If your hand is impaired in any way, our physicians may be able to greatly improve your condition and capabilities.
This type of very complex surgery can help to treat diseases that cause pain and impair the strength, function and flexibility of your wrist and fingers. With specialized training in hand surgery, Plastic Surgery Northwest surgeons will strive to restore normal function of fingers and hands injured by a trauma or correct birth abnormalities.

Common Hand Procedures

Carpal Tunnel Syndrome

A condition caused by pressure to the median nerve within the wrist, or “carpal tunnel” near the base of the palm. If you suffer from carpal tunnel syndrome, you may experience pain, tingling sensations, numbness in your fingers, weakness or aching. Carpal tunnel syndrome is associated with multiple conditions including: repetitive motion or overuse, fluid retention during pregnancy, injury to the nerve in the carpal tunnel or rheumatoid arthritis.

Carpal tunnel syndrome tends to be slightly more common in women as one gets older, and very common in certain diseases such as diabetes.  For patients with mild symptoms, simply reducing repetitive activity or taking more frequent breaks to rest and stretch may be enough to keep things under control.  Anti-inflammatory medicines may be helpful to settle down a short-term flare up.  If the nighttime numbness is the main issue, wrist braces worn while sleeping, cannot keep people comfortable.  If symptoms are not adequately controlled with the above treatments, consideration sometimes is made for surgery.  The surgery is a very safe and is typically done as an outpatient procedure that does not require general anesthesia.  For most people with surgery only needs to be done once.

Cubital Tunnel

A condition brought on by increased pressure or stretching of the ulnar nerve at the inner side of the elbow, a site commonly called the “funny bone”. Symptoms of cubital tunnel syndrome typically include pain and/or weakness in the forearm, numbness, and/or tingling most often in the ring and little fingers.


Rheumatoid arthritis is just one type of arthritis out of many. Patients with rheumatoid arthritis often wake up with stiff and swollen joints. Early on, many patients feel tired. While this condition can affect many parts of the body, two thirds of patients with rheumatoid arthritis have wrist and hand problems. Often, the joints feel hot and look red. Rheumatoid arthritis is most common in the wrist and knuckles and typically happens in both hands.

Three other common types of arthritis include:

  • Wear and tear arthritis (osteoarthritis)
  • Gouty arthritis
  • Psoriatic arthritis

Treatment options include anti-inflammatory medications, disease-modifying antirheumatic drugs, and a class of drugs called biological response modifiers (commonly called biologics). A physician may recommend splints or braces, exercise, and modification of daily activities. If joint synovitis cannot be controlled with medications, or if the tendons of the hand and wrist become inflamed or weakened by the disease, surgery may be needed. Surgery may also be needed to correct deformities of the fingers that often result from the disease and is performed by our Board Certified Plastic Surgeons.

Dupuytren’s Contracture

A disabling hand disorder where thick, scar-like tissue bands form within the palm and may extend into the fingers. Eventually, the contraction may progress to where it is difficult to fully straighten the fingers.  There is no known way to halt the process, either by medication, stretching exercises or bracing.  Some individuals may not require any intervention in their lifetime while others may have multiple procedures. As a general rule, if someone can still place their entire palm flat against a table, no intervention is usually required.

When the impact of hand function becomes unbearable, effective treatment is considered.  Most treatments involve some form dividing, removing or dissolving the thickened tissue from the affected digits.  This is typically done in an outpatient setting, often followed by therapy to restore motion and minimize recurrence.

Trigger Finger

A common disorder in older adults characterized by catching, snapping or locking of the involved finger flexor tendon, associated with dysfunction and pain. “Trigger finger” is actually inflammation and thickening of the tendon sheath and can affect almost any tendon in the wrist and hand.  The tendons get stuck as they try to pull, causing a clicking or catching sensation with bending of the joints.  In a more advanced case, the affected digit actually will get stuck in a flexed position The causes are over activity, rheumatoid arthritis, carpal syndrome, systemic diseases (such as diabetes), and trauma.

Ganglion Cyst

A firm or spongy lump under the skin near a joint or tendon. While the cause of this type of cyst is not known, it is more common in women than men and in people who are 15 to 40 years old. Ganglion cysts are typically harmless. While they usually dissipate on their own, ganglion cysts that are painful, interfere with the use of the joint, or are unsightly may be treated through aspiration or surgical removal. They are filled with joint space or tendon sheath fluid.

De Quervain’s Tenosynovitis

Pain on the thumb side of the wrist due to irritation or inflammation of the wrist tendons at the base of the thumb. It may be caused by an injury or repetitive motion. Signs of this condition include pain over the thumb side of the wrist when making a fist, or when grasping or holding objects. If splinting and over-the-counter anti-inflammatory medication do not work, we can administer cortisone injections to reduce swelling, or perform surgery to allow the tendons to move freely. This is common amongst new parents from frequently picking up their child.

Hand & Wrist Fractures

If left untreated, may limit use of the affected finger, hand, or wrist. Signs of a fracture include pain, swelling, deformity, and/or the inability to move the finger, hand, or wrist. In most cases, it’s important to seek medical care right away after an injury or trauma. We specialize in surgery of the hands and wrists, and are qualified to offer appropriate treatments, both surgical and nonsurgical, for fractures of varying degrees.

Tendon Injuries

Cause pain and swelling in the affected finger or joint. Tendons in the hands and wrists connect muscles to bone, making it possible to move the fingers, wrists, and forearms. If a tendon is stretched but intact after an injury, the associated joint is typically able to function within a few days. In this case, rest, compression, and restricted movement may be sufficient. When a tendon is severely torn or completely severed, the ends pull away from each other like a broken rubber band, and the tendon must be repaired through surgery. If properly repaired and allowed a period of recovery, a severed tendon can heal.

Artery & Nerve Repair

Requires specialized expertise in microsurgery of the hand to be performed properly. There are two main arteries of the forearm that run into the hand: 1) the radial artery runs along the thumb side of the forearm, 2) the ulnar artery runs along the outside of the wrist. A major nerve of the forearm, the median nerve, runs down the arm, passes through the carpal tunnel in the wrist, and branches out into the hand. If an artery or nerve in the hand or wrist is severed, it’s important to seek medical care from a specialist as soon as possible to avoid losing function or sensation.


Involves reattaching the blood supply to a fractured bone. This very intricate process may also include repair of the bone, tendons, muscles, nerves, and the overlying skin. Surgeons on our team are highly trained in hand surgery, reconstructive surgery, and cosmetic surgery, and are able to provide optimal outcomes for both function and aesthetics.

Hand Rejuvenation

Often we neglect the back of our hands leaving them to look older that we truly are.  Our hands need attention too.  While we spend time taking care of our face and body with creams and treatments, our hands are not usually the focus of our beauty regimen.  Hands are often exposed to the harsh elements and sun (especially while driving) and by our late 20s have what is known as “loss of volume” – leaving thin skin on the back of the hand that is wrinkled and shows many of our tendons and veins.

Hand rejuvenation is a treatment option available Plastic Surgery Northwest.  Your specific hand rejuvenation plan will be tailored to your needs and expectations by Dr. Laura Bonneau, Board Certified Plastic Surgeon.  Hand rejuvenation often present number of benefits to give you healthier, younger-looking skin, including the following:

  • Improved skin texture and elasticity.
  • More volume and plumpness to the skin.
  • Improved skin tone

If you are embarrassed or dismayed by the look of your hands, age spots, sun damage or wrinkles have taken their toll, Dr. Bonneau can accurately evaluate your possible candidacy for hand rejuvenation.  For more information, you can contact our office to schedule consultation. 

Post-Operative Care

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