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Porter Orthopedics provides leading orthopedic care in Middlebury, along with resources and access to The UVM Health Network. Meet our orthopedic providers and learn more about the services they offer.

Hand and Wrist

Hand and Wrist

Your hands and wrists are intricate structures containing over 2 dozen small bones; a network of ligaments, tendons and muscles; and a web of blood vessels and nerve endings, which give you your sense of touch. Because we use our hands and arms for so many common activities, they are vulnerable to injury.

Hand and wrist problems are common and can cause pain, loss of sensation, loss of movement, and impaired function. Overuse injuries such as carpal tunnel syndrome and tendonitis are among the most common causes of pain. Your hands, wrists, and elbows can also be affected by normal wear and tear on the joints, resulting in arthritis.

Hand Injuries

Having full use of your hands is the key to being able to enjoy a healthy, active life that is free of pain. Our goal at Porter Medical Center is to get you back to the activities you love, as quickly as possible. Your treatment will be dependent on your specific condition and lifestyle. The most common injuries treated include:

  • Acute hand injuries (fractures and sprains)
  • Lacerations requiring stitches or microsurgery
  • Tendon inflammation (tendonitis)
  • Arthritis and arthritic joint pain (osteoarthritis)
  • Nerve compression (carpal tunnel syndrome)
  • Congenital problems, growths or tumors (like Dupuytren’s disease)
  • Reconstruction of old injuries

Hand Therapy

The most crucial step on the road to recovery is proper rehabilitation. Once your individualized treatment plan is put together, you’ll most likely undergo therapy that will help with:

  • Increasing range of motion and flexibility
  • Increasing strength and function
  • Managing acute and chronic pain
  • Promoting healing, surgical repair and wound desensitization
  • A continued therapy treatment plan at home

Conditions We Treat

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a pain inducing condition that causes numbness, weakness and tingling within the hand and arm. It is caused by a pinched wrist nerve called the median nerve. It begins at your forearm and runs through the small space in your wrist known as the carpal tunnel, before ending in your hand. Carpal tunnel syndrome often begins with a dull achiness that extends from the wrist to the hand or forearm. With the proper treatment, the symptoms can be relieved and people are able to resume full function of the wrists and hands.

Carpal Tunnel Treatment

When seeking treatment for carpal tunnel syndrome, doctors will start with more conservative treatment plans. After a thorough diagnostic test and examination, they’ll determine which form of action is best. The nonsurgical options include wrist splinting, nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.

For the more persistent forms of carpal tunnel syndrome that can’t be managed with a non-surgical option, the two most common surgical treatments are endoscopic surgery and open surgery. At Porter Medical Center, our team of experienced hand surgeons, therapists and non-surgical providers are available to ensure you receive the personalized care that will lead to a successful recovery.

Hand Arthritis

There are over 100 types of arthritis, but one of the most common is osteoarthritis, which can occur in the hands when flexible tissues at the end of your bones wear down. It causes pain, swelling, redness, warmth, and can lead to limitation of movement. This type of condition is best treated by orthopedic specialists, rheumatologists, and rehabilitation therapists. The best form of treatment is determined by your specific arthritis diagnosis. Your doctor will work with you to determine the personalized treatment plan that can most effectively reduce the worsening of arthritis and its symptoms. The goal is to improve your quality of life and get you back to enjoying the activities you love.

Wrist Surgery

Based on the nature of your wrist injury, doctors will determine whether a conservative, non-operative treatment plan is suitable. While there are a wide range of treatment options available, our specialists will ensure you receive the proper personalized care. Non-operative treatments include:

  • Wrist casting – To facilitate the healing of an injury, a splint or casting may be recommended. More complex fractures would require surgery followed by hand therapy.
  • Wrist therapy – For the management of acute or chronic wrist pain, wrist therapy is prescribed. This helps to increase strength, range of motion and the dexterity of your wrist.
  • Corticosteroid injections – In order to relieve pain symptoms and the swelling associated with arthritis and other wrist conditions, you’ll be prescribed corticosteroid injections. The anti-inflammatory is injected into your wrist to relieve swelling and pain.

If your wrist injury is more severe, surgery could be the best form of action to repair fractures or torn/ruptured wrist ligaments. This would relieve long term pain that stems from joint degeneration. The following techniques are most commonly performed to correct injuries and manage your pain:

  • Cyst and tumor removal, including excision of ganglions – This procedure can either be an outpatient procedure or require local, regional or general anesthesia. It’s dependent on the location and size of the cyst being removed.
  • Fracture fixation – To properly set or stabilize a broken wrist bone, this procedure helps to improve alignment through the insertion of pins, screws, plates or other hardware that will realign the bones.
  • Joint realignment and joint fusion – Arthritis of the wrist results from a worn-down cartilage layer that allows fluid movement of the joints. This procedure is performed to eliminate pain by reconstructing, realigning or fusing the joint.
  • Wrist arthroscopy – This involves a minimally invasive procedure used to examine the internal structure of the wrist, to determine the appropriate surgery required for repairing ligament injuries, arthritis and fractures.
  • Carpal tunnel surgery, open carpal tunnel release and endoscopic carpal tunnel release – To improve severe carpal tunnel syndrome, this procedure is performed to enlarge the tunnel and make space for the nerve. This reduces pain and relieves pressure.
  • Microsurgery and peripheral nerve surgery – This form of surgery utilizes an operating room microscope to repair damaged blood vessels or nerves.
  • Wrist tendon or ligament repair – This involves an outpatient procedure performed to repair wrist tendons or ligaments that have been cut or torn
  • Tendon transfer – During a tendon transfer, a functioning tendon is shifted from where it was originally attached, to a new location to help bring functionality and movement back to both the hand and wrist.

Get the personalized care you need. Call today to request an appointment at 802-388-3194.