Orthopedic & Joint Replacement

Hand and Microvascular Surgery Conditions and Treatment Solutions

Trigger Finger

Trigger finger is a common condition of the hand characterized by catching or locking the fingers when bent to the palm. While the ring finger is the most commonly affected finger, digital triggering can occur in any finger. Often, the symptoms are worse in the evening, and the condition is more common in patients with diabetes.

Treatment Alternatives

Trigger digit release is usually done under local anesthesia. Usually, patients can engage in a program of early range of motion to facilitate recovery.

Dupuytrens Disease

Dupuytren’s disease is a thickening of the palmar fascial tissue that causes the fingers to bend towards the palm. It is characterized by nodular or cordlike thickening of the fascia (lining tissue) of the palm of the hand and can be associated with the inability to straighten the fingers. Hand and microvascular surgeons at Piedmont Hospital have extensive experience with non-surgical, minimally invasive methods of correction, including:

  • Percutaneous Aponeurotomy
  • Xiaflex Enzymatic Cord Degradation
  • Open surgical resection
  • Correction of complex recurrent deformity  

Newer methods of treatment for Dupuytren’s disease have simplified treatment for patients with this condition. Percutaneous Aponeurotomy and Enzymatic Cord Degradation can often forestall or eliminate a need for a more complicated open procedure. In addition, limited incision cord resection, open fasciectomy or cord removal are all treatment options that will be considered based on your individual needs.

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is the most common compressive neuropathy, or disease of peripheral nerves, in the upper extremity and is characterized by numbness and tingling in the thumb, index and long fingers.


When diagnosed early in the course of the condition, Carpal Tunnel Syndrome can often be effectively treated by non-surgical treatment strategies. More advanced cases and cases that don’t respond to non-surgical treatment choices may require surgical treatment, most often performed on an outpatient basis under local or regional anesthesia.

Nerve Injury

A laceration or cut to the arm, forearm and hand can result in a nerve laceration that causes loss of muscle function, loss of sensation or both. The specific pattern of the injury is determined by the specific nerve injured.


After a history and physical examination, some patients will require additional evaluation by electrophysiologic testing for a more comprehensive assessment. In most cases, microsurgical nerve repair is usually required for patients with nerve lacerations.

Patients with brachial plexus injuries and patients with chronic injuries may require more sophisticated nerve grafting procedures or nerve transfers. Piedmont physicians have one of the largest experiences with nerve transfers in the Southeast.

Brachial Plexus Injury

High-velocity trauma, or injury caused by a high-speed action, can be associated with significant nerve injuries to the brachial plexus, a network of nerves that sends signals from your spine to the upper extremities. These more serious injuries cause significant impairment to upper extremity use, including the shoulders, arms or hands. Most commonly avulsion mechanism injuries, meaning a pulling or tearing away from the spinal cord, brachial plexus injuries are not necessarily amenable to direct nerve repair.


Brachial plexus injuries often require more complex nerve reconstructions carried out using surgical teams. Piedmont surgeons have significant experience with brachial plexus exploration, nerve grafting, nerve transfers, free innervated muscle transfers, tendon transfers and joint fusions as methods for upper extremity reconstruction.

Microvascular Repair and Reconstruction

Piedmont Hospital was one of the first hospitals in Georgia to perform microsurgical procedures for patients and today is one of the few hospitals in Georgia that provide that service on a regular basis. Piedmont Hospital has an experienced team of surgeons that can provide prompt patient evaluation for acute traumatic injury for the most intricate surgical needs.

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