan for each patient. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Ganglion Cysts Overview [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/ganglion-cysts/#skiptomaincontent) **Ganglion cysts are benign lumps on the hands or wrists, and are asymptomatic for many patients. In other patients, however, a ganglion cyst may cause discomfort or problems with the way a joint functions.** **Before proper ganglion cyst treatment was widely available, people commonly tried to treat them by hitting them with a heavy book. This earned the nickname “bible bumps.” Fortunately, the experienced hand and wrist surgeons at the Institute for Hand Surgery at New York Plastic Surgical Group offer a range of effective treatment options for ganglion cysts for patients throughout the Long Island and New York areas.** - [What is a Ganglion Cyst?](https://newyorkhandandnerve.com/services/hand-upper-extremity/ganglion-cysts/#what) - [Ganglion Cyst Causes](https://newyorkhandandnerve.com/services/hand-upper-extremity/ganglion-cysts/#causes) - [Ganglion Cyst Symptoms](https://newyorkhandandnerve.com/services/hand-upper-extremity/ganglion-cysts/#symptoms) - [Ganglion Cyst Treatment: What to Expect](https://newyorkhandandnerve.com/services/hand-upper-extremity/ganglion-cysts/#expect) - [Preparing for Treatment](https://newyorkhandandnerve.com/services/hand-upper-extremity/ganglion-cysts/#preparing) - [Non-Surgical Treatment of Ganglion Cysts](https://newyorkhandandnerve.com/services/hand-upper-extremity/ganglion-cysts/#non-surgical) - [Ganglion Cyst Removal](https://newyorkhandandnerve.com/services/hand-upper-extremity/ganglion-cysts/#removal) - [Frequently Asked Questions About Ganglion Cysts](https://newyorkhandandnerve.com/services/hand-upper-extremity/ganglion-cysts/#faq) ## What is a Ganglion Cyst? Ganglion cysts are non-cancerous fluid-filled lumps or bumps that form on the end of stalks rising out of joints, joint linings, ligaments, or tendon sheaths. These mucous cysts are the most common cause of lumps on the hands or fingers. Ganglion cysts appear most frequently on the back of the wrist, but can also form on the underside of the wrist, fingers, elbows, and feet. Ganglion cysts may range in size from pea-sized to larger, and may change size over time. They may often seem to disappear or reappear.1 ## Ganglion Cyst Causes The exact cause of ganglion cysts is unknown. It is believed that these cysts form after arthritis or multiple small traumas to the area cause fluid to leak from a joint or tendon. This excess fluid leads to swelling under skin, forming a fluid-filled bump or lump.2 ## Ganglion Cyst Symptoms A ganglion cyst may or may not be painful. They appear as round or oval lumps on the wrist, back of the hand, palm, or fingers and can vary in firmness from very soft to very firm depending on their location. Symptoms of a ganglion cyst may include: - Tenderness to the touch - Pain - Depressions or grooves in the fingernails - Thin, stretched skin - Leaking of thick, jelly-like fluid3 ## Ganglion Cyst Treatment: What to Expect ## Preparing for Treatment If you have a lump growth on your hand, fingers, or wrist, the first step towards treatment is to schedule a consultation with an experienced plastic surgeon at the Institute for Hand Surgery at NYPSG. During this appointment, you will undergo a brief examination by one of our hand and nerve experts, which may include shining a light on the growth as well as imaging tests such as X-ray or MRI. If you are diagnosed with a ganglion cyst, your doctor will discuss your treatment options with you. ## How is a Ganglion Cyst Treated? In many patients, ganglion cysts cause no symptoms and may even go away on their own. However, if a ganglion cyst becomes a cosmetic concern, is causing pain or numbness, or impacts joint movement, treatment is necessary. ### Non-Surgical Treatment of Ganglion Cysts Non-surgical treatment of a ganglion cyst may involve: - Observation - Aspiration: draining the cyst of fluid - Immobilization: restricting movement with a brace or splint ### Surgical Removal of Ganglion Cysts In cases where a ganglion cyst does not adequately respond to non-surgical treatment or is impinging on a nerve, the cyst may need to be treated surgically. During ganglion cyst removal, or excision, the entire cyst is removed in addition to the stalk that connects the cyst to the joint or tendon. In some cases, this involves removing a portion of the joint capsule or tendon sheath so that the entire root of the cyst is removed.4 ### Recovery After Ganglion Cyst Removal Following ganglion cyst removal surgery, patients recover briefly at our surgical center before returning home. It is normal to experience discomfort and swelling after the procedure, and patients need to restrict use of the affected hand and wrist for 2 to 6 weeks. ## Frequently Asked Questions About Ganglion Cysts ### Who gets ganglion cysts? Anyone can get a ganglion cyst, but some people are more likely to develop them than others. Risk factors for ganglion cysts include: - Age: ganglion cysts are more common in patients between the ages of 15 and 40 - Gender: women are more likely to develop ganglion cysts - Previous injury to a joint or tendon - Arthritis5 ### Will my pain go away after ganglion cyst removal? Patients often experience rapid relief after they have recovered from ganglion cyst removal surgery, especially if the cyst was impinging on a nerve. ### Will my ganglion cyst come back after surgery? Surgical removal of ganglion cysts is very effective. However, there are infrequent cases where a ganglion cyst comes back after surgery. If a ganglion cyst returns, a hand surgeon from our team will perform revision surgery. ## Contact Us If a ganglion cyst is causing you concern or discomfort, [contact](https://newyorkhandandnerve.com/contact-us/ "Contact Us") our hand and nerve experts to schedule a consultation and learn more about your treatment options. 1 Mayo Clinic. Ganglion Cyst. Available: [https://www.mayoclinic.org/diseases-conditions/ganglion-cyst/symptoms-causes/](https://www.mayoclinic.org/diseases-conditions/ganglion-cyst/symptoms-causes/syc-20351156). Accessed May 24, 2023. 2 Gregush RE, Habusta SF. Ganglion Cyst. \[Updated 2022 Jul 18\]. In: StatPearls \[Internet\]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available: [https://www.ncbi.nlm.nih.gov/books/NBK470168/](https://www.ncbi.nlm.nih.gov/books/NBK470168/). Accessed May 24, 2023. 3 American Society for Surgery of the Hand. Ganglion Cyst. Available: [https://www.assh.org/handcare/condition/ganglion-cyst](https://www.assh.org/handcare/condition/ganglion-cyst). Accessed May 24, 2023. 4 American Academy of Orthopaedic Surgeons. Ganglion Cyst of the Wrist and Hand. Available: [https://orthoinfo.aaos.org/en/diseases–conditions/ganglion-cyst-of-the-wrist-and-hand/](https://orthoinfo.aaos.org/en/diseases--conditions/ganglion-cyst-of-the-wrist-and-hand/). Accessed May 24, 2023. 5 American Academy of Orthopaedic Surgeons. Ganglion Cyst of the Wrist and Hand. Available: [https://orthoinfo.aaos.org/en/diseases–conditions/ganglion-cyst-of-the-wrist-and-hand/](https://orthoinfo.aaos.org/en/diseases--conditions/ganglion-cyst-of-the-wrist-and-hand/). Accessed May 24, 2023. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Ulnar Tunnel Syndrome Overview [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/ulnar-tunnel/#skiptomaincontent) ## What Is Ulnar Tunnel Syndrome? **The ulnar nerve is one of three major nerves in the peripheral nervous system that give your arm the ability to move and feel. This nerve starts at the [brachial plexus](https://newyorkhandandnerve.com/services/nerve/brachial-plexus-complex-neurologic-trauma/) and passes down the arm through the wrist and into the little finger (pinky) and small muscles of the hand. It controls feeling and movement in your ring finger and small finger, and is also responsible for controlling fine movement of the small muscles in your hand.** **Ulnar nerve syndrome occurs when the ulnar nerve is compressed as it crosses the wrist into the hand (Guyon’s canal).** ## Signs & Symptoms Symptoms of ulnar nerve syndrome typically develop over time and can often be worse in the morning. The most common signs that the syndrome has occurred include: - Numbness in the ring and little fingers - Tingling - Weakness - Difficulty grasping objects - Pain in the ring finger, little finger, and/or the wrist ## Causes The most common cause of ulnar tunnel syndrome is the presence of a ganglion cyst, which is a fluid-filled cyst that develops from the wrist joint. Ulnar tunnel syndrome can also result from repetitive use or overuse. This tends to happen from using vibrating tools that cause the surrounding tissue to swell or from constant pressure on the palm of the hand, such as in activities like weightlifting or cycling. Other possible causes of ulnar tunnel compression can include wrist injuries and arthritis. The cause of your ulnar tunnel syndrome, such as from repetitive use versus extended pressure on the palm, will help your doctor find the most beneficial treatment option for your specific needs. ## Treatment Treatment for ulnar tunnel syndrome will depend on where the compression is occurring—in the wrist or the elbow. Your [reconstructive hand surgeon](https://newyorkhandandnerve.com/about/) will perform a physical exam to evaluate the arm, which will include evaluating for symptoms like muscle weakness and tingling. Diagnostic tests like X-rays, MRIs, nerve conduction studies may be utilized as well to make sure other problems are not contributing to your symptoms. It is not uncommon for [carpal tunnel syndrome](https://newyorkhandandnerve.com/services/nerve/carpal-tunnel/) to occur at the same time as ulnar tunnel syndrome. For mild cases of the condition, our surgeons will first recommend a non-surgical approach that may help relieve symptoms. These methods typically include the following: - Avoiding or modifying the activity that is causing symptoms - Splinting the wrist to limit movement - Anti-inflammatory medications to aid with symptoms Should these conservative options not resolve your symptoms, outpatient surgery may be your best option for restoring optimal function. Surgery typically involves relieving the pressure on the ulnar nerve and/or removing any cysts or other soft tissue growths causing the compression. The ligament covering the Guyon’s canal may be cut to further help with pressure relief. Symptoms should gradually fade after surgery. As the nerve heals over the course of several months, your surgeon will advise on post-operative care instructions, including physical therapy to rehabilitate the use of your wrist and hand. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Thumb Arthritis Overview [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/#skiptomaincontent) ## What Is Thumb Arthritis? **Thumb arthritis is a very common condition that can cause pain and even limit a person’s ability to engage in normal daily activities. The hand and nerve specialists at Institute for Hand Surgery at New York Plastic Surgical Group, a division of Long Island Plastic Surgical Group, offer a full range of thumb arthritis treatments to help patients find relief.