Prices in Germany are normally 75% below the cost of hand surgery in the US and are individually quoted. They include all medical expenses, the hospital stay, surgeon's fees, operation room fees, anesthesia, anesthesiologist's fees, medicine, nursing, semi-private room, meals, pre-op diagnosis, local phone and English TV.

• Carpal Tunnel Syndrome.
• Dupuytren's Contraction
• Supinatorlogen Syndrome

Hand Surgery: Carpal Tunnel Syndrome

Carpal Tunnel Syndromeis a medical condition in which the median nerve is compressed at the wrist causing symptoms like tingling, numbness, night time wakening, pain, coldness, and sometimes weakness in parts of the hand.

If all the symptoms go away with splinting and medication, then surgery will not be necessary. If not, then the "carpal tunnel release" surgery is recommended.[19] In general, milder cases can be controlled for months to years, but severe cases are unrelenting symptomatically and likely will come to surgical treatment.

There are several variations of technique to perform carpal tunnel release surgery. Each surgeon has differences of preference based on their personal beliefs and experience. All techniques have several things in common.

• They all involve brief (10-15 minute) outpatient procedures.
• They all involve some type of incision(s) on your wrist and/or palm.
• They all involve dividing (cutting) the transverse carpal ligament.
• They all incur a relatively rapid recovery time (days to weeks depending on the activity and technique).
• They all leave a cosmetically insignificant scar in most cases.

The two major types of surgery are open and endoscopic. Most surgeons perform open surgery, which is widely considered to be the gold standard. However, many surgeons are now performing endoscopic techniques. Open surgery involves a small incision somewhere on the palm about an inch or two in length. Through this the ligament can be directly viewed and divided with relative safety. Endoscopic techniques involve one or two smaller incisions (less than half inch each) through which instrumentation is introduced including probes, knives and the scope to see what you are doing. The ligament is viewed through a "keyhole" in this way and can be divided with relative safety. There are perhaps a half dozen commercial systems available that surgeons can use to do the endoscopic surgery.

Much debate has existed in the medical community of which technique is best. Open surgery is arguably a bit safer as there is less likelihood of inadvertent damage to surrounding nerves and blood vessels. Endoscopic surgery very likely will result in a quicker early recovery. In other words, people will feel less sore and be able to be more active in the several (1-5) weeks after surgery with endoscopic techniques. Several studies have suggested that either technique leaves patients with similar results if examined after about six weeks.

If the decision to operate is made, the technique choice is between the patient and surgeon. Surgeons can do either or both techniques. The surgeon can tailor treatments to patients' specific needs. Surgery to correct carpal tunnel syndrome has a 90% or better success rate, especially using endoscopic surgery techniques. In general, endoscopic techniques are as effective as traditional open carpal surgeries, though the faster recovery time typically noted in endoscopic procedures may be offset by higher complication rates. Success is greatest in patients with the most typical symptoms. The most common cause of failure is incorrect diagnosis, and it should be noted that this surgery will only fix carpal tunnel syndrome, and will not relieve symptoms with alternate causes. Recurrence is rare, and apparent recurrence usually results from a misdiagnosis of another problem. Complications can occur, but serious ones are infrequent to rare.

Carpal tunnel surgery is usually performed by an orthopaedic or plastic surgeon; some neurosurgeons and general surgeons also perform the procedure.

Hand Surgery: Dupuytren's Contracture

Dupuytren's Contracture is a fixed flexion contracture of the hand where the fingers bend towards the palm and cannot be fully extended (straightened). It is named after the famous surgeon Baron Guillaume Dupuytren, who described an operation to correct the affliction.

Surgical management consists of opening the skin over the affected cords of fibrous tissue, and dissecting the fascia away. The tendons can then be brought out to length. The procedure is not curative, and patients may need re-do surgery, however, the thickened fascia often invests the digital nerves and arteries, so there is significant risk of de-vascularization of the digit.

Hand Surgery: Supinatorlogen Syndrome

Supinatorlogen Syndrome is nervus radialis separating after passage through hiatus nervi radialis within the septum intermusculare laterale in the ulnar bow.

The nerve can be decompressed by a rolling skin cut at the radial elbow bend nervus radialis. Muscular departures are being spared and the entry of ramus profundus into supinator canal exhibited, then the obstructing entrapping tendons and fibres are split.

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The information provided herein is not intended to be a substitute for professional medical advice.

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