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Hand procedures

  • Trigger finger

    This presents as a finger that clicks or is stuck in flexion, often associated with pain due to swelling and inflammation (synovitis) of the tendon. The treatment of choice is a cortisone injection into the tendon sheath and if this is not successful surgical release of the tendon.

  • Finger fractures

    Each fracture or broken bone in the hand has a specific treatment protocol and thus requires an accurate diagnosis and treatment plan.

  • Scaphoid fractures

    Scaphoid fractures are often difficult to diagnose and may end up with non-union if not treated correctly in the early phase of the injury. Repeat radiographs or MRI scans may help to detect scaphoid fractures.  There are different treatment options available for the treatment of these fractures including cast application, splinting and surgical fixation. Non-unions are mostly treated by means of surgery.

  • Carpal Tunnel Syndrome

    This condition is due to compression of the Median nerve in the wrist. The most common symptoms include pins and needle feeling in the hand often associated with pain in the hand and forearm mostly at night or the early hours of the morning. The symptoms may vary and occur during the day as well. Treatment consists of splinting, and or cortisone injection in mild cases. Surgery is indicated after investigating the patient for medical causes and confirming the diagnosis with nerve conduction studies if the examination does not reveal typical signs.

  • Finger joint dislocation

    This is one of the most under rated injuries in the hand mostly by rugby players that "just pull it back into position". The injury is more serious and is associated with ligament damage and often bone damage that may require more treatment. If left untreated the fingers tend to become stiff and may end up skew or unstable.Treatment should include an assessment of the extent of ligament and bone damage.Appropriate splinting with physiotherapy to ensure full range of motion or surgical repair may be required.

  • Arthritis of the hand and wrist

    Arthritis of the base of the thumb (carpo-metacarpal arthritis) is the most common site in the hand to be affected and has a good outcome after surgery should conservative treatment with splinting and cortisone injections not be successful.

  • Tennis elbow syndrome

    Tennis elbow syndrome ( Lateral epicondylitis ) causes pain on the outer aspect of the elbow during activiyies that require a strong grip. The pain will only be present during activity in the early phase of the disease but may cause pain at rest or at night in more advanced disease. The initial treatment includes reducing activities that cause pain, splinting the wrist or using a specific brace around the upper forearm to rest the muscle insertion.

  • Constantia Hand Clinic

    Dr Engela established the Constantia Hand Clinic 14 years ago with Liane Dawe (Physiotherapist) and Karen Weskamp (Occupational therapist) both with a specific interest in hand and upper limb rehabilitation. The Constantia Hand Clinic offers a comprehensive multi disciplinary service at Constantiaberg Medi-Clinic.