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Median nerve decompression in carpal tunnel syndrome
The surgery is performed using a tourniquet and magnifying lenses. During the surgery, an incision is first made on the inside of the wrist. Then the fibrous band (flexor retinaculum) is severed to make space for the nerve. If present, benign soft tissue tumours or a thickened tendon tissue that may put pressure on the nerves are also removed. At the end of the procedure, the skin incision is sutured and a dressing is applied.
Splitting the tendon compartment to treat trigger finger or de Quervain syndrome
During this procedure, a skin incision of approx. 1cm is made above the narrowed tendon, and the A1 annular ligament or the 1st extensor compartment is severed. This makes space for the tendon to slide freely.
Surgery for Dupuytren's contracture
To ensure a good view, the surgery is carried out using a tourniquet and magnifying lenses. The extent of the intervention may vary widely depending on how much the disease has progressed. Sometimes it is enough to remove individual connective tissue strands. In advanced cases, it may be necessary to remove the entire sheet of connective tissue from the palm of the hand (fasciectomy). It may also be necessary to carefully remove adhesions in the area of nerves, vessels, and joint capsules during the surgery. A Z-shaped cut is usually made so that the scar does not cause the connective tissue to shrink later on. At the end of the surgery, a thin plastic tube is inserted to drain the wound secretions. It will be removed after 1-2 days.
Wrist arthroscopy for ganglion cyst or disc damage
Thanks to modern technical developments, it is possible now to image even the particularly tight wrist joint. The joint is pulled apart during the procedure using an external clamp, so that the precise specialized devices have enough space in the inner joint space. Optical instruments, which allow an assessment of the entire wrist, are introduced via three to five small incisions. Imaging makes many surgical interventions on the wrist possible. Examples are windowing of a ganglion, smoothing or removing a torn disc, or removing inflamed synovial membrane.
Trapezium resection arthroplasty in rhizarthrosis
The so-called trapezium resection with suspension, also called saddle joint arthroplasty, has been tried and tested for decades. The large trapezium bone is first removed in order to then insert a tendon strip from an adjacent tendon. This serves as a suspension of the thumb joint, as it were, and ensures adequate mobility. Immediately after the procedure, the joint is immobilised using a splint for three to six weeks. Only fingers are mobilised from the first day to promote blood circulation.