Patient Care Plastic and Reconstructive Surgery

Expert Care at Your Fingertips – Washington University Hand Surgery

We use our hands to work, play, and care for ourselves and others. When a condition impairs hand mobility, it causes not only physical pain – but can significantly impact one’s quality of life. There are many different conditions that can affect the form or function of the hands, wrists and fingers. These may range from minor temporary problems to major traumatic or degenerative conditions. Many conditions of the hand may worsen over time unless they are treated by a specialist.
Carpal tunnel syndrome, trigger finger and arthritis are among the most common chronic conditions of the arm, wrist and hand. Fortunately, highly effective treatments are available for each of these diagnoses.

Carpal Tunnel Syndrome

Carpal tunnel syndrome affects the median nerve within the hand and wrist. It occurs when there is too much pressure on the nerve, which can cause pain, weakness and a numb or tingling sensation. If you have this condition, you might notice that repetitive motions with your hand can aggravate the involved nerve. If untreated for too long, permanent nerve injury can result. For this reason, it is important to seek consultation soon after the onset of symptoms.

For some people non-surgical treatment is helpful. When surgery is necessary, carpal tunnel release is a safe and reliable option which can offer substantial relief. In this procedure, a surgeon makes an incision in the palm in order to access the transverse carpal ligament.  Dividing this tight structure relieves pressure on the median nerve, and usually results in rapid symptom relief.

Trigger Finger

People with trigger finger may have one finger that gets locked or stuck in a bent position, or they may have an affected finger that snaps or pops when it is flexed or bent. These symptoms are called “triggering.” The affected finger may feel sore or stiff. Sometimes soreness is the only symptom, and classic “triggering” is absent. The condition can begin as moderately inconvenient and progress to become more painful and problematic. Triggering can happen to any finger and may occur in both hands. When it affects the thumb, it’s called trigger thumb.
Treatment for trigger finger can include steroid injection, or a small surgery. Surgery for this condition involves a small incision in the palm, with exposure of the “A1 pulley,” which is a band of tissue which constricts the irritated tendon. Division of this pulley usually leads to rapid, complete, and permanent resolution of triggering and pain.


Simply defined, arthritis is inflammation of one or more of your joints. When the joints of the hand are affected by arthritis, daily activities can become difficult. Arthritis can happen in many areas of the hand and wrist. Osteoarthritis is the most common type of arthritis, and it can cause changes in the bones of the hand that result in pain and inflammation. Rheumatoid arthritis is a specific kind of arthritis, and it is a disabling disease that can cause severe inflammation, deform fingers, cause pain and impair movement.
Surgical treatments for advanced arthritis can help repair or replace a damaged joint to reduce pain and improve joint function. There are different types of arthritis surgery, which include arthroplasty (joint restoration or replacement), arthrodesis (fusion), and denervation (removal of selected nerve branches to reduce pain). Our hand surgeons are prepared to educate you regarding all options, and help you choose a surgical or non-surgical plan which matches your goals.

Hand Surgeons at Washington University

Washington University Plastic and Reconstructive Surgery is home to a diverse group of fellowship-trained hand and wrist surgeons, with expertise covering the entire spectrum of hand surgery.  Comprehensive care is offered for problems affecting the soft tissues, bones, tendons, nerves, and blood vessels which comprise the delicately balanced and anatomically complex human hand.  This includes tendon and nerve reconstruction or transfer, fracture repair, arthritis and other complex skeletal surgery, cancer reconstruction, revascularization and more.

Hand surgical procedures range from very minor to quite major, and most procedures can be offered under variable types of anesthetic. One specialized type of hand surgery, called WALANT surgery, is performed under a local anesthetic only and can help people with certain conditions return to their lives more quickly than traditional surgery. While wide-awake surgery is not appropriate for everyone, our surgeons are pleased to offer this new treatment paradigm to many appropriate patients.

Our hand surgeons can offer relief to people with conditions that limit their activities leisure, occupational, and self-care activities. We will help you develop a treatment plan after we have discussed all the options, including potential benefits and risks. Our team wants you to feel confident about the decisions you make concerning your health and well-being.

Our plastic and reconstructive surgeons see patients at the Center for Advanced Medicine at Barnes-Jewish Hospital and multiple clinical locations across the BJC HealthCare system. Our surgeons work closely with therapists at the Milliken Hand Rehabilitation Center to help patients return to daily life after surgery. 

To request an appointment, please fill out an online appointment form.