When injury, disease or a degenerative condition affects hand and wrist function, even simple actions can become painful or impossible. At UT Medicine, patients benefit from research-driven treatment techniques and advanced surgical expertise without the long waits often associated with hospital systems.

Our orthpaedic surgeons provide specialized treatment for the following conditions:

• Carpal tunnel syndrome – occurs when the median nerve, which travels through a narrow passageway in the wrist called the carpal tunnel, becomes compressed or irritated
• Dupuytren's disease (Dupuytren's contracture) – a progressive condition in which the fascia gradually thickens and tightens, forming rope-like cords that pull one or more fingers into a permanently bent position. Treatment options include needle aponeurotomy, enzyme injection therapy to dissolve the cord or surgical fasciectomy to remove the diseased tissue.
• Ganglion cysts – the most common soft tissue masses of the hand and wrist. For cysts that recur or are causing significant symptoms, outpatient surgical excision can provide beneficial treatment.
• General wrist fractures and ligament tears – can produce scaphoid fractures, as well as distal radius fractures and intercarpal ligament tears. Quick and accurate diagnosis is essential, as untreated scaphoid fractures can progress to avascular necrosis and long-term wrist arthritis.
• Golf-related injuries – can result in hamate hook fractures, flexor tendon injuries and wrist sprains. These injuries can be subtle or missed on standard X-rays, requiring advanced imaging for accurate diagnosis.
• Pickleball and tennis injuries – can commonly lead to wrist tendinitis, triangular fibrocartilage complex (TFCC) tears and stress fractures. Lateral epicondylitis, also known as "tennis elbow," can extend its effects into the wrist, while TFCC injuries cause ulnar-sided wrist pain that is often misdiagnosed or undertreated.
• Skier's thumb – may be treated with splinting, while complete ligament tears typically require surgical repair to restore pinch strength and stability
• Thumb basal joint arthritis (CMC arthritis) – develops when the cartilage in this joint wears down over time, leading to pain, swelling and weakness precisely where the thumb generates its pinching and gripping strength. Surgical reconstruction removes the arthritic bone and reconstructs the joint using a tendon graft, helping to restore function and relieve pain.
• Wrist arthritis – develops with cartilage loss, similar to thumb arthritis. Surgical reconstruction including partial fusions and wrist joint replacement can restore wrist motion and improve pain.
• Trigger finger (stenosing tenosynovitis) – develops when inflammation narrows the tendon sheath surrounding the flexor tendons that bend your fingers. Corticosteroid injections into the tendon sheath are effective for many patients and can provide lasting relief. When injections fail or the triggering is severe, surgical release of the constricted tendon sheath can restore smooth tendon movement.

Injuries to the upper extremity may also involve the shoulder and elbow, requiring coordinated evaluation across multiple joints. At the Hand and Wrist Clinic, many patients can be seen quickly and begin treatment without unnecessary delays.

When people think of surgery, they often picture a hospital operating room and the administration of general anesthesia. At UT Medicine’s Musculoskeletal Institute, we understand the need for convenient and affordable procedures and offer a range of hand, wrist and elbow surgeries that can be performed in-office using newer techniques for local anesthesia.

Advantages of in-office procedures:

• Can be performed to correct a variety of hand and wrist conditions, including many minor injuries
• Are typically performed under local anesthesia
• While pain in your hand and/or arm is numbed, you do not lose consciousness as you would under general anesthesia.
• Minimal time spent at the doctor’s office, typically around an hour
• Many procedures are brief, taking approximately 10 minutes.
• Relatively affordable, with multiple payment options available
• Patients can eat breakfast the day of your surgery.
• For some procedures, patients can drive themselves home.
• Can be more convenient and accessible, compared to a hospital or surgery center

Your recovery time following the procedure may vary. Oftentimes, patients are able to resume most of your regular activities immediately.

Treatment options and procedures performed at the Hand and Wrist Clinic include:

• Carpal tunnel release surgery — reliably decompresses the nerve and restores sensation and strength
  
• Hand trauma/injury evaluation – may involve fracture fixation using plates, screws or pins; nerve repair or grafting; vascular repair to restore blood flow; and soft tissue reconstruction to cover exposed structures
  
• Joint fusion (arthrodesis) – permanently joins two bones across a damaged joint, helping to eliminate painful motion
  
• Joint replacement (arthroplasty) – involves removing the damaged joint surfaces and replacing them with implants designed to restore motion and reduce pain. Arthroplasty can be effective for patients with rheumatoid arthritis who need to preserve range of motion for daily activities.
  
• Ligament reconstruction and tendon interposition – an effective surgical procedure to treat arthritis of the thumb
  
• Percutaneous needle release – a minimally invasive, office-based technique that allows a trained hand specialist to release constricted tissue using a needle rather than a traditional incision
  
• Surgical release to treat trigger finger – can restore smooth tendon movement when corticosteroid injections fail or the triggering is severe
  
• Tendon surgical repair – involves meticulous technique to restore tendon continuity while allowing the repaired tendon to glide smoothly within its sheath
  
• Treatment for Dupuytren's disease – options include needle aponeurotomy (a percutaneous technique to break up the cord), enzyme injection therapy to dissolve the cord or surgical fasciectomy to remove the diseased tissue

At UT Medicine’s Musculoskeletal Institute, our academic medical center environment means that complex reconstructive cases benefit from a multidisciplinary approach, bringing together the expertise needed to manage even the most challenging injuries. UT Medicine’s Sports and Injury Clinic works closely with hand specialists to coordinate care for trauma patients.