Hand and Upper Extremity Surgery

Reconstruction and Trauma Surgery
The reconstruction and trauma team shares a partnership with the Ryder Trauma Center located on the medical school's campus. The Ryder Trauma Center handles the care of all major traumas in the area and is the only Level I trauma center in Miami-Dade County, managing 3,500 trauma cases annually. This relationship affords the medical center's reconstruction and trauma team extensive experience with surgical reconstruction procedures necessary after many traumatic injuries.

The team has the skill and expertise to perform any type of reconstruction required, from complex wound closure, skin grafting, muscle flaps and microsurgery required for more extensive damage. Because it is located at an academic center, an interdisciplinary team approach is possible and patients benefit from excellent surgeons and medical care personnel coming from a variety of specialties.

Carpal Tunnel Syndrome
Carpal tunnel syndrome can cause tingling, numbness, aching and impaired hand function. The carpal tunnel is a passageway through the wrist carrying tendons and one of the hand's major nerves. Pressure may build up within the tunnel because of disease (such as rheumatoid arthritis), injury, fluid retention during pregnancy, overuse or repetitive motions.

In the operation to correct carpal tunnel syndrome, the surgeon makes an incision from the middle of the palm to the wrist. He or she will then cut the tissue that is pressing on the nerve to reduce the pressure.

Rheumatoid Arthritis
Rheumatoid arthritis is an inflammation of the joints. It can be a disabling disease that affects the appearance and function of the hands or other parts of the body. It often deforms fingers and forces them into a bent position that interferes with movement.

For some patients, surgery is the best treatment option. Surgeons usually can repair or reconstruct almost any area of the hand or wrist by removing tissue from inflamed joints, repositioning tendons or implanting artificial joints.

Dupuytren's Contracture
Dupuytren's contracture is a disorder of the skin and underlying tissue on the palm side of the hand. Thick, scar-like tissue forms under the skin of the palm and may extend into the fingers, pulling them toward the palm and restricting motion. The condition usually develops in mid-life and has no known cause, although it has a tendency to run in families.

Surgery is the only treatment for Dupuytren's contracture. The surgeon cuts and separates the bands of thickened tissue, freeing the tendons and allowing better finger movement. The operation must be done very precisely because the nerves that supply the hand and fingers are often tightly bound up in the abnormal tissue. In some cases, skin grafts are also needed to replace tightened and puckered skin.

Congenital Defects
Some individuals are born with congenital deformities of the hand. These deformities may cause improper hand growth and significant problems in the use of the hand. Most problems can be solved at an early age - even as early as infancy — due in part to advances in modern surgical techniques.

Syndactyly, a condition in which two or more fingers are fused together, is one of the most common congenital defects. Surgeons usually can correct this by cutting the tissue that connects the fingers and then grafting skin from another part of the body. Other common congenital defects include short, missing or deformed fingers, immobile tendons and abnormal nerves or blood vessels. In most cases, these defects can be treated surgically and significant improvement can be expected.