BOARD CERTIFIED PLASTIC SURGEON   |   BOARD CERTIFIED HAND SURGEON

Hand Surgery

The goal of the hand surgeon is to restore form and function of the hand through precise surgical technique. Expertise in a variety of surgical techniques and procedures are required to achieve these goals. Procedures performed in this practice are often minimally invasive, and result in minimal to no pain with rapid recovery. Common hand conditions are described below.


Arthritis

Degenerative osteoarthritis and rheumatoid arthritis of the hand and wrist are conditions which can produce pain, stiffness, and joint distortion which leads to functional impairment. Patients with symptoms that do not improve or can no longer be managed with medical treatment such as therapy, splints, injections and medications are candidates for surgery. Surgical treatment includes soft tissue reconstruction of ligaments, tendon transfers and rebalancing, joint replacement and joint fusion. Treatment plans are specified for each patient individually to produce the best functional improvement with the least amount of down time and recovery.

Arthroscopic Wrist surgery

Persistent post-traumatic wrist pain with normal x-rays may indicate wrist ligament disruption, tendon injury, subluxation or post-traumatic arthritis. MRI study will often clarify the cause of pain. Many conditions can be treated with minimally invasive arthroscopic procedures.

Tendonitis

Tendonitis, or tenosynovitis, is a frequent cause of wrist and hand pain. This is many times misdiagnosed as carpal tunnel syndrome. Some types of tendonitis include trigger finger, Dequervain’s tenosynovitiis, ECU tendonitis, lateral epicondylitis (tennis elbow), medial epicondylitis, and flexor tenosynovitis. Treatment for these conditions depends upon severity, duration of symptoms, previous treatments, and include splinting, medications, injections and surgery.

Carpal Tunnnel Syndrome

This is one of the most commonly diagnosed, and misdiagnosed, conditions in the hand. Carpal tunnel syndrome is caused by compression of the median nerve in the wrist, which causes numbness, tingling, pain, loss of fine movement coordination, atrophy of muscles and functional impairment. Treatment includes splinting, anti-inflammatory medications, injections and therapy for select patients. Symptoms that persist or worsen with medical management will benefit from surgery. Surgery can be performed through an open incision or endoscopically. Endoscopic carpal tunnel release is quick, minimally invasive, is usually pain free and patients recovery quickly. Other types of nerve compression syndromes include Cubital Tunnel Syndrome, Radial Tunnel Syndrome, Radial Sensory Neuritis, and anterior interosseous syndrome, which are sometimes confused with carpal tunnel syndrome.

Removal of Tumors, Cysts

Ganglion cysts, lipomas, and giant cell tumors are the most common causes of masses in the hand and wrist. Some cysts can be treated with needle drainage (aspiration) but the recurrence rate is high. Recurrent cysts respond well to surgical excision, and in properly performed procedures and compliant post-operative care, the recurrence rate is low. Surgery for lipomas, giant cell tumors and other benign tumors is generally performed through small, minimally invasive incisions, is usually pain free, and recovery is rapid.

Congenital Differences

Extra digits (polydactyly), webbed fingers (syndactyly), locked thumb (trigger thumb) are the most common hand differences seen at birth. Depending upon the condition and severity, treatment can been performed during the newborn period or later in development.

Trauma Repair and Reconstruction

Tendon, bone, joint nerve injuries of the hands and wrist occur frequently. It is the goal of a hand surgeon to preserve function and form through precise anatomic repair, and reconstruction. Techniques include fracture fixation with early motion, tendon grafts and transfers, joint reconstruction with implants and soft tissue arthroplasty, nerve reconstruction with grafts, synthetic conduits, and soft tissue reconstruction with skin grafts, tissue flaps, and microsurgical tissue transfers.

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Procedures

Dr. Fealy performs a wide range of plastic and reconstructive procedures, specializing in hand surgery, trauma and cancer reconstruction. Dr. Fealy also specializes in cosmetic procedures of the face, breasts and body.
Featured Procedures

Location
Ventura
Michael J. Fealy, MD, FACS
Ventura Orthopedics Medical Group

2525 Erringer Rd
Simi Valley, CA 93065
Phone (805) 527-1404
Fax (805) 527-5246

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