Is your hand injured or in pain?

Located in Irvine, Los Angeles, California, Dr. Chad Wu is a Chief Plastic Surgery in Yale NewHaven Health-Westerly Hospital, board certified hand surgeon internationally recognized for excellence in the diagnosis, treatment, and comprehensive management of adult and pediatric hand, wrist, and upper extremity conditions and injuries. Dr. Wu takes a personalized approach to each patient, spending the time necessary to explain and understand your condition. Together, we work towards getting you back to the sports, activities, and hobbies you enjoy.

Dr. Wu and his staff are dedicated to providing the highest level of quality hand care for their patients offering a wide range of medical services including advanced imaging, injections, surgery, and therapy. While most conditions improve with conservative treatment, for those requiring surgery, Dr. Wu offers state of the art minimally invasive and arthroscopic techniques based on up to date research and technology. Most procedures are performed on an outpatient basis under local anesthetic and monitored sedation.

When you choose Dr. Chad Wu, you are choosing a provider that will ensure the most up to date, highest quality care available. Whether you are seeking an initial evaluation or a second opinion for your injury or condition, Dr. Wu and his staff are available to discuss further options for your care.

COMMONLY TREATED CONDITIONS:

  • Carpal Tunnel Syndrome
  • Cubital Tunnel Syndrome
  • Wrist Pain
  • Wrist Arthroscopy
  • Wrist Fractures
  • De Quervain’s Tendonitis
  • Trigger Finger
  • Tendon Repair
  • Thumb Basal Joint Arthritis
  • Ganglion Cysts
  • Hand Fractures
  • Microsurgery
  • Hand & Wrist injuries

CARPAL TUNNEL SYNDROME

Carpal tunnel syndrome is a pinched nerve in the wrist caused by increased pressure on the nerve. Symptoms of carpal tunnel syndrome include pain, numbness, tingling, weakness, clumsiness, and a tendency to drop things. The numbness and/or tingling most often affects the thumb, index, middle, and ring fingers. Electrodiagnostic studies are often used to confirm the diagnosis and rule out other conditions. Treatment options include wrist splints, activity modification, steroid injections, and surgery.

CUBITAL TUNNEL SYNDROME

Cubital tunnel syndrome is entrapment of the ulnar nerve as it travels across the elbow. Symptoms may include numbness and tingling in the ring and small fingers as well as the hand. Diagnosis is based on clinical examination as well as electrodiagnostic studies. When identified early, symptoms may be managed with conservative treatments such as activity modification, anti-inflammatory medication, and steroid injection. If conservative methods fail to provide relief, or if muscle weakness develops in your hand, surgery may be necessary to relieve pressure along the nerve. The results of surgery are generally good. However, if the nerve is badly compressed or if there is muscle loss, the nerve may not return to normal function and some symptoms may remain even after the surgery. Nerve recovery can take a prolonged period of time.

WRIST PAIN

Wrist pain is often caused by sprains or fractures from sudden injuries. But wrist pain can also result from long-term problems, such as repetitive stress, arthritis and carpal tunnel syndrome. Because so many factors can lead to wrist pain, diagnosing the exact cause can be difficult, but an accurate diagnosis is essential for proper treatment and healing. Dr. Wu will examine your wrist, to check its flexibility and stability and to see where it hurts. X-rays are taken to check the alignment of the wrist bones and to check for any fractures. Occasionally other studies such as Magnetic Resonance Imaging (MRI) may be performed.

WRIST ARTHROSCOPY

Arthroscopy is a minimally invasive technique of visualizing the inside of a joint. The wrist is a complex joint made up of many bones and ligaments, which hold the bones together. Wrist arthroscopy allows the surgeon to diagnose and treat many problems of the wrist through a series of very small incisions (portals). In the last 5 years, the wrist has become the third most common joint to undergo arthroscopy, after the knee and shoulder. Because the incisions used with wrist arthroscopy are smaller and disrupt less soft tissue than conventional open surgery, pain, swelling and stiffness are minimized and recovery is often faster.

WRIST FRACTURES

The wrist is made up of eight small bones and the two forearm bones, the radius and ulna. A fracture may occur in any of these bones when enough force is applied, such as when falling down onto an outstretched hand. Severe injuries may occur from a more forceful injury, such as a car accident or a fall off a roof or ladder. Osteoporosis, a common condition in which the bone becomes more brittle, may make one more susceptible to getting a wrist fracture. Examination and x-rays are needed so that your doctor can tell if there is a fracture and to help determine the treatment. Sometimes a CT scan or MRI may be used to get better detail of the fracture fragments and associated injuries. In addition to the bone, ligaments (the structures that hold the bones together), tendons, muscles, and nerves may be injured as well when the wrist is broken. These injuries may need to be treated in addition to the fracture.

