Hand Surgery

What is hand surgery?

Hand surgery treats conditions affecting the hand — nerves, tendons, joints, bone and skin. It is reconstructive rather than cosmetic surgery, performed to restore function, relieve pain and preserve the use of the hand.

The hand is a densely packed structure in which nerves, tendons, vessels and joints sit within millimetres of one another. Small problems produce disproportionate loss of function, and surgery requires precision in a confined space. Plastic and reconstructive surgical training covers this anatomy in detail, including nerve repair, tendon reconstruction and microsurgery.

Dr. Anavekar treats a range of hand conditions, most of which are referred by a GP or another specialist.

Conditions commonly treated

Carpal tunnel syndrome

Compression of the median nerve where it passes into the hand, causing numbness, tingling and pain in the thumb, index and middle fingers — often worse at night. Surgery releases the ligament compressing the nerve. Where symptoms have been present a long time, some numbness may persist after surgery, which is why early assessment matters.

Trigger finger

A tendon catching as it passes through a narrowed sheath, causing the finger to click, lock or become stuck in a bent position. Treated by releasing the sheath.

Dupuytren's contracture

Thickening of the tissue in the palm, drawing one or more fingers into a bent position that cannot be straightened. Surgery removes or divides the affected tissue. It is a condition that can recur.

Ganglion cysts

Fluid-filled swellings arising from a joint or tendon sheath, most often on the back of the hand. Removed where they cause pain, restrict movement or continue to enlarge.

De Quervain's tenosynovitis

Inflammation of the tendons at the base of the thumb, causing pain with gripping and lifting. Common after pregnancy and with repetitive activity. Surgery releases the tendon compartment where non-surgical treatment has not helped.

Hand trauma

Tendon and nerve injuries, fractures, and soft tissue loss requiring repair or reconstruction.

Skin lesions of the hand

Including skin cancers, which require careful reconstruction to preserve function.

Do I need surgery?

Not every hand condition requires an operation, and surgery is generally considered once non-surgical measures have been tried or where delay risks permanent damage.

Non-surgical treatment may include:

• Hand therapy and targeted exercises
• Splinting, particularly at night for carpal tunnel syndrome
• Activity modification
• Anti-inflammatory medication
• Corticosteroid injection

Surgery is generally recommended where symptoms persist despite these measures, where function is significantly limited, or where there is progressive nerve compression — because prolonged compression can cause permanent nerve damage and muscle wasting that surgery cannot reverse.

What is involved

Assessment

Your hand is examined, symptoms and their effect on daily activity discussed, and any imaging or nerve conduction studies reviewed. Further investigations are arranged where needed. The likely benefit of surgery, and what it can and cannot restore, is explained.

On the day

Many hand procedures are performed as day surgery under local or regional anaesthetic, sometimes with sedation; more complex reconstruction may require general anaesthetic. The approach depends on the procedure and is discussed beforehand.

A dressing or splint is applied afterwards, and you will be given instructions about keeping the hand elevated and dry.

After surgery

Elevation is important in the first days to reduce swelling and pain. Hand therapy is frequently arranged, and for tendon and nerve injuries it is central to the outcome rather than optional — the surgery restores the anatomy, but therapy restores the movement.

Your recovery

Recovery varies substantially with the procedure. The following is a general guide for common minor hand procedures such as carpal tunnel or trigger finger release.

Tendon repairs, nerve repairs, fractures and joint surgery follow longer and more structured protocols, often with splinting and supervised therapy. Dr. Anavekar will give you a timeline specific to your procedure.

Potential benefits

Hand surgery may:

• Relieve pain and night-time symptoms
• Restore or preserve grip strength and dexterity
• Prevent progression of nerve compression and permanent damage
• Restore finger movement where tendons are catching or contracted
• Improve ability to work, drive and manage daily tasks

Outcomes vary between individuals and cannot be guaranteed. Where nerve compression has been long-standing, recovery of sensation may be incomplete. Results depend on the condition, its duration, your general health and your engagement with hand therapy.

Costs and Medicare

Hand surgery is reconstructive, and Medicare item numbers generally apply to both consultation and surgery, though the specific item depends on your exact diagnosis and procedure — for example, carpal tunnel release, trigger finger release, Dupuytren’s contracture surgery and ganglion excision are each billed under different items. With a valid GP or specialist referral, a rebate is available for your appointment. We encourage you to check with your private health fund and Medicare about your eligibility for relevant rebates ahead of your appointment, as this can give you a clearer picture of your likely out-of-pocket cost.

Where surgery is required, private health insurance may contribute to hospital costs, subject to your level of cover and any waiting periods. Some minor procedures can be performed in rooms or as day surgery, which affects the overall cost.

You will receive a written quote setting out all costs and expected rebates before proceeding. For questions about fees or health fund cover, contact the practice on 03 9075 0005.

Why Evolve

Dr. Namrata Anavekar is a Fellow of the Royal Australasian College of Surgeons and a specialist plastic and reconstructive surgeon. She graduated with honours from Monash University and completed the Australian Plastic Surgery Training Program, with rotations through St Vincent's Hospital, The Royal Children's Hospital, The Alfred and The Austin, followed by an international fellowship in Switzerland and France.

Dr. Anavekar is a board member of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS) and has authored multiple research publications. She holds several public and private hospital appointments, and is a professional member of ASAPS, the Australian Society of Plastic Surgeons (ASPS), the Royal Australasian College of Surgeons (RACS), the Australian Medical Association (AMA), and the International Society of Aesthetic Plastic Surgery (ISAPS).

She consults from Bulleen and Sunbury, Melbourne.

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