Hand, wrist and elbow treatments are surgeries, procedures, and other remedies for conditions affecting the joints and structures of the arm. This includes muscles, tendons, ligaments, cartilage, nerves, and other joint components. When problems occur with any of these structures, treatment often starts with nonsurgical approaches. However, surgery may eventually become necessary. Common hand treatments Effective hand treatments include: Medications and injections for hand and finger arthritis Splinting for finger fractures Surgery to treat hand injuries, Dupuytren’s contracture, mallet finger, and trigger finger Common forms of elbow surgery Treatments for this commonly injured area include: Elbow arthroscopy is minimally invasive surgery to diagnose and possibly treat elbow problems. Elbow replacement removes a damaged or diseased elbow joint and replaces it with an artificial one. Elbow tenotomy trims a damaged or scarred tendon tissue in the elbow. It is a tennis and golfer’s elbow treatment. Tommy John surgery reconstructs a torn ulnar collateral ligament (UCL). This ligament stabilizes the inner side of the elbow joint. The medical name for this surgery is UCL reconstruction. Common forms of wrist surgery Wrist problems can affect the hand, and both can benefit from such wrist surgeries as: Carpal tunnel release is surgery to treat carpal tunnel syndrome. It relieves pressure on the median nerve by cutting part of the carpal ligament in the wrist. Casting or surgery for fractures and breaks Wrist arthroscopy is similar to elbow arthroscopy and diagnoses and treats many wrist problems, such as unexplained wrist pain and tingling in your fingers to wrist fractures. Wrist replacement removes a damaged or diseased wrist joint and replaces it with an artificial one. Hand, wrist and elbow treatments can relieve pain and correct physical problems with the structures of the hand and arm. Depending on the problem, most orthopedic surgeons suggest nonsurgical (conservative) treatments, including cortisone injections, before recommending surgery. The general goals of these treatments are to restore function, reduce disability, and improve your symptoms and quality of life. However, conservative measures may not be enough. Common conditions that may require hand, wrist or elbow surgery—with or without an initial attempt at conservative measures—include: Acute injuries and trauma, such as fractures, dislocations, sprains, strains, and ligament or tendon tears Arthritis including osteoarthritis and rheumatoid arthritis Nerve problems, such as cubital tunnel syndrome and carpal tunnel syndrome Overuse injuries due to chronic and repetitive stress on a bone or joint structure Unexplained hand, wrist or elbow problems Orthopedic surgeons and hand surgeons commonly perform hand, wrist and elbow treatments. Orthopedic surgeons treat, prevent and rehabilitate bone and joint problems. They use both medical and surgical approaches to manage these types of problems. Hand surgeons are either orthopedic surgeons, plastic surgeons, or general surgeons who further specialize in surgery of the hand, wrist and forearm. Hand, wrist and elbow surgery usually takes place in a hospital or surgery center. The details of the procedure will depend on your particular problem and the specific treatment you need. Many of these treatments are major surgeries that require a considerable amount of recovery. Your doctor may use either traditional open surgery with a large incision or a minimally invasive procedure, depending on the surgery. Some hand, wrist and elbow procedures are outpatient surgeries, but many still involve general anesthesia. This lets you sleep through the surgery. In some cases, your doctor may recommend regional anesthesia with sedation to relax you. This is common with arthroscopy. What to expect the day of your hand, wrist or elbow surgery In general, this is what happens the day of your surgery: You will talk with a preoperative nurse, who will ask you to change into a hospital gown. You may have a brief physical exam. You will talk with an anesthesiologist or nurse anesthetist about your medical history and the anesthesia you will have. Your surgeon will visit with you to explain the procedure one more time. Be sure you fully understand the procedure and what to expect afterwards. You will get a sedative to help you relax before the team takes you to the operating room (OR). Your team will start anesthesia in the OR. With general anesthesia, you won’t remember anything else until you wake up in the recovery room. After a minor procedure, you should be able to go home the same day. However, a hospital stay is often necessary for major surgeries. In either case, your doctor will give you detailed information about activity level, medications, and follow-up appointments before you leave. Any type of surgery or procedure involves risks and potential complications. Some of these can be serious and may develop during surgery or recovery. General risks of surgery Although surgical teams have measures in place to address these problems immediately, it’s important to know ahead of time about the following surgical risks: Anesthesia reaction, such as an allergic reaction and problems with breathing Bleeding Blood clots Infection Potential