** - [What is Thumb Arthritis?](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/#arthritis) - [Thumb Arthritis Causes](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/#causes) - [Thumb Arthritis Symptoms](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/#symptoms) - [Thumb Arthritis Treatment: What to Expect](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/#treatment) - [Preparing for Treatment](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/#preparing) - [How is Thumb Arthritis Treated?](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/#treated) - [Non-Surgical Treatment of Thumb Arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/#nonsurgical) - [Surgery for Thumb Arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/#surgery) - [Recovery After Thumb Arthritis Surgery](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/#recovery) - [Frequently Asked Questions About Thumb Arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/#faqs) ## What is Thumb Arthritis? Arthritis is a condition that affects the joints, which are located at the junction where two bones meet. The ends of each bone are covered by a smooth layer of cartilage, which prevents friction so the joint can move smoothly. The most common form of arthritis, osteoarthritis (OA), happens when the cartilage becomes degraded or wears away. This is frequently a result of wear and tear, but may also be caused by trauma or injury, systemic disease, or other factors.1 In the thumb, arthritis most commonly develops in the joint at the base of the thumb. This may be referred to as the basal joint or the thumb carpometacarpal (CMC) joint. This joint, located beneath the fleshy part of the thumb near the wrist, makes it possible for the thumb to pinch, swivel, and pivot. The CMC is a saddle joint where the stability is maintained mostly from the surrounding joint capsule and ligaments. This is essential for mobility, but makes it less stable by nature. Because the CMC joint is subject to so much use, it is very susceptible to the development of osteoarthritis. ## Thumb Arthritis Causes The most common cause of thumb arthritis is wear and tear, so this condition is most likely to appear later in life. The thumb is used to perform countless daily tasks, so everyone is vulnerable to developing osteoarthritis of the thumb. However, some people are at a higher risk for developing basal joint arthritis. Risk factors for thumb arthritis include: - Age: this condition most commonly appears in people over the age of 40 - Gender: females are more likely to develop thumb osteoarthritis - Hereditary conditions that affect the joints - Obesity - Previous thumb injuries - Rheumatoid arthritis - Frequent use of the thumb joint, such as for an occupation or sport2 ## Thumb Arthritis Symptoms Symptoms of thumb arthritis include: - Pain - Swelling - Inflammation - Stiffness - Loss of strength - Difficulty grasping objects - Decreased range of motion - Bony or enlarged appearance of the CMC joint ## Thumb Arthritis Treatment: What to Expect ### Preparing for Treatment If your thumb joint is swollen and painful, the first step to finding relief is to attend a consultation with a fellowship trained hand surgeon who specializes in the treatment of hand and wrist conditions at the Institute for Hand Surgery at NYPS Group. Here, you will undergo a physical examination and your hand doctor may also order X-rays or other imaging tests before discussing your treatment options with you. ### How is Thumb Arthritis Treated? Treatment for thumb arthritis is dependent on the severity of a patient’s symptoms and the extent to which thumb arthritis impacts their daily activities. #### Non-Surgical Treatment of Thumb Arthritis Many patients find adequate relief from their basilar thumb arthritis symptoms through non-surgical treatment. This may include: - Ice or heat - Over-the-counter anti-inflammatory medication (which can also provide pain relief) - Steroid injections - Immobilization (splinting) #### Surgery for Thumb Arthritis Thumb arthritis surgery may be performed when all non-surgical treatment options have been exhausted. There are a number of surgical options for patients with arthritis of the thumb: - Joint fusion - Thumb joint reconstruction - [Thumb joint replacement](https://newyorkhandandnerve.com/services/hand-upper-extremity/hand-finger-joint-replacement/) (arthroplasty) - Partial thumb joint removal, using a tendon to support the thumb bone3 - Joint denervation #### Recovery After Thumb Arthritis Surgery Following thumb arthritis surgery, the joint will need to be supported and immobilized by wearing a cast or splint for a number of weeks. Patients often undergo physical therapy to help them regain strength and mobility. Most patients are able to get back to their normal activities several weeks to months after their thumb arthritis surgery. Overall, surgery for thumb arthritis is very successful for pain relief with very high patient satisfaction. ## Frequently Asked Questions About Arthritis of the Thumb ### Can thumb arthritis be prevented? The thumb joint is used so frequently that it is impossible to entirely prevent thumb arthritis. However, there are certain steps you can take to reduce damage to the cartilage in your thumb, such as: - Avoiding repetitive thumb movements when possible - Modify activities to avoid certain overhand and direct pinching motions - Using an ergonomic keyboard - Maintaining a healthy weight ### Is thumb arthritis the cause of my thumb pain? Arthritis of the CMC joint is the most frequent cause of chronic [thumb pain](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-pain/ "Thumb Pain Causes, Symptoms, Diagnosis, and Treatment"), especially in patients over the age of 40. However, there may be other conditions causing or contributing to your discomfort, such as trigger thumb (stenosing tenosynovitis or De Quervain’s tenosynovitis. Working with an experienced hand and joint doctor is the best way to properly diagnose the cause of your pain and find the right treatment to improve your symptoms. ## Contact Us If your thumb joint is swollen and painful, [contact](https://newyorkhandandnerve.com/contact-us/ "Contact Us") the experienced hand doctors at the Institute for Hand Surgery at NYPS Group to learn more about your treatment options. We are proud to treat patients throughout the New York City area. 1 American Academy of Orthopaedic Surgeons. Arthritis: An Overview. Available: [https://orthoinfo.aaos.org/en/diseases–conditions/arthritis-an-overview/](https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-an-overview/). Accessed May 30, 2023. 2 Mayo Clinic. Thumb Arthritis. Available: [https://www.mayoclinic.org/diseases-conditions/thumb-arthritis/symptoms-causes/](https://www.mayoclinic.org/diseases-conditions/thumb-arthritis/symptoms-causes/syc-20378339). Accessed May 30, 2023. 3 American Academy of Orthopaedic Surgeons. Arthritis of the Thumb. Available: [https://orthoinfo.aaos.org/en/diseases–conditions/arthritis-of-the-thumb/](https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-thumb/). Accessed May 30, 2023. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Fractures Overview [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/fractures-broken/#skiptomaincontent) ## What Is a Fracture? **Fractures are the result of a crack or break in the bone. Because so many daily activities involve hand use, fractures suffered in the hands, forearm, or wrist can make even the simplest tasks difficult or impossible to perform. Many athletes, mechanics, postal workers, or other individuals whose job involves repeated stress on the hands are at an increased risk of experiencing these types of breaks. Children may also have a higher likelihood of suffering fractures in this area, due to the nature of child play and sports-related activities. An untreated fracture can cause loss of function in the affected body part over time, making it very important to seek care from an experienced [hand surgeon](https://newyorkhandandnerve.com/about/) as soon as an injury occurs or symptoms of a fracture start to develop.** ## Signs & Symptoms Immediate pain and swelling are the most obvious symptoms of a fracture in the forearm, wrist, or hand. You may also notice a deformity or an inability to move or use the affected area. In general, the symptoms of a fracture may include: - Severe pain - Bruising - Numbness - Loss of motion In some cases, the fingers, wrist, or forearm may appear “bent” if an individual suffers an unstable fracture—this means the fracture has caused bone pieces to move or shift into an improper location. The resulting irregular appearance can indicate the bone has broken. ## Causes The most common causes of fractures in the hand and upper extremities are falls, sports, and motor vehicle accidents. We often use our hands to catch ourselves as we fall and the resulting impact can stress the bones to the point of breaking. Similarly, sudden trauma resulting from car accidents, workplace injuries, or other direct blows commonly result in a fracture. Osteoporosis may also weaken the bones and increase the risk of a forearm, wrist, or hand fracture. ## Treatment Treatment for a bone fracture in the forearm, wrist, or hand can vary according to the severity of your injury, the nature of the break, and the needs of the patient. Many times, an X-ray or physical examination is used to diagnose a fracture and get a better idea of how the bone is broken. In general, fractures suffered in this area can be treated by: - **Wearing a cast, splint, or brace to encourage proper healing**—this will hold the bones in place and prevent you from moving the hand, wrist, or forearm during your recovery period. Sometimes, the ends of the broken bones may need to be realigned first in a process called fracture reduction. In either case, the stability provided by a cast, splint, or brace can help the fracture heal without the need for surgery. - **Surgical care**—when the bones are misaligned, crushed, splintered into multiple pieces, or appear through the skin, surgery may be required to restore the bones to the proper position. This procedure involves using pins, rods, screws, or plates to keep the fractured bones in place. For both treatments, some physical hand therapy may be necessary after the bone heals to help the area regain strength, motion, and function. During your consultation, one of our reconstructive hand surgeons can examine the extent of your fracture and discuss a personalized treatment plan to meet your needs. When treated soon after injury, fractures in the hand and upper extremities often heal very well and full function can typically be restored. However, you will most likely require a few months of recovery time, depending on your unique rate of healing and physical demand. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Kienböck’s Disease Overview [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/kienbocks-disease/#skiptomaincontent) ## What Is Kienböck’s Disease? **Kienböck’s disease (avascular necrosis of the lunate) develops when the lunate bone, the central bone in the wrist, loses its blood supply and begins to deteriorate. The lunate is one of eight bones that make up the base of the hand. Located in the center of the wrist, this bone provides support for the joint and works with the forearm bones (radius and ulna) to help with your wrist’s ability to move. When the lunate is damaged, this can lead to stiffness and pain, as well as eventual arthritis. Kienböck’s disease is a condition that slowly progresses over time, but with proper treatment, symptoms can be treated and function can be maintained.