Conditions that affect the soft tissues of the hands cause a range of symptoms, and these symptoms affect one’s quality of life. As a fellowship trained hand and peripheral nerve specialist, John R. Barbour, MD, FACS, is a triple board-certified plastic and reconstructive surgeon who offers soft tissue hand surgeries for the residents of the Washington, DC area, including Fairfax, Arlington, Alexandria and surrounding communities in Virginia.
About Soft Tissue Hand Surgeries
- Raynaud’s Treatment
- Tendon Surgery
- Congenital Hand Anomalies
- Ganglion Cyst
- Scleroderma Treatment
- Dupuytren’s Contracture
Tendon Surgery
Tendons are fibrous bands of tissue that connect the bones to the muscles. Inflammation, tears and other problems cause a range of symptoms, such as stiffness, pain and limited range of motion. The main function of a tendon is to connect skeletal muscles to bones. Without tendons we cannot contract our muscles, therefore a tendon injury can greatly affect or even inhibit the ability to move the affected fingers, hand or arm.
A tendon injury is usually caused by a penetrating injury to the hand or fingers. In many cases this is due to a laceration or puncture wound but can be cause by a blunt impact or crush injury. It is important that the surrounding structures of the hand are closely examined as well, since tendon injuries are often seen in conjunction with fractures, dislocations and damage to nearby nerves or blood vessels.
A torn tendon will almost always require surgical repair. A partial or full thickness tendon laceration from trauma will need immediate repair to ensure mobility to the fingers or hand is kept. These injuries should be repaired quickly as to avoid any permanent disability in the affected area. Dr. Barbour will evaluate your injury using multiple techniques to determine its severity and the complexity of the repair needed.
Congenital Hand Anomalies
Congenital hand anomalies are deformities that develop in the womb and are present at birth. Any type of deformity in a newborn could become a challenge for a child as he or she grows. Hand deformities can become particularly disabling as the child grows and begins using their hands for tasks. There are many degrees of deformities, these range from a minor deformity such as unequal fingers, to a severe deformity such as total absence of a bone. Dr. Barbour treats many congenital hand anomalies, the most common are Syndactyly and Polydactyly. Surgery for congenital hand anomalies is usually best done in the first few years of life so that the look, feel and function of the corrected hand is the most natural for the child.
The most common types of hand malformations are polydactyl and syndactyly:
- Extra Digits (Polydactyly) – Polydactyly is the presence of one or more extra fingers on the hand, or a supernumerary digit. Most commonly an extra finger may be small, non-functional and made of only skin and soft tissue. The extra finger is most commonly adjacent to the thumb or little finger. The main treatment of polydactyly is surgery to remove the extra parts and more importantly to correct associated problems with what remains.
- Fused Fingers (Syndactyly) – Syndactyly is an abnormal connection of the fingers to one another. In children born with syndactyly the fingers are “webbed” or fused together. Syndactyly can be simple, where fingers are joined by skin or soft tissue or complex, where bones of the fingers are fused together. The main treatment of syndactyly is surgery to separate the joined parts and more importantly to add skin to correct the fact that there usually is not enough skin to go around two complete fingers.
The goal of treatment is to improve the function and appearance of the affected hand to the best extent possible. Dr. Barbour will evaluate you/your child and customize a specific treatment plan based on several factors. Factors such as; age, overall health, medical history, extent of condition, and expectations of the patient/parent are all considered when determining the best course of treatment. Surgical treatment is more likely to result in a satisfactory outcome if surgery is done in the first few years of life to give the child the most ability to adapt and accommodate to the changes in their hand.
Ganglion Cysts
Ganglion cysts appear as abnormal lumps that are found on the joints and tendons. Although ganglion cysts can develop in any area of the body, most cases involve the hands, wrists, feet and ankles. Like other cysts, ganglion cysts are fluid-filled sacs that are normally round. Smaller ganglion cysts may not cause symptoms, but larger cysts can cause pain and limited mobility.
Physical examination and symptom review is typically adequate for diagnosing a ganglion cyst, but imaging tests may be needed for those that occur deeper in the tissues. Moving the joint and tendon may worsen the cyst, so Dr. Barbour may recommend limiting activities to allow the ganglion cyst time to reduce in size. If this conservative approach does not work, the cyst may need to be drained or removed via surgery.
Dr. Barbour offers soft tissue hand surgeries for the residents of the Washington, DC area, including Fairfax, Arlington, Alexandria and surrounding communities in Virginia. To learn more about soft tissue hand surgeries, contact Barbour Plastic Surgery to schedule a personal consultation.