complications of hand, wrist and elbow surgery Most hand, wrist and elbow surgeries are successful, but potential complications include: Decreased wrist or elbow strength Development of arthritis Dislocation, loosening, and wear and tear of the new joint, which may require additional surgery Failure to heal or poor healing Graft failure Nerve, muscle, or blood vessel damage Persistent symptoms, such as pain, stiffness or disability Scarring of joint structures Reducing your risk of complications One of the best ways to reduce your risk of complications is open and honest communication with your surgeon and the surgical staff. You can reduce your risk of certain complications by: Following your doctor’s orders regarding activity and diet before your surgery and during recovery Notifying your doctor or a staff member immediately about any concerns you have, such as bleeding, fever, or increase in pain. Plan ahead for when you are recovering at home. Know how to contact your doctor or the doctor on call. Taking your medications exactly as directed Telling all members of your care team if you have allergies. When the entire care team knows, everyone is more aware and alert about possible problems. There are steps you can take before surgery to help improve your comfort and outcome afterwards. Preparing for hand, wrist or elbow surgery includes: Arranging a ride home. You should also have someone to stay with you for the first 24 hours. Getting preoperative testing if your doctor orders it. This will vary depending on the procedure and your medical history. Losing excess weight before surgery—even a little bit helps Making sure all your healthcare providers have your complete medical history. This includes chronic conditions, allergies and medications. When listing medications, include prescriptions, over-the-counter drugs, herbal treatments, and vitamin supplements. Not eating or drinking before surgery as directed Stopping smoking as soon as possible to help the healing process Taking or stopping medications as directed Questions to ask your doctor There is a lot to remember before surgery. Make a list of your questions so you remember to ask them during your appointments. Questions you may want to ask your doctor include: Why do I need the procedure you are recommending? Are there any other options we can try first? How long with the surgery take? When can I go home? What restrictions will I have after surgery? What kind of assistance will I need at home? When can I return to work and other activities? When will I start physical therapy? How many treatments are typically necessary for recovery? How will you manage my pain? What if I have side effects from the pain medicine? When should I follow up with you? How should I contact you after hours if I have a problem? When you know what to expect, it is easier to plan and prepare for a successful recovery. How long will it take to recover? Some hand, wrist and elbow treatments take more time to recover than others. You may need to wear a cast, splint or sling for a few weeks after surgery. This will keep your arm or hand in the proper position for healing. You will also likely need physical therapy. Physical therapy helps you regain strength and function in your elbow, wrist or hand. Gradually, you will return to normal activities. Follow your doctor or therapist’s recommendations for activities and ask before starting new ones. Doing too much early in your recovery increases the risk of injury and can lengthen your recovery time. In general, full recovery can take several weeks to months. Will I feel pain? You will have pain and discomfort after hand, wrist or elbow surgery. The amount of pain varies depending on the specific procedure and your condition going into surgery. Open surgery to repair a serious injury will likely be more painful than wrist arthroscopy. Controlling your pain is important for healing and a smooth recovery. It allows you to fully participate in your rehabilitation. Tell your doctor if your pain worsens or changes because it could be a sign of a complication. When should I call my doctor? For questions between appointments, contact your doctor’s office. However, you should call your doctor right away or seek immediate medical care if you have any of the following: Bleeding more than expected (based on your surgical incision care instructions) Breathing problems or shortness of breath Confusion or changes in level of alertness Chest pain, pressure or tightness Drainage of pus, redness or swelling around your incision Fever. It’s common to have a fever right after surgery. Your doctor will give you instructions about when to call for a fever. Inability to urinate or move your bowels Leg pain, redness or swelling, which could mean you have a blood clot How might surgical treatment affect my everyday life? After surgery, most people find relief from their symptoms. They return to their favorite activities with little or no pain or limitations. It is possible to have some lingering problems in some cases. It is also possible to reinjure yourself or develop problems in the future. Talk with your doctor and physical therapist so you know what to expect after recovery. Ask about ways to protect yourself against future issues with your hand, wrist or elbow.