** ## Signs & Symptoms Individuals suffering from Kienböck’s disease will typically notice a combination of the following symptoms: - Pain in the wrist - Tenderness at the lunate bone - Swelling - Stiffness of the wrist The condition does not usually affect both wrists. Since Kienböck’s disease worsens very slowly, many people go months, if not years, before seeing a doctor about their symptoms. After time has passed, they may also develop [wrist arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/ligament-tears-wrist-arthritis/). ## Causes Multiple factors can cause Kienböck’s disease to develop. This can include: - Irregular bone structure, such as an abnormally shaped lunate or uneven radius and ulna bones - Trauma to the area - Other medical conditions that affect blood supply Kienböck’s disease is most common in men 20 to 40 years old. It has also been found more often in those with conditions like lupus, cerebral palsy, and sickle cell anemia. ## Treatment Diagnosing Kienböck’s disease can usually be done after reviewing your medical history, carrying out a physical exam, and taking X-rays. If the disease is in its early stages, diagnosis can be more complicated since X-rays may not show the bone degeneration. As a result, an MRI may be necessary to look at the blood supply of the bone. Treatment for Kienböck’s disease is intended to reduce pain and improve function affected by the condition. The best treatment for a patient will depend on the stage of their disease. If caught early on, our [reconstructive hand surgeons](https://newyorkhandandnerve.com/about/) may recommend simply monitoring the disease or immobilizing the area. If the condition is more severe, surgery is usually the best treatment. Hand therapy can also be useful for limiting the effect Kienböck’s disease has on the wrist’s function. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Hand Pain Solutions [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/hand-pain/#skiptomaincontent) ## Hand Pain: When It’s Time To See a Doctor The human hand is made up of complex anatomical structures which include bones, muscles, tendons, ligaments, and nerves. Unfortunately, because the hand is generally one of the most used body parts, it is also susceptible to painful conditions. Typing, texting, brushing your teeth, and preparing food are daily activities we often don’t think much about. However, when pain occurs, these once simple tasks can quickly feel impossible. Hand pain can present for a variety of reasons that range from repetitive motion to severe injury. When you’re suffering from persistent or debilitating hand pain, it’s always best to obtain a professional evaluation in order to receive effective medical treatment. We’ve put together a simple guide to determine when you should make an appointment with a specialist to relieve your hand pain. ## Persistent Pain Hand pain isn’t always chronic. Pain from a sprain or [tendonitis](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/) may resolve on its own after several weeks, while [thumb arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/thumb-arthritis/) pain can come and go intermittently. In cases where you’ve injured your hand, you might experience acute pain that gradually fades over a few days or weeks as it heals. If you’re experiencing pain that lasts more than 4-6 weeks, it’s important that a physician investigate the symptoms to find the source. A thorough physical examination can help uncover the cause of your persistent hand pain and be the first step to obtaining relief. ## Pain Is Impacting Your Quality of Life There typically is no cause for concern if you have mild hand pain that isn’t disrupting you on a daily basis. However, even moderate hand pain can impact your quality of life, and severe hand pain can be debilitating. From difficulty performing everyday tasks to stiffness that inhibits productivity, chronic hand pain can make life miserable. If hand pain is preventing you from doing the things you enjoy, such as gardening, cooking, or writing, or affecting your livelihood, it’s time to see a hand specialist. ## Conservative Therapy Hasn’t Worked It’s generally best to start with conservative therapy when you experience hand pain from conditions like arthritis, carpal tunnel, [cubital tunnel](https://newyorkhandandnerve.com/services/nerve/cubital-tunnel/) and [tendonitis](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/). Conservative therapies include things like limiting the use of your hand for a period, using a splint or a brace, ice or heat, over-the-counter pain relievers, and occupational or physical therapy. While for some patients conservative therapy may be enough to ease hand pain, others may continue to struggle. Our surgeons have extensive experience treating hand pain that hasn’t responded to conservative therapy or will help guide you through the proper non-surgical treatments. If conservative options have failed to resolve your pain, then give our team a call. We are eager to help you find a path to relief. ## You Have Coexisting Conditions Many patients with hand pain also have other overlapping medical conditions. Common medications to treat pain and inflammation can interfere with the ongoing treatment of your other conditions. If you have a coexisting condition, it’s important to see a doctor who can design a custom treatment plan. For example, there are certain anti-inflammatory medications that can make acid reflux worse. Our doctors understand medication interactions and will ensure that they are treating your pain in the best way for your unique needs. ## Schedule A Consultation For Hand Pain If you have hand pain, our expert physicians will work with you to find the best solution for relief. Our doctors are dedicated to improving the quality of our patients’ lives, one hand at a time. Please [contact us](https://newyorkhandandnerve.com/contact-us/) today to schedule a consultation. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Congenital Hand Anomalies [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/congenital-anomalies/#skiptomaincontent) ## What Are Congenital Hand Anomalies? **Congenital hand anomalies are deformities of the extremities that are present from birth. As with any congenital difference, they will have profound social, emotional, and physical effects on both the child and their family. These structural issues can interfere with the child’s ability to move their fingers and/or thumb as they get older, which can cause lasting disability as the child learns to interact with the world around them. These birth defects can range from mild to severe deformities—some can affect function as the child grows, while others do not.** ## Symptoms of Congenital Hand Anomalies Depending on the type and severity of a deformity, the symptoms may be subtle or obvious. Common issues associated with congenital hand anomalies include the following: - Altered or limited function - Over- or underdeveloped limbs - Extra or missing thumb or fingers - Fused part of the hand If you have any concern over the structure or function of your child’s hand, you should visit a [reconstructive hand surgeon](https://newyorkhandandnerve.com/about/) to learn if a congenital anomaly may be present and how to move forward with treatment to maximize the appearance and function of the affected limb. ## Causes of Congenital Hand Anomalies The upper extremities develop in the first trimester of pregnancy. When there is an issue during this growth process, the arms and hands can develop congenital anomalies. While certain deformities are inherited genetically, others have an unknown cause. ## Types of Congenital Hand Anomalies There are many types of congenital hand anomalies that can occur. Some of the most common pediatric hand deformities include: - **Syndactyly:** occurs when two or more fingers do not separate in utero and are fused together—also referred to as “webbed” fingers. This is most common in the middle and ring fingers. - **Polydactyly:** can cause the growth of one or more extra fingers on the thumb side or the pinky side of the hand. This is a particularly common deformity, and the extra digits can often be surgically removed and the area reconstructed. - **Thumb hypoplasia:** is when the thumb is abnormally small or underdeveloped. This can range from a thumb that is slightly small but still has all of its structures, to a thumb that is undersized and has disabilities from missing or underdeveloped bones, tendons, or other parts. - **Congenital trigger thumb:** Overgrowth of the tendon can cause the thumb to lock, click, or pop when it is being bent or straightened. In some cases, the thumb cannot be straightened at all. In addition to these [hand conditions](https://newyorkhandandnerve.com/services/hand-upper-extremity/), there are other, more rare deformities that can develop in utero, such as central ray deficiency (lobster claw hand), macrodactyly, arthrogryposis, and more. ## Congenital Hand Anomalies Treatment The treatment for a child’s hand anomaly will be determined according to their specific growth pattern and the details surrounding their problem. The best treatment for a child will be based on factors such as their age, medical history, and the severity of their deformity. Depending on your child’s specific condition, one or more of the following treatment options may be recommended: - Finger manipulation or stretching - Splinting of the affected areas - Skin grafts - Prosthetics - Separation of fused fingers - Removal of extra digits - [Physical or occupational therapy](https://newyorkhandandnerve.com/contact-us/patient-information/#hand) - Complex surgical reconstruction If surgery is necessary, this can often be performed as early as infancy to correct certain deformities, ensuring your child continues to grow properly. We recommend an initial evaluation as soon as possible after birth to determine the ideal treatment plan for your child. Reconstructive surgery may also be necessary to provide optimal function for your child’s hand. We understand that congenital hand anomalies can be very upsetting for parents. Our reconstructive hand surgeons are highly experienced at effectively correcting these deformities through treatments ranging from conservative means to complex reconstructive surgeries. The Institute for Hand Surgery at New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group is committed to helping improve form and function of pediatric patients with deformities, helping your child to live a complete and fulfilling life. