Hand and wrist surgeries are operations that help fix problems in your hands and wrists, like broken bones, arthritis, or injuries to the tendons, ligaments, or nerves. Surgery might be: Arthroscopic: less invasive surgery. The surgeon makes small cuts and uses a tiny camera to see inside. They can then fix or take out the damaged parts. Open: for more complicated problems, the surgeon makes a larger cut to get a better look and fix the damaged parts directly.

Elbow surgery is an operation that helps fix problems in the elbow, like injuries or wear and tear from arthritis. Surgery might be: Arthroscopic: less invasive surgery. The surgeon makes small cuts and uses a tiny camera to see inside the elbow. They can then fix or take out the damaged parts. Open: for more complicated problems, the surgeon makes a larger cut to get a better look and fix the damaged parts directly. Joint Replacement: when the elbow joint is badly damaged, the surgeon might remove the damaged areas and replace them with parts made of special materials.

This condition occurs when there is abnormal thickening of the deep tissue between the palm of your hand and your fingers. This thickening occurs very gradually and will start to make your fingers curl toward your palm. If this condition gets to the stage where it significantly limits your hand function, surgery may be recommended. This usually involves removal of the thickened tissue, allowing you to straighten your fingers again.

A large number of orthopaedic procedures on joints are performed using an arthroscope, where a fibre optic telescope is used to look inside the joint. Through this type of keyhole surgery, fine instruments can be introduced through small incisions (portals) to allow surgery to be performed without the need for large cuts. This allows many procedures to be performed as a day stay and allows quicker return to normal function of the joint. Arthroscopic surgery is less painful than open surgery and decreases the risk of healing problems. Arthroscopy allows access to parts of the joints which can not be accessed by other types of surgery.

Knee surgery is an operation that helps fix problems in your knee, like an injury, arthritis, a torn ligament, or damaged cartilage. Surgery might be: Arthroscopic: less invasive surgery. The surgeon makes small cuts and uses a tiny camera to see inside the knee. They can then fix or take out the damaged parts. Open: for more complicated problems, the surgeon makes a larger cut to get a better look and fix the damaged parts directly. Joint Replacement: when the knee is badly damaged, the surgeon might remove the damaged areas and replace them with parts made of special materials.

Orthopaedic deformities can be congenital or acquired as the result of injury, infection or tumour. Resulting in crooked limbs or discrepancies in limb length, such deformities can affect appearance and function and can often cause significant pain. Osteotomy is the division of a crooked or bent bone to improve alignment of the limb. These procedures normally involve some form of internal fixation, such as rods or plates, or external fixation which involves external wires and pins to hold the bone. The type of procedure for fixation will be explained when the surgery is planned. Some of the more common orthopaedic deformities are: Intoeing Bow legs (genu varum) Club foot (talipes) Developmental dislocation of the hip Bunions Limb length discrepancy

Osteotomy is the division of a crooked or bent bone to improve alignment of the limb. These procedures normally involve some form of internal fixation, such as rods or plates, or external fixation which involves external wires and pins to hold the bone. The type of procedure for fixation will be explained when the surgery is planned.

In many cases tendons will be lengthened to improve the muscle balance around a joint or tendons will be transferred to give overall better joint function. This occurs in children with neuromuscular conditions but also applies to a number of other conditions. Most of these procedures involve some sort of splintage after the surgery followed by a period of rehabilitation, normally supervised by a physiotherapist.

The anterior cruciate ligament (ACL) is a strong, stabilising ligament running through the centre of the knee between the femur (thigh bone) and tibia (shin bone). When the ACL is torn, frequently as the result of a sporting injury, arthroscopic surgery known as ACL Reconstruction is performed. The procedure involves replacement of the damaged ligament with tissue grafted from elsewhere, usually the patellar or hamstring tendon. The ends of the grafted tendon are attached to the femur at one end and the tibia at the other using screws or staples. For more information about ACL reconstruction please click here.

Carpal Tunnel Syndrome is caused by a pinched nerve in the wrist that causes tingling, numbness and pain in your hand. Surgery to relieve carpal tunnel syndrome involves making an incision (cut) from the middle of the palm of your hand to your wrist. Tissue that is pressing on the nerve is then cut to release the pressure.

Several small incisions (cuts) are made on the knee through which is inserted a small telescopic instrument with a tiny camera attached (arthroscope). This allows the surgeon to look inside the joint, identify problems and, in some cases, make repairs to damaged tissue.

The menisci are two circular strips of cartilage that form a cushioning layer between the ends of the femur (thigh bone) and tibia (shin bone) in the knee joint. Together the medial and lateral menisci, on the inside and outside of the knee, respectively, act as shock absorbers and distribute the weight of the body across the knee joint. The menisci can become torn through injury or damaged from age-related wear and tear and may require surgery. The most common meniscal surgery is partial meniscectomy in which the torn portion of the meniscus is cut away so that the cartilage surface is smooth again. In some cases meniscal repair is carried out, in this case the torn edges of the meniscus are sutured together. Both procedures are performed arthroscopically. For more information please click on the following link for meniscal tears and for meniscal transplant surgery.

For elderly patients joint replacement surgery is commonly required to treat damaged joints from wearing out, arthritis or other forms of joint disease including rheumatoid arthritis. In these procedures the damaged joint surface is removed and replaced with artificial surfaces normally made from metal (chromium cobalt alloy, titanium), plastic (high density polyethelene) or ceramic which act as alternate bearing surfaces for the damaged joint. These operations are major procedures which require the patient to be in hospital for several days and followed by a significant period of rehabilitation. The hospital has several ways of approaching the procedure for replacement and the specifics for the procedure will be covered at the time of assessment and booking of surgery. Occasionally blood transfusions are required; if you have some concerns raise this with your surgeon during consultation.

Otherwise known as degenerative arthritis. OA occurs when there is a breakdown of the cartilage, leaving the bones unprotected. It is very common and usually affects people as they get older. You can get it at any age and are more likely to if you have previously injured a joint, or are overweight. The symptoms can be very mild with just occasional pain with activity. Worsening symptoms include pain with activity and stiffness with rest. Joints can become swollen and restricted in movement. Joints can change shape as the bone changes in response to loss of protection. You otherwise feel well. The diagnosis is made on the basis of the history, examination findings and sometimes x-rays. The severity of joint damage seen on x-ray does not always correlate with the degree of pain you experience. Treatment includes guided exercises, weight reduction if needed, pain relief and sometimes surgery. For more information see www.arthritis.org.nz

An incision (cut) is made over the damaged tendon. The damaged ends of the tendon are sewn together and, if necessary, reattached to surrounding tissue.

Orthopaedic surgeons have expertise in the treatment of fractured (broken) bones, particularly in the assessment of damage that may have occurred around the fracture. Follow-up of a fracture may involve monitoring the progress of the healing bone, checking the position of the bone in a cast and deciding when other steps in management such as re-manipulation of the fracture or removal of a cast is required. Click here for more information about fractures.