Common Hand Day Surgery

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Dr Paul Thng Leong Keng image

MBBS (Singapore)

FRCS (Edin)

FRCS (Glas)

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Tenosynovitis refers to a group of conditions where tendons in the hand passing through an enclosed space become painful. Some examples include:

  • Stenosing tenosynovitis, or trigger finger
  • DeQuervain tenosynovitis

This commonly occurs when inflammation narrows or irritates the tendons passing through the common tendon sheaths. While the cause of these conditions is not exactly known, repetitive actions involving the use of the tendons can frequently make the condition more painful. It is also more common in women, in patients with diabetes and sometimes may be triggered by the presence of a growth (e.g. ganglion) around the tendon sheath.

Why early treatment is preferable

Repetitive irritation of the tendon sheath can produce scarring, which may result in thickening of the sheath. The movement of the tendons in the sheath may also worsen leading to further restriction in the range of motion.

Treatment Options

The purpose of treatment is to reduce the inflammation and entrapment of the tendons within the tendon sheath. This can be achieved through a variety of methods; e.g. medication, injections including steroids, appropriate physical therapy and rest. If the condition is more serious then surgical release of the tendon sheath may be recommended. (see below for graphic demonstrations)

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a hand condition that causes pain, numbness and tingling sensation in the hand. It is caused by a pinched nerve in the wrist. A number of factors can contribute to carpal tunnel syndrome, including the anatomy of your wrist, certain underlying health problems and possibly patterns of hand use.

Often there may not be an apparent cause for carpal tunnel. It is however more common in women. Patients with chronic inflammatory conditions (e.g. rheumatoid arthritis) or patients with potentially nerve-damaging conditions (e.g. diabetes) may also be more prone to carpal tunnel syndrome. Sometimes a growth in the carpal tunnel may also contribute to the pinched nerve.

Why early treatment is preferable

Prolonged compression can result in wasting and weakness of the hand, since if it becomes prolonged may become permanent

Treatment Options

Treatment aims to decrease the pressure on the nerve and includes rest, medication and various physical therapy methods including splinting. If the condition remains severe then surgical release may become necessary. (see graphic demonstration)

Dr Paul Thng Leong Keng

Senior Consultant Orthopaedics Surgeon / Spine Specialist
MBBS (Singapore) ∙ FRCS (Edin) ∙ FRCS (Glas)

Dr. Thng has been recognized for his work internationally and has been invited to demonstrate live spine surgical and operative skills in several countries.

  • Senior Consultant and Medical Director, PTL Spine & Orthopaedics Clinic
  • Visiting Senior Consultant Orthopaedic Surgeon, Changi General Hospital
  • Adjunct Associate Professor, National University Hospital
  • Trustee, AO Foundation
  • Associate Editor, Global Spine Journal
  • Scientific Reviewer, Singapore Medical Journal and Annuals of the Academy

Dr Paul Thng Leong Keng is a fellowship-trained orthopaedic surgeon subspecializing in spinal surgery. Based on hospital OTM records from 2003-2013, he performed over 3000 operations and over 1200 spine procedures, both open and minimally invasive. He has held various prestigious positions such as the Head of Spine service at Changi General Hospital, Chairman of AOSpine East Asia, and Executive Member of AOSpine International Board.

Dr. Thng has been recognized for his work internationally and has been invited to demonstrate live spine surgical and operative skills in several countries. He continues to contribute to the field through research and serves as an associate editor of the Global Spine Journal.

PTL Spine & Orthopaedics

Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road #07-34
Singapore 329563
+65 6734 7005 (Appointments)
+65 9247 7031 (After Office hours)
+65 6734 5574 (Fax)

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