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Mallet Finger Treatment [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/mallet-finger/#skiptomaincontent) ## Mallet Finger Treatment in Long Island and NYC Mallet finger, also known as “baseball finger,” is the result of a tendon injury that prevents a finger or thumb tip from extending on its own. This common injury should be promptly addressed by a hand expert to ensure that it heals properly and finger function is not compromised. At The Institute for Hand Surgery at [New York Plastic Surgical Group](https://www.lipsg.com/), a division of Long Island Plastic Surgical Group, our experienced hand specialists can diagnose mallet finger and provide the proper treatment to help you maintain function in your injured finger or thumb. ## What is Mallet Finger? Mallet finger is an injury that occurs when the tendon at the back of a finger or thumb (the extensor tendon) is torn at the tip of the digit. Extensor tendons are located at the top of the hand and keep the fingers straight. When the tip of a finger or thumb is struck by an unyielding object, the tendon is damaged, torn, or bends further than it should. This results in a finger or thumb that does not straighten on its own. In some cases of mallet finger injuries, the extensor tendon may be pulled away from the point where it attaches to the finger. Sometimes, a small piece of bone pulls away with the tendon. This is called an avulsion injury.1 ## Causes of Mallet Finger Mallet finger is often referred to as “baseball finger,” as this injury commonly happens when a ball strikes the fingertip or thumb. In truth, any impact to the fingertip or tip of the thumb can cause mallet finger, as can forceful bending of the fingertip. ## Mallet Finger Symptoms Many people with mallet finger think of their finger as “jammed.” The tip of the finger droops, and does not straighten on its own. Additional symptoms of mallet finger may include: - Pain - Swelling - Bruising - Blood collection beneath the nail - Nail detachment2 ## Diagnosis of Mallet Finger It is important to seek prompt attention from a hand expert if you believe you have a mallet finger. If you notice that there is blood under the nail or the nail of the finger has become attached, it is especially important to have the injury examined. This could be a sign of a nail bed injury or compound fracture that could compromise the function of that finger and cause lasting pain. The first step in diagnosing mallet finger is a physical examination. The doctor will hold the injured finger and ask you to straighten it, or push the finger into a straight position and observe whether it can remain there. An X-ray may also be performed to make sure the joint of the finger is properly aligned and determine whether any pieces of bone have pulled away with the tendon. ## Nonsurgical Treatment for Mallet Finger At The Institute for Hand Surgery at NYPS Group, it is our policy to recommend the most conservative treatment that will be effective for mallet finger. Typically, this involves splinting to keep the finger straight so that the tendon heals properly. At first, the splint should be worn constantly. After 6-8 weeks, the splint may be worn less frequently. Once a mallet finger has healed, we will show you some simple exercises that will help you retain motion at the tip of the injured finger. You may still notice a slight droop to the fingertip or a bump at the back of the finger, but this should not cause pain or prevent you from performing normal activities. ## Surgical Treatment for Mallet Finger In most cases, splinting and physical therapy are the only treatment necessary for mallet finger. However, if the joint becomes misaligned or if large bone fragments have broken off with the injury, surgery may be necessary. Mallet finger surgery may involve stabilizing the finger with wires or small screws, repairing or replacing the damaged tendon, or fusing an injured finger joint to keep it straight. ## Contact The Institute for Hand Surgery If you have suffered a painful mallet finger injury, it is important that you seek attention from a hand expert who can help you heal properly. To schedule a consultation at The Institute for Hand Surgery at New York Plastic Surgical Group, please [contact us](https://newyorkhandandnerve.com/contact-us/) today. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Tennis Elbow Overview [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/tennis-elbow/#skiptomaincontent) ## What Is Tennis Elbow? **Tennis or golfer’s elbow, also known as lateral epicondylitis, is a painful [upper extremity injury](https://newyorkhandandnerve.com/services/hand-upper-extremity/) involving the tendons that attach the muscle to the bone on the outer side of the elbow (lateral side). This muscle is called the extensor carpi radialis brevis—it helps you extend and straighten your wrist. With tennis elbow, the tendon begins to break down where it connects to this muscle, which can be very painful when you’re lifting or gripping objects. This repetitive motion is most commonly experienced with tennis players, but the condition can develop from other work-related or athletic activities.** ## Signs & Symptoms Pain in the outer elbow is the main reason people with tennis elbow see a doctor. This symptom usually happens when using the muscle to grip or lift objects, since this puts stress on the tendon. Others may notice that simply touching the area feels sore and tender. In some cases, moving the elbow even slightly can hurt. The pain caused from tennis elbow usually starts at the elbow but can go all the way down to the forearm and hand. ## Causes Tennis elbow can result from a variety of activities, with the most common reasons being overuse and trauma. - **Overuse:** Repeating the same motion on a regular basis—often with work or athletics—can cause stress on the area where the tendon attaches to the muscle. Common activities that lead to overuse of this area include gripping an overly large racquet handle or repeatedly grasping objects like those used in plumbing, painting, and weaving. - **Trauma:** If the outer elbow undergoes a sudden hit, strain, or activity, this can cause the tendon to swell, leading to the tissue breaking down. Tennis elbow most commonly occurs in men and women between the ages of 30 and 50. However, it can develop outside of this age range. ## Treatment A variety of treatment options are available for tennis elbow. One or more may be recommended for you depending on the severity of your condition and what treatments have been attempted in the past. In the beginning, your doctor may recommend non-surgical treatments to see if this helps your condition. In general, most patients will see improvement in their symptoms with appropriate rest and time, but it may take 8-12 months to completely resolve. If you don’t get the relief you need to function normally from day to day, you may need to undergo surgery. In general, our team has found positive outcomes from the following treatments: - Limiting the activity that causes pain or modifying how it is performed - Anti-inflammatory medicines or injections can be used to reduce the pain and inflammation - A brace worn just below the elbow can lower the stress on the tendon, helping it heal - Physical therapy may be recommended to stretch and strengthen the area - Shockwave therapy sends pulses of energy to the area to help the tendon heal - Steroid injections to decrease short-term pain - Surgery removes the degenerated tissue (either through traditional open surgery or minimally invasive arthroscopic surgery) Should you need to undergo surgery, recovery will take about four to six months. As you heal, you’ll need to practice physical therapy to improve your arm’s range of motion and strength. Our reconstructive [hand surgeons](https://newyorkhandandnerve.com/about/) at the Institute for Hand Surgery will determine the best treatment plan to get you pain free and back to your favorite activities. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Pigmented Nail Lesions [Skip to main content](https://newyorkhandandnerve.com/hand-upper-extremity/pigmented-nail-lesions/#skiptomaincontent) September 28, 2022 _[By Dr. Brian A. Pinsky](https://www.lipsg.com/doctors/plastic-surgeon-dr-pinsky-new-york-nyc/)_ ![Close image of Pigmented Nail Lesions](https://newyorkhandandnerve.com/wp-content/uploads/2022/09/pigmented-nail-lesion.webp)A pigmented nail lesion is a concern that comes up more often than you would think, and most people don’t know what to do about it. The potential of melanoma can be scary, and many people aren’t comfortable dealing with nails. However, I typically see around two patients a month with pigmented nail lesions who have received referrals from dermatology offices. ## Understanding Melanoma It is estimated that the number of melanoma cases diagnosed in the US will increase by almost 6% to over 200,000 cases. The reason for the increase is not entirely clear. A vast majority of skin cancers (est 90%) are due to UV radiation from sun exposure. The increased incidence of skin cancers may be due to longer lifespans, climate change, and the prevalence of indoor tanning beds. One area related to the diagnosis and treatment of skin cancer is the evaluation and management of pigmented lesions of the nail bed and surrounding area. This is a topic that often confuses patients, primary care physicians, and specialists alike. ## Are Pigmented Nail Lesions Cancerous? The vast majority of pigmented nail lesions are benign. Longitudinal pigmented streaks are known as longitudinal melanonychia or melanonychia striata. The differential diagnosis of pigmented nail lesions includes fungal infections, viral wart, subungual hematoma (blood collection), medication-induced pigment (chemotherapy), ethnic-type pigmentation, benign nevus, squamous cell carcinoma, and melanoma. The clinical examination always begins with a thorough history including the duration of the pigmented lesion, any changes over time, history of [trauma](https://newyorkhandandnerve.com/services/hand-upper-extremity/fingertip-injuries/), and family history of melanoma. There are several clinical factors to keep in mind that help differentiate benign from potentially malignant nail pigmentation: - **Age** – 50–70 - **Ethnicity** – Acral lentiginous melanoma is more common in those of Asian, African-American, and Native American descent. - **Lesion width** – >3mm concerning for malignancy - **Coloration** – Gray/tan vs. darker brown/black - **Borders** – Sharp distinct borders usually suggest a benign lesion. - **Change** – Rapid increase in size or change in morphology - **Digit involved** – The thumb/great toe is most common. Typically a single digit =malignancy, and multiple digits = benign. - **Hutchinson’s sign** – Pigmentation on the nail fold is highly suspicious for melanoma. - **Family history of melanoma** ## Treating Pigmented Nail Lesions Benign appearing pigmented nail lesions can be safely observed. This is the case with most nail pigment. Most sources recommend re-evaluation every 3 months initially to evaluate for changes. Serial photographs can help track any changes that may occur. Patients can be treated for a fungal infection with oral or topical anti-fungal to see if the nail coloration or nail dystrophy resolves. Pigmented lesions that present with any malignant features should be biopsied. I will offer a biopsy to patients with equivocal lesions for peace of mind, and I have not found any that regret receiving a negative biopsy result. Proper biopsy technique involves a full thickness excision of nailbed tissue down to bone involving any visible pigment. I perform these under local anesthesia and tourniquet control as an office procedure. The nail is elevated off the nailbed and relaxing incisions are made in the corners of the nail fold. The nail fold with the nail attached are reflected back proximally. This gives a complete view of the nailbed and germinal matrix as the pigmented lesions often originate in the germinal matrix under the nail fold. The tissue is excised with a scalpel or punch. A scalpel is used to undermine the nailbed tissue and close the biopsy site without tension using absorbable sutures. This minimizes any post-operative nail deformity. The nail is then replaced and sutured down. Patients are back to full activities in a week with minimal long-term issues. Any suspicious pigmented nail lesions should be evaluated by a dermatologist or hand surgeon to determine the need for a biopsy and further treatment. If you have questions or would like to schedule an appointment, [contact the hand surgeons at The Institute for Hand Surgery at New York Plastic Surgical Group](https://newyorkhandandnerve.com/contact-us/). [Previous Post](https://newyorkhandandnerve.com/hand-upper-extremity/a-commitment-to-education-3/) [Next Post](https://newyorkhandandnerve.com/hand-upper-extremity/faqs-about-fingertip-injuries/) [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Fingertip Injury Treatment [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/fingertip-injuries/#skiptomaincontent) **The fingertips are often exposed during routine activities at home, in athletics, and at work, making them vulnerable to a variety of accidents. In fact, fingertip injuries are one of the most common injuries of the hand. Our doctors at the Institute for Hand Surgery at New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group frequently treat this area to not only reduce pain but to also make sure you can move and use your fingertip like normal again.