Our surgeons at Carilion treat all kinds of hand and arm conditions. We provide advanced surgical options for complex and chronic conditions. Traditional surgeries may require anesthesia and longer recovery.

Joints

We treat joint problems in your hand, wrist or fingers to help you move better and feel less pain. 

• Arthroplasty: This minimally invasive surgery uses a camera and small instruments to see the inside of your joint. We replace damaged joints in the fingers, thumb or wrist to improve motion and relieve pain from severe arthritis.
• Rheumatoid hand surgery: We fix joint damage or tendon problems caused by rheumatoid arthritis. It can improve how your hand looks and works.

Nerve and blood vessels

We fix nerve and blood vessel problems in your hand or arm to ease pain, improve feeling and help your hand heal.

• Nerve decompression or repair: We relieve pressure on nerves in the elbow, forearm or wrist. This is a treatment for carpal tunnel, cubital tunnel and radial tunnel syndromes.
• Carpal tunnel release: The surgeon cuts into the ligament pressing against your nerve. This creates more space for the nerve inside your wrist.
• Reconstructive microsurgery: We use tiny tools to reconnect nerves or blood vessels. We use this approach for severe hand injuries or cancer surgery.

Broken bone repair

Some types of bone breaks require realigning the bones surgically. We may use rods and screws to hold the bones in place.

Not all hand or arm injuries need surgery. Small tears and simple fractures often get better with more conservative treatment. Even conditions like ​​carpal tunnel can improve with therapy and bracing.

There are several things your doctor might suggest before you have surgery, including:

• Ergonomic changes (especially for overuse conditions like carpal tunnel or tennis elbow)
• Medicine for pain and inflammation
• Pain injections for longer-term relief
• Physical therapy to help strengthen muscles or learn new patterns of movement
• Braces or splints to limit the mobility of your hand, wrist, arm or shoulder

We offer wide-awake surgical options for certain hand conditions. Wide-awake local anesthesia with no tourniquet (WALANT) is a new approach to surgery.

Wide-awake hand surgery uses local anesthesia only. There are no IVs or tourniquets, either, since tourniquets usually require general anesthesia.

WALANT turns a longer surgery into a shorter surgery. Because there’s no general anesthesia, it cuts down on pre-surgery testing. There’s very little recovery time, meaning you can go home more quickly.

What can I expect with wide-awake surgery?

Wide-awake surgery is an outpatient surgery.

During the surgery, you’ll get an anesthetic that numbs the area your surgeon is working on. As the name suggests, you’ll be awake and even able to talk to your surgeon the whole time.

This can help the surgeon know how the repair is going. For example, the surgeon can ask you to move a hand or finger to check your range of motion.

Even though you’re awake, you won’t feel pain. Wide-awake surgery tends to have high rates of satisfaction. People like that it’s faster, easier to schedule and has good results.

As with other surgeries, working with a hand therapist can help speed your recovery. At Carilion, we have one of the largest team of certified hand therapists in Southwest Virginia. Our program compares to some of the best in the nation.

Conditions we treat with wide-awake surgery

Your surgeon will talk to you about whether wide-awake surgery is an option for your procedure. We most often use wide-awake surgery for:

• Carpal tunnel
• Fractures or dislocations
• Trigger finger
• Ganglion cysts
• Nerve injuries
• Ligament injuries
• Tendon injuries