Hand & Wrist
Procedures routinely undertaken
- Dupuytren’s contracture release (fasciectomy, dermofasciectomy, fasciotomy)
- ganglion excision
- trigger finger release
- carpal tunnel release (nerve entrapment)
- ulna nerve decompression
- tendon transfers
- base of thumb arthritis (CMCJ arthritis) correction
- wrist arthroscopy
- wrist instability correction
- partial and full wrist fusion
- distal radioulnar joint stabilisation
- distal radioulnar joint replacement (APTIS™ joint)
- ulna shortening
- ulna wafer procedure
- MCPJ and PIPJ replacement arthroplasty
- fusions for painful joints
- soft tissue stabilisation for collapsing joints
Professor Lees specialises in the surgical treatment of all forms of hand and wrist conditions including common conditions such as carpal tunnel syndrome, Dupuytren’s contracture, and base of thumb arthritis. She is an experienced microsurgeon and has an established children’s hand practice. She goes out each year to work on a surgical camp for leprosy and burns patients with the charity Hands for Life.
Professor Lees’ uses scientific evidence-base to inform her practice and has regard to guidelines where these exist. She provides comprehensive care in hand surgery including provision of second opinions for complex cases. As a Professor, she has the opportunity to teach, undertake research, write papers and attend scientific meetings keeping current and up to date in best practice in hand surgery.
The consultation will include discussion of your specific hand or wrist problem and will detail the impacts this is having on your day to day life. It may be helpful to record symptoms in the form of a diary particularly where the main problem is pain and where the condition is not obvious or visible. If you have had any specialist investigations such as scans or nerve conduction studies done elsewhere it is helpful to bring copy reports with you to your first consultation.
We routinely audit our work to ensure that we learn and reflect on our practice. You will be asked to fill in a questionnaire as part of your initial assessment and may be asked to join in with our national BSSH audit.
It is important from a physical point of view you are in the best medical condition for any proposed surgery. It is important that you are frank about your previous medical history so that surgical safety is maintained.
Any proposed surgery will be discussed in detail and will include a description of the likely outcome and recovery time in your particular case, as well as discussion about possible risks and limitations of the procedure.
Most hand and wrist surgery is undertaken on a day patient basis. If you have no one at home with you or have certain medical conditions then we will advise that you stay overnight. Much of our surgery is undertaken using supraclavicular block where the arm is numbed but you stay awake through the procedure. You can also go to sleep with a general anaesthetic if you prefer. Either way you will need to starve for 6 hours before operation. The anaesthetist will discuss your anaesthetic in detail when you are admitted.
You will receive a letter once assessment is complete that will include recommendations for treatment with a clear quotation of the costs involved if you are self-pay and codes if you are proceeding on an insured basis.
If you have particular questions prior to the consultation then it may be helpful to write these down and bring them with you as it is easy to forget what you intended to ask. It is often helpful to have a friend or relative accompany you.
We are pleased to work with Hand Therapist Denise O’Brien as part of our pathway to giving you the best possible result from your hand surgery. Remember, recovering from hand surgery operations does mean that you will have to do some exercises at home after the surgery.
If you are already attending your own hand physiotherapist we are happy to work with them by arrangement. For many hand surgery operations there is a need to undergo a period of rehabilitation that commonly includes having a splint made and wearing that splint for a period of weeks. The hand therapist will work with you to restore normal movement to the fingers and wrist and will help deal with stiffness, swelling and residual discomforts.
For many hand surgery procedures there will be some ‘downtime’ in which you cannot drive your car and will need a relative or friend to bring you to appointments. The impacts on your particular job and the recovery period will be discussed at your consultation and again through your follow up appointments. There will likely be impacts on your sporting activities including going to the gym and these will be discussed in your consultations. Remember to allow enough time between surgery and going on a holiday – we can advise if asked.