** **Depending on the nature of the injury, you may end up damaging soft tissue, bone, tendons, and/or nerves. To make sure you regain full use of your fingertips after an injury, it’s important that you get medical care immediately and seek treatment from a well-qualified [reconstructive hand surgeon](https://newyorkhandandnerve.com/about/).** ## Signs & Symptoms The signs and symptoms of an injured fingertip will vary based on the cause of the accident, such as if the area was cut versus crushed. Depending on the severity of the injury, you may experience one or more of the following: - Bleeding - Swelling - Limited movement - Nail injury - Amputation When you see one of our reconstructive surgeons, they will do their best to alleviate your discomfort and improve your symptoms. To provide the best treatment for your needs, they’ll first need to understand what caused your injury. ## Causes People injure their fingertips in a wide range of ways—from getting crushed by a heavy object to getting shut in a door to being cut by a sharp tool. Depending on the nature of the accident, the fingertip can be damaged in a number of ways. This can involve the skin, nail bed, bone, tendons, and/or nerves. ## Treatment Treatment will ultimately depend on how your fingertip was injured and how severe the injury is. After learning how your injury happened, your doctor will take a look at how your fingertip looks and moves. This will include checking on its blood supply, seeing how well you can bend and straighten the finger, and, if necessary, performing an x-ray to look for any broken bones. Based on this information, your doctor may recommend one or more of the following treatment options: - Gauze, tape, or other dressings and wound care will often work well in many situations - A splint may be needed to keep the finger in its proper position - Surgery to repair damage, such as a suture to close the wound, placement of a metal pin to keep the damaged bone in place, or reconstructive flap surgery - Amputation if the damage is too severe to restore the fingertip’s form and function Our most important goal is to restore good quality skin coverage with touch sensation. Although the fingertip is just a small part of the finger and overall hand, seeking a qualified reconstructive surgeon is important for regaining normal movement and full function. If you end up needing surgery, you can expect your finger to be sore or sensitive for several months. Even after successful treatment, it’s possible that your fingertip may have some numbness and the skin or finger may look or feel different. Despite potential limitations to treatment, our surgical team is highly experienced at performing reconstructive fingertip procedures and are committed to helping you regain as much function as possible following any fingertip injury. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## De Quervain's Tenosynovitis [Skip to main content](https://newyorkhandandnerve.com/hand-upper-extremity/de-quervains-tenosynovitis/#skiptomaincontent) March 24, 2021 By Haritha B. Veeramachaneni, MD Patients with De Quervain’s Tenosynovitis, commonly known as [De Quervain’s Tendinosis](https://newyorkhandandnerve.com/services/hand-upper-extremity/tendonitis/), have painful tendons on the thumb side of the wrist. In De Quervain’s Tenosynovitis, the first dorsal compartments are held within a tunnel-like tendon sheath. Excessive movement of the tendons causes inflammation, pain and swelling within the tendon sheath. This can be due to a thickening of the soft tissues that make up the tunnel or an increase in the amount of soft tissue within the tunnel. ## Symptoms of De Quervain’s Tenosynovitis Patients with de Quervain’s Tenosynovitis often describe a feeling of sharp or dull pain and swelling. Pain typically occurs at the base of the thumb or at the wrist, especially with forceful gripping or twisting. ## Diagnosing De Quervain’s Tenosynovitis ![](https://newyorkhandandnerve.com/wp-content/uploads/2021/03/Hand-Pain.jpeg) Your doctor may palpate for first dorsal compartment tenderness during the physical exam as part of the evaluation for wrist tendonitis. ![Hand-Pain](https://newyorkhandandnerve.com/wp-content/uploads/2021/03/Image-2.jpeg) One examination maneuver your doctor may perform is the Finkelstein test which evaluates an active movement which places specific stress on the first dorsal compartment tendons to determine their degree of inflammation. ## What Causes De Quervain’s Tenosynovitis? The exact cause of the De Quervain’s Tendonitis is unknown, but many experts believe that changes in the use of the hand may be a cause. Repetitive movements, changes in hormones, and swelling or inflammation may also be factors. ## How is De Quervain’s Tenosynovitis Treated? There are several first-line conservative treatments that may relieve symptoms: - A splint that stops you from moving your thumb and wrist - Tylenol or anti-inflammatory medications (e.g., Ibuprofen) - A steroid injection into the tendon sheath If these treatments do not help, surgery may be needed to relieve symptoms. ## Contact The Institute for Hand Surgery at Long Island Plastic Surgical Group If you suffer with wrist or thumb pain, we can help. [Contact us](https://newyorkhandandnerve.com/contact-us/) with any questions or to schedule a consultation appointment. [Previous Post](https://newyorkhandandnerve.com/nerve/nerve-compression-syndrome/) [Next Post](https://newyorkhandandnerve.com/in-the-news/john-stamos-shares-hospital-selfie-after-surgery/) [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Brachial Plexus Injury [Skip to main content](https://newyorkhandandnerve.com/services/nerve/brachial-plexus-complex-neurologic-trauma/#skiptomaincontent) ## What Is the Brachial Plexus? **Peripheral nerve injuries are a common result of complex trauma to the upper extremity. This can have a lasting effect on how the shoulders, arms, and hands function. The brachial plexus is a network of nerves that sends signals from the spinal cord into the upper extremity down to the fingertips. It is most commonly damaged from injuries to the neck or shoulder area during motor vehicle accidents or falls from great heights. When the brachial plexus becomes injured or impaired, patients may experience a variety of symptoms ranging from pain and discomfort, electric shock-like feelings, to complete loss of movement or sensation. Depending on the location and amount of damage, a brachial plexus injury can temporarily or permanently affect a person’s ability to use part or all of their arm. This is why it is critical to see a [reconstructive hand surgeon](https://newyorkhandandnerve.com/about/) to make sure the nerves are not permanently damaged, and to get early treatment to regain as much of the function as possible.** ## Signs & Symptoms Symptoms of brachial plexus and other complex neurologic trauma will vary based on which area was injured and the amount of damage that occurred. When these nerves are not working properly, patients may experience one or more of the following: - Burning sensations - Electric shock-like sensations that travel up or down the arm - Numbness - Weakness - Pain - Inability to move the hand, wrist, or arm Symptoms typically only affect one side of the body; however, they can often be debilitating without treatment. ## Causes Brachial plexus injury is caused by a nerve being compressed or stretched; or in severe cases, the nerve may be completely torn. This can result from trauma to the upper or lower nerves in the brachial plexus. For example, when the shoulder is pushed down and your neck stretches away from it, this can damage the upper nerves. Or, when your arm is forced over your head, this may affect the lower nerves. The most common causes of brachial plexus injury include: - Contact sports: Football players and wrestlers are especially prone to neurologic trauma in the upper extremity. - Car accidents: Vehicle and motorcycle accidents can damage the brachial plexus, stretching the nerves beyond their normal range. - Difficult childbirths: A baby’s shoulders can get caught within the birth canal, resulting in a stretched or torn brachial plexus. - Inflammation: Inflamed tissue can put pressure on the nerves, causing them to not function properly. - Tumors: These growths can compress the brachial plexus causing damage. ## Treatments To determine the best form of treatment, your doctor will perform a physical exam and may require imaging tests such as a CT scan or MRI. Most patients will also require nerve conduction testing and will be referred to the appropriate specialist for this test. This will allow them to understand the extent of your damage, which can range from a nerve being stretched to it being torn from the spinal cord. In order to regain optimal function and feeling in your arm, it is important to get treated as early as possible. Even if the injury seems minor, seeking medical care to evaluate the severity of the damage can help prevent permanent function loss. If the brachial plexus has only been stretched, you may recover without the need for treatment. However, many cases require physical therapy or further treatment to restore function and prevent stiffness. If your injury requires surgery, your doctor may perform one or more of the following: - Neurolysis, or scar release, around the injured section of the nerve - Nerve graft to replace the damaged section of nerve - Peripheral nerve transfer—replacing the torn nerve farther down the arm with a branch of a functioning nerve to another area - Microvascular muscle transfer to replace the lost function with a muscle from another part of the body - Tendon transfer to replace the lost function by re-routing a muscle that still functions in the area - Joint fusions can be used to stabilize certain joints to a better functioning position Brachial plexus injuries are extremely complex, and it may take months to years to recover. When you come in for your consultation, one of our surgeons will educate you about your condition and create a personalized treatment plan to allow for the best possible outcome. