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Orthopedics · Hand and wrist

Minor procedures on the hand

Does your finger catch, pull into your palm, or does your wrist hurt on the thumb side? We treat trigger finger, Dupuytren's contracture and de Quervain's disease with a minor procedure under local anesthesia, and you go home the same day. If everything is in order, the procedure can take place as soon as within a week of the consultation.

Book an orthopedic consultation How the procedure works
  • No referral from a GP needed
  • Operated by Prof. MUDr. Radek Hart

Minor procedures under local anesthesia

1 weekthat soon the procedure can happen
anesthesia
localonly the hand is numbed, general anesthesia is not needed
until the procedure
1 weekfrom the consultation, if everything is in order
home
same dayyou go home after the procedure
procedures
3trigger finger, Dupuytren's contracture, de Quervain's disease

When a procedure is considered

Catching, contracted fingers and pain at the thumb

All three problems involve tendons or connective tissue in the hand and usually start gradually. If the problems persist or limit the hand, a minor procedure relieves them.

  1. Trigger finger

    A finger or thumb catches when bending, snaps, and may stay bent, so you straighten it with your other hand. It hurts at the base of the finger in the palm, where a tender lump is often found, usually worse in the morning. It is more common after age 40, in women, with diabetes, rheumatoid arthritis and frequent forceful gripping.

  2. Dupuytren's contracture

    Lumps, dimples or tough cords appear under the skin of the palm. The cords gradually pull the fingers toward the palm, most often the ring and little finger, until you can no longer lay your hand flat on a table. It usually does not hurt and worsens slowly, over months to years. It is more common in men, people with a family history, smokers, and people with diabetes or epilepsy.

  3. De Quervain's disease

    The wrist hurts on the thumb side, especially when gripping, turning the wrist or lifting, for example a child. Two thumb tendons are irritated in the narrow tunnel they pass through, and their sheath thickens. It more often affects women, people in their forties and fifties, and women during pregnancy or after childbirth.

  4. Tingling fingers?

    We treat this too with a minor procedure under local anesthesia. About carpal tunnel surgery

Simplified diagram of a finger from the side: the flexor tendon passes under the pulley at the base of the finger and glides freelyHealthy finger: tendon glides freelypulley (annular ligament)holds the tendon to the boneflexor tendon of the fingerfinger bones Simplified diagram of a trigger finger: the tendon is thickened and catches on the edge of the thickened pulley; during the procedure the pulley is cutTrigger finger: tendon catchesthickened pulleythickened tendon catcheson the edge of the pulleyhere the pulley iscut during the procedure
  • outline of finger and palm
  • bones
  • flexor tendon of the finger
  • pulley at the base of the finger
Simplified diagram of a finger from the side (palm at the bottom), not an actual image.

When to operate

When a minor procedure is appropriate

A minor procedure comes into question when the problems persist and limit you. Whether and when to operate is decided by the doctor at the consultation.

Trigger finger

The finger gets stuck

When the snapping does not subside.

  • The finger stays stuck and you straighten it with your other hand
  • Snapping and pain at the base of the finger do not subside

De Quervain

Pain at the thumb persists

When the pain does not subside.

  • The wrist hurts on the thumb side when gripping and turning
  • The pain limits everyday activities, such as lifting a child

Dupuytren

Fingers pull toward the palm

When contracted fingers limit the hand.

  • You can no longer lay your hand flat on a table
  • The more advanced the contracture, the harder it is to treat, so it is better to come early

Which procedures we perform

All procedures are done under local anesthesia, and you go home the same day. Prof. Hart will recommend which one is suitable for you after examining your hand.

  • Trigger finger release

    The surgeon releases the pulley at the base of the finger that constricts the tendon. The tendon then glides freely again. The other pulleys stay in place, so hand function is not affected.

  • Dupuytren's contracture surgery

    Through an incision in the palm and on the finger, the surgeon removes the thickened tissue that pulls the finger and straightens it. This does not make the disease go away permanently, but after removal of the altered tissue the risk of recurrence is lower than after merely cutting the cord.

