Name of the Procedure:

Neuroplasty; digital, 1 or both, same digit

Summary

Neuroplasty, focusing on a single digit or both sides of the same digit, is a surgical procedure aimed at releasing entrapped or compressed nerves in the fingers. It is performed to alleviate pain and restore function in the affected finger(s).

Purpose

Neuroplasty is conducted to address nerve entrapment, compression, or scarring that can cause significant pain, tingling, numbness, or loss of function in the fingers. The main goal is to relieve symptoms and improve hand functionality.

Indications

• Persistent pain or discomfort in a finger(s) due to nerve compression.
• Symptoms of numbness, tingling, or weakness in the digit.
• Conditions such as carpal tunnel syndrome or digital nerve entrapments.
• Failure to respond to conservative treatments such as medication or physical therapy.

Preparation

• Patients may be asked to fast for several hours before the procedure.
• Adjustments in medications, especially blood thinners, may be necessary.
• Pre-operative diagnostic tests may include nerve conduction studies or electromyography (EMG).

Procedure Description

1. The patient is typically administered local anesthesia to numb the area.
2. A small incision is made around the affected digit.
3. The surgeon carefully identifies and isolates the entrapped or compressed nerve.
4. The surrounding tissue causing the compression is released or removed to free the nerve.
5. The incision is sutured closed, and a dressing is applied.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

Neuroplasty is usually performed in an outpatient surgical center or a hospital.

Personnel

• Surgeon (typically an orthopedic or hand specialist)
• Operating room nurse
• Anesthesiologist or nurse anesthetist (for anesthesia administration)
• Surgical technologist (for assisting during the procedure)

Risks and Complications

• Common risks include infection, bleeding, and swelling.
• Rare complications may involve nerve damage, persistent numbness or pain, and delayed wound healing.
• Scarring and reduced range of motion at the surgery site.

Benefits

• Significant reduction in pain and discomfort.
• Improved sensation and function in the affected digit.
• Enhanced overall hand function, potentially realized within weeks after recovery.

Recovery

• Post-procedure, the patient may need to rest and keep the hand elevated to reduce swelling.
• Dressings need to be kept clean and dry.
• Physical therapy may be recommended to regain full range of motion.
• Recovery time varies from a few weeks to a couple of months, with follow-up appointments to monitor progress.

Alternatives

• Non-surgical treatments include medications, physical therapy, and splints.
• Steroid injections may provide temporary relief.
• Pros of alternatives: Less invasive with shorter recovery times.
• Cons of alternatives: May not provide lasting relief and might require eventual surgical intervention.

Patient Experience

• During the procedure, the patient should not feel pain due to local anesthesia, though pressure sensations may be noticed.
• After the surgery, mild to moderate pain can be managed with medications.
• Swelling and discomfort are expected but should diminish over time.
• Proper pain management, including prescribed medications and home remedies such as ice application, can enhance comfort.