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") BESbswy ## Fracture Treatment Comparison [Skip to main content](https://newyorkhandandnerve.com/featured-surgeons/a-commitment-to-education-2/#skiptomaincontent) May 21, 2020 LIPSG is honored to have a piece featuring our very own board-certified plastic surgeon, [Dr. Brian A. Pinsky](https://www.lipsg.com/doctors/plastic-surgeon-dr-pinsky-new-york-nyc/), in one of the top leading peer reviewed journals the [Plastic and Reconstructive Surgery-Global Open](https://journals.lww.com/prsgo/Fulltext/2019/05000/Extra_articular_Metacarpal_Fractures__Closed.25.aspx). This was also the only article featured on the podcast from this issue. The article describes a retrospective study that compares the outcomes of single metacarpal, extra-articular fractures treated with closed reduction and percutaneous pinning (CRPP) versus open reduction and internal fixation (ORIF). It took place at NUMC (tertiary care Level 1 trauma center), where patients population was examined to see whether fixing the fracture with pins would have a better outcome than plates and screws. “Our original hypothesis was that plates and screws would yield a better outcome because the fixation is stronger, requires less time in a splint, and allows movement early after surgery,” says Dr. Pinsky. However, the results showed there was no significant difference in functional outcome in many instances. Both CRPP and ORIF are viable techniques with good clinical outcomes and low complication rates. ORIF of closed metacarpal fractures allowed for earlier mobilization when compared with CRPP without compromising fracture stability, clinical or functional short-term outcomes.  ORIF was preferred in late presenting injuries, comminuted fractures, and patients that needed earlier mobilization to return to work or activity. For more information on this study, read the article [here](https://journals.lww.com/prsgo/Fulltext/2019/05000/Extra_articular_Metacarpal_Fractures__Closed.25.aspx). The hand and upper extremity are essential for carrying out many of our daily activities and interacting with the world around us. Visit our [conditions and treatments page](https://newyorkhandandnerve.com/services/) to learn more about what we treat. [Article](https://journals.lww.com/prsgo/Fulltext/2019/05000/Extra_articular_Metacarpal_Fractures__Closed.25.aspx): **Extra-articular Metacarpal Fractures: Closed Reduction and Percutaneous Pinning Versus Open Reduction and Internal Fixation** Author Information: Vasilakis, Vasileios MD\*,†; Sinnott, Catherine J. MD\*; Hamade, Malack BS\*; Hamade, Hassan BS\*; Pinsky, Brian A. MD, FACS\*,† Plastic and Reconstructive Surgery – Global Open: May 2019 – Volume 7 – Issue 5 – p e2261 doi:10.1097/GOX.0000000000002261 [Previous Post](https://newyorkhandandnerve.com/in-the-news/hailey-bieber-begged-fans-to-stop-roasting-her-about-her-pinky-fingers-which-are-crooked-due-to-a-genetic-condition/) [Next Post](https://newyorkhandandnerve.com/in-the-news/third-thumb-human-augmentation-rewires-the-brain/) [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Hand Sprains and Strains [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/hand-sprains-strains/#skiptomaincontent) ## Treatment of Hand Sprains and Strains in Long Island, Manhattan, and NYC Sprains and strains are soft tissue injuries that can affect the ligaments, muscles, and tendons of the hand or wrist. While these terms are often used interchangeably, they are actually different types of injuries. In most cases, hand sprains and strains can be treated conservatively, but in severe cases surgery may be necessary. The experienced hand surgeons at The Institute for Hand Surgery at New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group can properly diagnose a hand sprain or strain and provide effective treatment. ## What is a Wrist Sprain? A sprain is an injury to a ligament, which is the fibrous band of tissue that connects bones at a joint. Sprains can range from a mild stretching of the ligament to a partial or complete tear. One of the most common injuries to affect the wrist is a wrist sprain, which happens when the wrist is forcefully twisted or bent, often by falling onto an outstretched hand. There are different grades of wrist sprains: - **Mild (Grade 1) Sprain:** Here, the ligaments are stretched but do not tear. - **Moderate (Grade 2) Sprain:** In a moderate sprain, the ligaments are partially torn. A grade 2 sprain may involve some loss of hand or wrist function. - **Severe (Grade 3) Sprain:** A severe sprain occurs when the ligament is torn or is pulled off from where it attaches to the bone. This tearing may also pull a piece of the bone away, which is called an avulsion fracture. A grade 3 sprain may require surgery.1 ### Symptoms of Hand and Wrist Sprains Hand/Wrist sprains and strains may cause a range of symptoms, including: - Bruising - Swelling - Tenderness - Stiffness - A sensation of popping or tearing - A feeling of warmth near the injury - Joint contracture In some cases, these symptoms may be caused by an unrecognized fracture. For this reason, if you suspect you have a hand or wrist sprain or strain, it is important to have your injury examined by a hand expert who can properly diagnose and treat the injury. ## What is a Hand Strain? While a sprain is an injury to a ligament, a strain is an injury to a muscle or tendon, the fibrous cord that attaches a muscle to a bone. Like sprains, strains can vary in severity, ranging from a stretch of a muscle or tendon to a partial or complete tear. Hand strains are common in sports where extensive gripping is required, like gymnastics, golf, rowing, and tennis.2 ### Symptoms of Hand Strains A hand or wrist strain may cause symptoms such as: - Pain - Muscle spasms - Muscle weakness - Inflammation - Cramping - Swelling3 ## Treatment for Hand Sprains and Strains Conservative treatment for hand sprains and strains is the same, and can be remembered by the letters “RICE”: - Rest - Ice - Compression - Elevation Physical therapy is often recommended as treatment after a sprain or strain and splinting may be recommended for a period of time. In cases of a severe sprain or strain, hand or wrist surgery may be required to alleviate symptoms and preserve functionality. ## Contact the Institute for Hand Surgery If you have suffered a hand or wrist injury that may be a sprain or strain, it could be more severe than you think. Put ice on the area, then [contact](https://newyorkhandandnerve.com/contact-us/) the hand experts at The Institute for Hand Surgery at New York Plastic Surgical Group to schedule an examination. 1 American Academy of Orthopaedic Surgeons. Wrist Sprains. Available: [https://orthoinfo.aaos.org/en/diseases–conditions/wrist-sprains/](https://orthoinfo.aaos.org/en/diseases--conditions/wrist-sprains/). Accessed September 10, 2021. 2 American Academy of Orthopaedic Surgeons. Sprains, Strains and Other Soft-Tissue Injuries. Available: [https://orthoinfo.aaos.org/en/diseases–conditions/sprains-strains-and-other-soft-tissue-injuries/](https://orthoinfo.aaos.org/en/diseases--conditions/sprains-strains-and-other-soft-tissue-injuries/). Accessed September 10, 2021. 3 National Institute of Arthritis and Musculoskeletal and Skin Diseases. Sprains and Strains. Available: [https://www.niams.nih.gov/health-topics/sprains-and-strains](https://www.niams.nih.gov/health-topics/sprains-and-strains). Accessed September 10, 2021 [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Pediatric Hand Surgery [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/pediatric-injuries-surgery/#skiptomaincontent) **The hands are a critical tool as children explore their surroundings and interact with others. As they learn and communicate, their bones and soft tissue are continuing to develop, which makes them more prone to getting injured. While adults and children can suffer from similar injuries, some of the most common traumatic injuries seen in pediatric patients include the following:** - [Hand and wrist fractures](https://newyorkhandandnerve.com/services/hand-upper-extremity/fractures-broken/) - [Fingertip injuries](https://newyorkhandandnerve.com/services/hand-upper-extremity/fingertip-injuries/) (especially in the nail bed) - Amputations Aside from experiencing certain hand injuries more often than adults, children and adolescents have a slightly different bone consistency and improved ability to heal that factors into how they should be treated. They have what is known as growth plates (physes), which is the area where the bone grows and hardens. Before the growth plates have fully developed and closed, they are particularly vulnerable to injury. Fractures that occur in the growth plates are often referred to as Salter-Harris fractures, which are divided into five types based on the patterns of injury and how they affect the zones of the growth plate. When a severe fracture occurs, this can lead to complications, like stunting the bone’s ability to grow. This is why treatment for pediatric hand injuries must consider how the growth plates are affected to protect the patient’s long-term function and development. ## Symptoms of Traumatic Injuries Since accidents involving children and adolescents can be very different, depending on their age and environment, symptoms of pediatric hand injuries will greatly vary. Younger children tend to have more injuries related to falls or the fingers getting crushed, such as getting smashed in a door. Older children tend to have more injuries caused by playing sports. Depending on the cause and extent of the injury, one or more of the following symptoms may be experienced: - Swelling - Bruising - Lacerations - Deformity - Chronic pain - Limited mobility Fortunately, children tend to heal faster, and deformities can often be improved as they grow. With proper treatment from experienced [hand surgeons](https://newyorkhandandnerve.com/about/), pediatric patients can likely get back their hand’s healthy form and function with little to no symptoms of the injury. ## Making the Diagnosis The nature of a hand injury is very important for finding the right treatment. When getting your injury looked at, you should tell your doctor any details related to the accident to give them an idea of what damage may have resulted. Your doctor will then perform a physical exam and may also need to take an X-ray, ultrasound, or other diagnostic test to determine how severe the injury is. With the help of this information, they can see the extent of your injury, including how the growth plates were affected, allowing them to move forward with recommending treatment. ## Pediatric Hand Treatment & Surgery The majority of pediatric hand injuries can be treated with non-invasive techniques. However, some require surgery to correct the problem and make sure the hand still develops and functions properly. When considering treatment, our team will recommend the least invasive option possible that can still provide the best long-term results. One factor that is especially important when treating pediatric patients is timing. If serious injuries go untreated for too long, this can end up resulting in deformity or lasting issues with function. In a growth