Hand and Wrist Surgery at OSI
OSI surgeons perform common hand and wrist operations, including carpal tunnel and Guyon canal release, trigger finger release, and fracture fixation. Many hand and wrist problems also respond to splinting or injection, and those options are part of the same plan.
Hand and wrist operations are performed at our partner hospitals across the region, with follow-up at any of our six clinic locations. For information on hand and wrist conditions, evaluation, and non-operative treatment, see Hand & Wrist Care at OSI, or browse the full list of hand and wrist conditions.
Nerve Release
Carpal tunnel release is one of the most common hand surgeries we perform, and one of the most common operations in orthopedics. The transverse carpal ligament, which forms the roof of the carpal tunnel, is divided to relieve pressure on the median nerve. The procedure can be done endoscopically (through one or two small incisions using a camera) or through a traditional open approach, both of which take roughly ten minutes. Numbness and tingling typically improve within days to weeks; grip strength recovers over one to three months.
Not every patient with carpal tunnel syndrome needs surgery. Mild to moderate cases often respond to night splinting and a corticosteroid injection, and we will try those first when appropriate. Surgery is recommended when symptoms keep coming back, when nerve testing shows significant pressure on the nerve, or when the muscle at the base of the thumb has started to shrink (a sign the nerve has been squeezed long enough to cause muscle damage).
Guyon canal release addresses compression of the ulnar nerve at the wrist. It is far less common than carpal tunnel release but follows a similar principle: the roof of Guyon canal is divided to decompress the nerve. Cubital tunnel syndrome (ulnar nerve compression at the elbow) is addressed on the Elbow page.
Tendon Surgery
Trigger finger release
Trigger finger release is a brief procedure that divides the A1 pulley at the base of the affected finger, eliminating the catching or locking that occurs when the flexor tendon can no longer glide smoothly through the narrowed sheath. The operation takes roughly five minutes under local anesthesia. Most patients use the hand for light tasks the same day. Grip strength and full motion return within a few weeks.
Trigger finger frequently responds to a single corticosteroid injection, and we will offer that first in most cases. Surgery is recommended when injections have failed, when the finger is locked in a fixed position, or when the patient prefers a definitive solution.
Tendon repair
Cut tendons and tendons that snap require surgical repair to restore finger or thumb motion. Mallet finger (a torn tendon at the fingertip) is usually treated with splinting alone, but cases that also involve a bone fragment or that have gone untreated may need surgery. Jersey finger (a tendon torn off the bone at the fingertip) almost always needs surgical reattachment, ideally within the first one to two weeks of injury.
Flexor tendon repairs are technically demanding procedures that require a structured hand therapy protocol afterward. The repaired tendon must be protected while healing, and early controlled motion (guided by a hand therapist) is essential to prevent adhesions that limit finger movement.
De Quervain release
De Quervain release opens the tight tunnel on the thumb side of the wrist to relieve pressure on the tendons that run through it. It is performed when splinting and an injection have not resolved the pain on the thumb side of the wrist. The procedure takes roughly ten minutes, and most patients return to normal activity within three to four weeks.
Arthritis Surgery
Thumb CMC arthroplasty
Thumb CMC arthroplasty is the standard surgical treatment for advanced arthritis at the base of the thumb that has not responded to splinting, injections, or activity changes. The worn-out small bone at the base of the thumb is removed, and a portion of a nearby tendon is used to fill the space and steady the thumb. The procedure reliably eliminates the bone-on-bone grinding pain of advanced arthritis while preserving thumb motion and pinch strength.
Recovery is longer than most hand procedures: the thumb is immobilized in a cast or splint for four to six weeks, then motion and strengthening progress over the following two to three months. Most patients reach maximum improvement by four to six months.
Dupuytren fasciectomy
Dupuytren fasciectomy removes the thickened cords of tissue in the palm that pull one or more fingers down toward the palm. The procedure is offered when the bent finger gets in the way of using the hand, typically when the finger can no longer be straightened to lay flat on a table. The diseased tissue is carefully removed while protecting the nerves and blood vessels of the finger. Recovery involves splinting and hand therapy to hold the correction. Dupuytren disease can come back over time, but surgery typically provides years of improved hand function.
Ganglion and mucous cyst excision
Ganglion cysts and mucous cysts are harmless fluid-filled lumps that come from a joint or tendon. Many go away on their own or cause few symptoms. Removal is offered when a cyst is painful, limits motion, or (in the case of a mucous cyst at the end joint of a finger) changes the nail or threatens the skin. The cyst and the small stalk that feeds it are removed. Cysts come back only rarely after surgery.
Hand and Wrist Fracture Surgery
Fractures of the hand and wrist are among the most common injuries we treat. Many heal well with splinting or casting alone, but displaced or unstable fracture patterns require surgical fixation to restore alignment and allow early motion.
Distal radius fractures are the most common wrist fracture. When the fracture is out of position, runs into the joint, or is unstable, surgery to set the bone and hold it with a plate (open reduction and internal fixation, or ORIF) restores the joint surface and allows the wrist to start moving sooner than it would in a long cast. The procedure takes roughly 45 minutes. Most patients begin guided motion within one to two weeks and return to full activity by three months.
Scaphoid fractures deserve special attention because this small wrist bone has a tenuous blood supply. Nondisplaced scaphoid fractures can be treated with casting, but displaced fractures or those at risk for nonunion benefit from screw fixation, which compresses the fracture and allows earlier return to activity. Delayed diagnosis or inadequate treatment of scaphoid fractures can lead to nonunion and eventual wrist arthritis.
Metacarpal fractures (breaks in the long bones of the hand, including the common boxer's fracture behind the small finger) are usually treated with splinting, but fractures that are twisted, shortened, or run into a joint may need pin or plate fixation to keep the hand working properly.
Phalangeal fractures follow a similar principle: stable fractures are splinted with early buddy taping and motion, while unstable or displaced fractures need surgical fixation (pins, screws, or small plates) to restore alignment and allow early rehabilitation.
Nail-bed injuries in the fingertip often accompany fingertip-bone fractures. Surgical repair of the nail bed restores nail growth and fingertip contour. These are typically performed as urgent procedures on the day of injury.
For the full picture on fracture care across all regions, see Fracture & Trauma Care at OSI.
All Hand and Wrist Procedures We Perform
Joint
Fracture fixation
Soft tissue
What Surgery Day Looks Like
Most hand and wrist surgery is short and outpatient: small incisions, often local or regional anesthesia, home the same day with a bandage or splint. Some procedures, like trigger finger and carpal tunnel release, take only minutes. You leave with written instructions, elevation rules to keep swelling down, and a plan for the first follow-up visit. Someone needs to drive you home if you had sedation.
Recovery and What to Expect
Recovery timelines vary by procedure and by patient. A carpal tunnel release patient typically returns to light hand use within days and full grip strength by six to twelve weeks. Trigger finger release is similar. Thumb CMC arthroplasty has the longest recovery among common hand procedures: four to six weeks in a cast or splint, then two to three months of therapy to regain strength and motion. Fracture fixation recovery depends on the bone involved and the severity of the injury, but most patients begin supervised motion within one to two weeks of surgery and return to full activity by three months.
Hand therapy (occupational therapy specializing in the hand and upper extremity) is a critical part of recovery for many hand and wrist procedures, particularly tendon repairs, fracture fixation, and thumb arthroplasty. The therapist works with your surgeon to progress motion and strengthening on the right timeline for your specific procedure and healing.
Who You Will See Here
All three of our board-certified orthopedic surgeons perform hand and wrist surgery. Meet our providers.