  • Tendon release for de Quervain's disease

    The surgeon first finds and protects the small nerves nearby, then opens the thickened tendon sheath so that the tendons have more room and stay stable. Hand and wrist function do not change.

  • Carpal tunnel surgery

    It relieves pressure on the nerve in the wrist when tingling and numbness of the fingers persist and limit you. Details of the procedure

Not sure whether the procedure is right for you? The examination will decide. Book a consultation

How the procedure works

From booking to going home

A minor procedure under local anesthesia: only the hand is numbed, general anesthesia is not needed. You go home the same day.

  1. Booking

    Online or by phone. A referral from your GP is not required.

    online or by phone

  2. Consultation and examination

    Prof. Hart examines the hand and tests the motion of the fingers and thumb. For trigger finger and de Quervain's disease, the examination is usually enough; an X-ray is mostly not needed.

    diagnosis and treatment plan

  3. Procedure

    Under local anesthesia, only the hand is numbed. How long it takes depends on the type and extent of the procedure.

    within a week of consultation

  4. Going home

    The same day. Keep the hand elevated afterwards and move your fingers as instructed; this eases swelling and stiffness.

    follow-up and physical therapy

Recovery and physical therapy

The hand returns to work gradually

After the procedure, expect mild pain, swelling and stiffness. Keeping the hand elevated and moving the fingers gently helps. If needed, we continue with physical therapy right at the clinic.

Room of the short-stay ward at HR Clinic

  1. Trigger finger

    You can start moving your fingers right after the procedure. The wound heals within a few weeks, but swelling and stiffness may take 4 to 6 months to fade. People feel fully recovered after about 6 months on average.

  2. Dupuytren's contracture

    Recovery usually takes 4 to 12 weeks, often with a splint and exercises. The finger may not be completely straight, and the contracture can return after years, in roughly one in five patients.

  3. De Quervain's disease

    A dressing is applied to the wound, sometimes a splint as well. You return to normal use of the hand once the pain subsides and strength returns. Complications are rare; with diabetes there is a slightly higher risk of wound healing problems.

  4. Return to work

    When you can return to work depends on how much your job strains the hand. You will get an estimate for your work at the consultation.

Prof. MUDr. Radek Hart, Ph.D., FRCS, MHA

Who operates

Prof. MUDr. Radek Hart, Ph.D., FRCS, MHA

Orthopedic surgeon and traumatologist of the musculoskeletal system, head physician of HR Clinic. He sees patients in Znojmo and Vienna; after a consultation in Vienna, the procedure can be performed in Znojmo.

More about Prof. Hart Professional website ortho-hart.at

Price We will tell you the price of the procedure at the consultation, based on the findings and the extent of the procedure.

Frequently asked questions

What patients ask most often

Related articles and procedures

Painful finger joints: osteoarthritis and treatment Carpal tunnel surgery Osteoarthritis of the thumb and finger joints Wrist surgery
Will the procedure hurt?

The procedure is done under local anesthesia, and the hand is numb. Afterwards you may feel pain, swelling and stiffness for a few days; keeping the hand elevated and moving the fingers gently helps.

When is a trigger finger operated on?

When the finger stays stuck or the snapping and pain do not subside. The surgeon releases the pulley at the base of the finger that constricts the tendon, and the tendon then glides freely again. The other pulleys stay in place, so hand function is not affected.

Is Dupuytren's contracture gone for good after surgery?

No, not so far. The procedure straightens the fingers and the hand works better again, but the disease can return after years. It is benign and does not spread to other parts of the body. The more advanced the contracture, the harder it is to treat, so it is better to come early.

My wrist hurts at the thumb after childbirth. What can I do?

De Quervain's disease appears during pregnancy and often within 4 to 6 weeks after childbirth. If the pain does not subside and limits you, come in for an examination. Prof. Hart will assess whether a minor procedure is appropriate.

Do I need a referral from my GP?

No. You can simply book online or by phone.

How soon can I have the procedure?

If everything is in order, the procedure can take place as soon as within a week of the consultation. We will arrange the date based on the examination results.

Booking

Book an orthopedic consultation

Online or by phone, at the clinic in Znojmo. A referral from your GP is not required.

Book a consultation
Book a consultation