plate fracture, especially, the injury needs to be corrected before the growth plate closes (usually between the ages of 16 and 21). By doing so, the patient can get the best possible outcome from their treatment. Some of the most common approaches to treating pediatric hand injuries are as follows: - **Casts or splints:** In injuries like a sprain or fracture, simply preventing the injured hand, finger, or wrist from moving by using a cast or splint can be sufficient. - **Stitches:** For a hand laceration, the area will be properly cleaned and stitches may be necessary to close the wound. - **Skin graft or flap:** If a burn, scrape, cut, or similar injury significantly damages an area of skin, a graft may be placed or flap may be created to promote healing. - **Setting a bone:** If an injury causes dislocation or a misaligned bone, your doctor may need to move the bone back into the right position before further treatment is done. - **Pins or other metal fixation:** When a bone is fractured, metal pins may be surgically placed through the skin to ensure the bone fragments stay in their proper position as the area heals. These are usually removed once the broken bone has healed. Whether the treatment for a pediatric patient’s injured hand requires one of the above approaches or a combination of them, our surgeons will go over what the treatment will entail and how to properly care for your child throughout the healing process. When you choose the Institute for Hand Surgery at New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group, you will receive care from experienced hand surgeons who are highly skilled at performing complex pediatric procedures. Our mission is to not only help your pediatric patient feel better, but make sure their growing body continues to develop in a healthy way. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Wrist Ligament Tears [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/ligament-tears-wrist-arthritis/#skiptomaincontent) **In the upper extremities, pain can be the cause of significant distress and can make simple movements and completion of daily activities very difficult. The wrist and arm are among the most frequently used body parts, and even a minor injury in these delicate areas can affect your quality of life. Pain in the hand and wrists is frequently related to underlying ligament injuries or damage to the join surfaces known as arthritis. The expert [reconstructive hand surgeons](https://newyorkhandandnerve.com/about/) at the Institute for Hand Surgery at New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group can provide you with comprehensive care that can reduce the symptoms of your condition and help restore function lost in your hand or wrist.** - [Ligament Tears](https://newyorkhandandnerve.com/services/hand-upper-extremity/ligament-tears-wrist-arthritis#tears) - [Wrist Arthritis](https://newyorkhandandnerve.com/services/hand-upper-extremity/ligament-tears-wrist-arthritis#arthritis) ## Ligament Tears Ligaments are the connective tissues that join the bones together. Ligament injuries can range from partial or minor tears, commonly referred to as a sprain, to complete tears that will result in unstable joints. The most common reason for a ligament tear is trauma to the wrist experienced after an injury, or the sudden impact of a fall. Because we often use our hands to catch us as we fall forward or backward, the palm, wrist, and thumb are some of the most common sites of a ligament tear. While minor sprains may only stretch the ligament, more severe injuries will completely tear the ligament and can lead to additional injuries, such as [hand and wrist fractures](https://newyorkhandandnerve.com/services/hand-upper-extremity/fractures-broken/) or arthritis. In the wrists, ligament tears are a very common injury and typically cause pain, tenderness, and weakness at the site of the injury. ### Signs & Symptoms Ligament tears most often result in swelling, bruising, pain, and instability in the affected area. This can make moving and using the body part difficult. Sometimes, it can be difficult to distinguish a ligament tear from a fracture because many of the symptoms overlap. An X-ray, physical examination, or MRI may be required to properly diagnose a ligament tear. ### Treatment Depending on the extent of your injury, ligament tears can be treated with a number of solutions. Treatment options include: - **Wearing a cast or splint**—In some cases, immobilizing the area alone will encourage proper healing. Partial ligament tears where the joints remain stable are usually treated without surgery with very good outcomes. - **Injections—** One common strategy for pain relief is to inject a steroid medication into the affected area to decrease inflammation. - **Hand therapy**—Therapy may be needed after splinting or casting to treat or prevent stiffness. The muscles around an affected joint can be strengthened to decrease pain and prevent further damage over time. - **Surgery**—When non-surgical treatments fail to address your injury, a procedure involving sutures, pins, screws, and other specialized devices can effectively repair the ligament. Tendons or other soft tissues in the area can be re-routed to replace the torn ligament if it can’t be directly repaired. For injuries lasting several months or years, surgery may involve removal of the affected bones, a partial wrist fusion, complete wrist fusion, or wrist replacement. Should your injury require surgery, your doctor can discuss the particulars of your procedure in an appointment or consultation. Understand.com Player # Step 1: Introduction Wrist arthroscopy is a procedure used for diagnosing and treating problems inside the wrist joint. A special viewing instrument called an arthroscope is attached to a camera and inserted through a small incision to see inside the joint. The arthroscope allows your surgeon to see the ligaments, cartilage, and soft tissues of the wrist joint under magnification without making large, open incisions. # Step 2: Anatomy The wrist is one of the most complex of all the joints in the body. It’s made up of eight small bones, many connecting ligaments and tendons, muscles, nerves, and blood vessels. Articular cartilage covers the ends of the bones, allowing them to slide smoothly against one another. Ligaments connect bones to one another, while tendons connect muscles to bones and control the actions of the fingers, thumb, and wrist. All of the nerves in the hand, which control muscle movements and provide sensation, travel through the wrist along with the blood vessels that supply blood to the hand. # Step 3: Why Arthroscopy? Identifying the exact cause of wrist pain is sometimes difficult due to the complexity of the joint. At times imagery methods, such as x-ray, CT scans, or MRI are not able to detect a specific injury causing the pain. Wrist arthroscopy is typically used in these situations to help identify and treat the underlying cause of the wrist pain such as torn ligaments, cysts, and degenerative changes to cartilage from arthritis. When injuries to the ligaments of the wrist are identified by MRI or other methods, wrist arthroscopy is often used to allow the surgeon to evaluate and treat the injury without having to make a large incision. In some situations conditions such as ganglion cysts or wrist arthritis may also be treated with wrist arthroscopy, thus avoiding larger incisions. # Step 4: Preparation and Positioning Wrist arthroscopy is typically done under general or regional anesthesia. The type of anesthesia is chosen by your surgeon based on several factors. If general anesthesia is used, you are given medication so you are asleep during the procedure so you feel no pain. Regional anesthesia with IV sedation involves injecting medication into an IV in your arm to numb your hand, wrist, and arm. You will also be given medication so you are relaxed and may fall asleep during the procedure. After the anesthesia, your arm will be secured and your hand positioned in a device called a traction tower, which holds it in place during the procedure and allows the space between the bones in the joint to be expanded (distracted) for better visualization. # Step 5: Incisions, Visualization, and Diagnosis Two or more small incisions, called portals, are made on the back of your wrist to allow the arthroscope and other instruments to be inserted. To expand the joint and to improve visualization, saline solution flows through a tube and into the wrist. The image from the arthroscope is projected onto a video monitor where the surgeon can watch while maneuvering inside the joint. Once your surgeon has determined the cause of your pain or problem, surgical repairs may be completed through the small portals or your surgeon may need to make a larger incision to complete the repair as an open procedure. After arthroscopy, the incisions are closed with sutures and covered with a bandage. A numbing agent is injected to reduce pain after the procedure. A splint, cast, or brace may then be applied to protect the wrist until you follow up with the surgeon. # Step 6: Recovery You can expect to have some pain, swelling, and possibly stiffness around your wrist after the procedure. You will likely be advised to keep your hand elevated to help reduce swelling. Sutures will be removed in one to two weeks and you may be required to wear a splint, brace, or cast depending on the specific repair performed. Recovery time is considerably shorter with small arthroscopic incisions, compared to open procedures with large incisions. Arthroscopy enables your surgeon to inspect the complex anatomy of your wrist and allows for both diagnosing and treating a variety of wrist problems. menu Wrist Arthroscopy Content provided by **NYPlasticSurgical** together with 0:00 # NYPlasticSurgical's Note Step 1: Introduction Thank you for visiting our website and viewing our 3D Animation Library. These animations should assist you in better understanding your condition or procedure. We look forward to answering any additional questions you may have at our next appointment. 0:00 /4:30 5.1K views 3 likes ## Wrist Arthritis Arthritis is a condition in which the gliding cartilage surfaces of the joints are worn away causing inflammation, pain, stiffness, and difficulty moving the wrist. While arthritis can be suffered in many different areas, the wrist is one of the most common areas to develop the condition. Wrist arthritis typically occurs after a prior injury to the joint, or due to an inflammatory, auto-immune condition. The amount of joint damage typically varies on a case-by-case basis; however, wrist arthritis typically gets worse over time, and symptoms can become severe if left untreated. ### Signs & Symptoms There are many different types of arthritis that can be suffered in the wrist, but all can make it difficult to perform simple daily tasks. Symptoms of wrist arthritis typically include: - Pain or swelling in the region - Joint stiffness - Reduced range of motion in the wrist - Joint weakness If you are experiencing these symptoms, one of our reconstructive hand surgeons can help you determine the type of arthritis in your wrist and create a personalized treatment plan that will effectively address your condition. Proactive treatment can often relieve symptoms of wrist arthritis and slow the progression of joint damage. ### Causes The reason why arthritis develops in the wrist is largely dependent on the type of arthritis that you have—a factor that your doctor can help you determine. In general, the following may contribute to the gradual swelling of wrist joints: - Normal “wear and tear” caused by repetitive motion in the wrist - Older age - A family history of arthritis - The body’s immune system attacking its own tissues - Trauma to the cartilage after an injury, such as a broken wrist bone or torn ligament ### Treatment There are many different ways to manage the symptoms of wrist arthritis, and at the Institute for Hand Surgery at NYPS Group, one of our doctors can help determine which course of action is best suited to your needs. Non-surgical remedies for arthritis in the wrist may include: - Wearing a wrist splint or cast to immobilize the area and ease stress on the joint - Anti-inflammatory medications that can reduce swelling - Modifying or limiting the activities that trigger your painful symptoms - Physical therapy in the wrists and hands In some cases, non-surgical treatment may not be enough to relieve the symptoms of wrist arthritis. If the condition begins to significantly reduce your quality of life, surgery may be recommended. Surgical treatment may involve: - Removing the affected bones - Fusing the painful bones - Replacing the damaged cartilage and bones While more conservative methods of treatment are recommended before resorting to surgery, your doctor will be able to discuss further details of your procedure during your appointment. At the Institute for Hand Surgery at NYPS Group, one of our experienced reconstructive hand surgeons can develop a unique treatment plan designed to reduce your symptoms and help you regain function and mobility in your wrist. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Finger Joint Replacement [Skip to main content](https://newyorkhandandnerve.com/services/hand-upper-extremity/hand-finger-joint-replacement/#skiptomaincontent) Persistent [finger or hand pain](https://newyorkhandandnerve.com/services/hand-upper-extremity/hand-pain/), often caused by arthritis, can be debilitating and can prevent a person from engaging in everyday activities like preparing food, hygiene tasks, gripping, typing, and more. In cases of hand or finger pain caused by arthritis, the skilled hand experts at The Institute for Hand Surgery at New York Plastic Surgical Group, a division of Long Island Plastic Surgical Group, typically will initially recommend the most conservative, non-surgical treatment that will effectively alleviate pain and other symptoms. When conservative measures fail to provide adequate relief, it may be time to consider hand or finger joint replacement surgery, known as arthroplasty. ## Who Has Hand or Finger Joint Replacement? Most of our patients who undergo hand or finger joint arthroplasty are older, and suffer from the painful effects of osteoarthritis or rheumatoid arthritis. Arthritis, simply put, is cartilage loss of a joint. In healthy joints, articular cartilage cushions the end of bones and gives the joint a smooth surface upon which to glide. A fluid called synovial fluid, produced in the lining of the joint, lubricates the smooth surface of the cartilage. The inflammation of osteoarthritis is a result of a breakdown of the cartilage in a joint, while rheumatoid arthritis attacks the synovial membranes that help to lubricate the joints. This can lead to symptoms such as: - Pain - Swelling - Stiffness - Tenderness1 ## Benefits of Hand or Finger Joint Arthroscopy Replacing a hand or finger joint that has been damaged by arthritis or trauma can provide multiple benefits, including: - Reduction in joint pain - Restoration or maintenance of joint motion - Improved alignment of hand or finger bones - Improved hand or finger function ## Hand and Finger Joint Replacement for Arthritis When joints of the hand or fingers become stiff and painful due to arthritis, replacing them can help alleviate symptoms, realign bones, and restore more normal function. Just as a hip or knee joint can be replaced, so can the joints of the hand and fingers. Hand or finger joint arthroplasty involves removing the joint that has been damaged by arthritis and replacing it with an artificial joint. This is usually performed on the knuckles at the base of the fingers (metacarpophalangeal or MCP joints) and the joints at the base of the hand (proximal interphalangeal or PIP joints). Replacement joints differ in material depending on the function, range of motion, and position of the damaged joint. Hand or finger joint replacements may be made from silicone, metal, or ceramics. ## The Hand or Finger Joint Replacement Procedure Hand or finger joint arthroplasty is performed under general or local anesthesia. The surgeon creates an incision to access the affected joint in order to remove it thd damages cartilage and bone. Next, the artificial hand or finger joint is placed and the incision is closed with sutures. ## Recovery After Hand and Finger Joint Replacement Following hand or finger joint reconstruction surgery, it is often necessary to wear a cast or splint to protect the hand as it heals. Patients may need to modify the way they use their hands during this period so that the replaced joint can heal properly, but most patients can return to their normal activities about three months after hand or finger joint replacement. Working with a special hand therapist can help improve recovery.3 ## Contact Us Hand or finger joint replacement is a delicate and highly specialized procedure for which extensive training is required at The Institute for Hand Surgery at NYPS Group, our experienced surgeons have the delicate touch and technical skill necessary to perform this procedure successfully. If you are troubled by chronic hand pain and would like to learn more about hand or finger joint replacement surgery, please [contact us](https://newyorkhandandnerve.com/contact-us/) to schedule a consultation with an expert hand surgeon on our team. 1 Cleveland Clinic. Arthritis. Available: [https://my.clevelandclinic.org/health/diseases/12061-arthritis](https://my.clevelandclinic.org/health/diseases/12061-arthritis). Accessed September 7, 2021. 2 American Society for Surgery of the Hand. Knuckle, Wrist & Finger Joint Replacement. Available: [https://www.assh.org/handcare/condition/finger-joint-replacement](https://www.assh.org/handcare/condition/finger-joint-replacement). Accessed September 7, 2021. 3 American Academy of Orthopaedic Surgeons. Hand Arthritis. Available: [https://orthoinfo.aaos.org/en/diseases–conditions/arthritis-of-the-hand/](https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-hand/). Accessed September 7, 2021. [![Schedule An Appointment](https://newyorkhandandnerve.com/wp-content/themes/nyhandnerve-yellow/images/follow-button.svg)](https://newyorkhandandnerve.com/contact-us/ "Schedule an Appointment") ## Understanding Arthritis Symptoms [Skip to main content](https://newyorkhandandnerve.com/arthritis/my-fingers-hurt-do-i-have-arthritis/#skiptomaincontent) January 22, 2021 By: Roger Simpson, MD, MBA, FACS Arthritis is a joint disorder characterized by inflammation. A joint is the area of the body where two different bones meet. In the hand, finger and wrist joints allow the body parts connected to these bones to move smoothly. Arthritis is defined as inflammation of one or more of these joints, usually accompanied by pain. The Arthritis Foundation estimates that 1 in 5 people over the age of 18 will develop arthritis. Pain and stiffness of the fingers is a common reason for a visit to the doctor. ## How do I know if I have arthritis? The most common signs of arthritis include pain, stiffness, swelling, redness, and decreased range of motion. ## What does arthritic pain feel like? Pain from arthritis can be constant or it may come and go. It can be present at rest or while moving the hand and fingers. Swelling and redness can occur over the joint that has inflammation from arthritis. The area may feel warm to the touch. Swelling for several days should prompt a visit to the doctor. Stiffness of the joint upon awakening in the morning or during periods of disuse is a common finding. Difficulty moving a joint that does not improve is often a sign of arthritis. ## What should I do if I think I have arthritis? Obtaining a diagnosis is the first and most important step in the evaluation process. One of the most effective early treatments for arthritis is an active exercise program. This emphasizes stretching of the joints. Gentle exercise programs are especially beneficial. ## There are different types of arthritis of the fingers Osteoarthritis (degenerative) arthritis: Arthritic joints feel sore and stiff, especially if you haven’t moved them in a while. Often in the morning you’ll wake up and it may take several minutes for the joints of your hands and fingers to move smoothly. This type of arthritis may worsen with age. These symptoms can be accompanied by progressive curvature of the fingers. Osteoarthritis causes the cartilage cushion at the end of the bones to breakdown. It commonly affects the small finger joints as well as the base of the thumb. Inflammatory arthritis: This is an immune condition also producing inflammation with pain and swelling in the joints. Usually the small joints of the fingers and toes can be affected. This process begins with inflammation of the soft linings of the joint and progresses. Examples of inflammatory arthritis are rheumatoid arthritis and psoriatic arthritis to name a few. **Infectious arthritis:** This can result from bacteria, virus, or fungus entering a joint. Joint pain and fever may accompany the rapid swelling. **Metabolic arthritis:** The body may fail to eliminate certain metabolites resulting in crystal deposits forming in joints. Gout may produce acute or progressive arthritis of the hand. More often, symptoms include a sudden onset of severe pain in one joint with swelling and redness. ## Should I see a doctor about arthritis? You should see your doctor for any joint pain that persists. It’s important to establish an accurate diagnosis and to determine an effective plan of treatment. Some arthritis is common with aging and occurs when the cartilage cushion wears away from the ends of the bones. A frequent location is at the base of your thumb. This can cause severe pain, swelling, decreased strength and a decreased range of motion. This makes it difficult to accomplish simple tasks like turning doorknobs or opening jars. Early management may include a combination of medication and splints. Occasionally surgery is required when the arthritic changes are excessive, and pain restricts normal thumb function. This reconstruction is associated with good functional improvement. Enlarged or bony deformities can form at the base of the thumb or around the small joints of the hand. The smooth surfaces of the joint are worn down. Bone eventually rubs against bone causing friction and further joint damage. Arthritis is somewhat more common in women than men. Treatment of arthritis of the hand begins conservatively by reducing the inflammation and swelling with a subsequent decrease in the pain on motion. If conservative methods of treatment cannot control the associated pain, surgical intervention may be required to rebuild the joint space, reduce pain, and improve hand function. 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