DE QUERVAIN’S TENDONITIS

First dorsal compartment tendonitis is a condition brought on by irritation or inflammation of the wrist tendons at the base of the thumb. The inflammation causes the compartment around the tendon to swell and enlarge, making thumb and wrist movement painful. Making a fist, grasping or holding objects—often infants—are common painful movements with de Quervain’s tendonitis. It usually caused by taking up a new, repetitive activity. New mothers are especially prone to this type of tendonitis: caring for an infant often creates awkward hand positioning, and hormonal fluctuations associated with pregnancy and nursing further contribute to its occurrence. A wrist fracture can also predispose a patient to de Quervain’s tendonitis, because of increased stresses across the tendons. Tenderness directly over the tendons on the thumb-side of the wrist is the most common finding.

TRIGGER FINGER

Trigger finger occurs when normal tendon gliding is prevented by swelling and inflammation. Trigger fingers are more common with certain medical conditions such as rheumatoid arthritis, gout and diabetes. Repetitive tasks may aggravate the condition. In most cases, however, the cause of the trigger finger is unknown. Trigger finger may start with discomfort felt at the base of the finger or thumb. Other symptoms may include pain, catching or locking, and stiffness. Treatment options include anti-inflammatory medications, night splinting, steroid injections, and surgery. The goal of surgery is to open the tunnel at the base of the finger so that the tendon can glide more freely. Finger motion can return quickly, or there can be some stiffness after surgery. Occasionally, hand therapy is required after surgery to regain motion.

TENDON REPAIR

Tendon repair is surgery done to treat a torn or otherwise damaged tendon. Tendons are the soft, band-like tissues that connect muscles to bone. When the muscles contract, the tendons pull the bones and cause the joints to move. When tendon damage occurs, movement may be seriously limited. The damaged area may feel weak or painful. Tendon injury may occur anywhere in the body where there are tendons. The joints that are most commonly affected by tendon injuries are the shoulders, elbows, ankles, knees, and fingers. Tendon repair surgery may be helpful for people who have tendon injuries that are making it difficult for them to move a joint or are very painful.

THUMB BASAL JOINT ARTHRITIS

Arthritis is thinning of the cartilage, which is the smooth surface of the joint. Thumb arthritis can result from a genetic predisposition and can also occur with age and long-term wear and tear. Patients with thumb arthritis report pain and weakness with pinching and grasping, opening jars, writing, and turning doorknobs or keys. X-rays can aid the diagnosis of arthritis, demonstrating narrowing of the joint space, bone spurs, and deformity. Initial options for treatment can include conservative methods such as ice/heat, anti-inflammatory medications, splinting, hand therapy, and injections. Surgical treatment is an option when conservative methods fail to provide adequate relief.

GANGLION CYSTS

Ganglion cysts are common lumps within the hand and wrist that occur adjacent to joints or tendons and are filled with clear fluid or gel. The cause of ganglion cysts is unknown however joint strain and tendon irritation may play a role in their formation. Ganglions occur in patients of all ages. Ganglions may increase or decrease in size or even disappear altogether. They may or may not be associated with pain. The diagnosis is usually based on clinical examination. Treatment can include observation, aspiration or drainage, and surgical removal. Surgical treatment is generally successful although cysts may recur.

HAND FRACTURES

The hand is made up of many bones that form its supporting framework. A fracture occurs when enough force is applied to a bone to break it. When this happens, there is pain, swelling, and decreased use of the injured part. A fracture may cause pain, stiffness, and loss of movement. Some fractures will cause an obvious deformity, such as a crooked finger, but many fractures do not. Because of the close relationship of bones to ligaments and tendons, the hand may be stiff and weak after the fracture heals. Fractures that involve joint surfaces may lead to early arthritis in those involved joints. Medical evaluation and x-rays are usually needed so that your doctor can tell if there is a fracture and to help determine the treatment. Depending upon the type of fracture, Dr. Wu may recommend one of several treatment methods. A splint or cast may be used to treat a fracture that is not displaced, or to protect a fracture that has been set. Some displaced fractures may need to be set and then held in place with wires or pins without making an incision. This is called closed reduction and internal fixation. Other fractures may need surgery to set the bone (open reduction). Once the fracture has enough stability, motion exercises may be started to try to avoid stiffness.

MICROSURGERY

Reconstructive microsurgery is a surgical field where specialized operating microscopes and precision instrumentation are utilized to perform intricate operations on tiny structures. The magnification of a microscope is needed to complete the complex task. Advances in reconstructive surgery have made it possible to reliably transfer a wide range of tissues and body parts from one location to another to correct fingers/hand and breast reconstruction. Dr. Wu specializes in hand and microsurgery to provide patients with complete care and current surgical techniques. He understands that trauma and breast reconstructive defects affects the patients ability to work, participate in activities that patients enjoy, and, in some cases, it affects the ability to perform normal, daily routines.

Dr. Chad Wu uses an effective multidisciplinary approach to treat conditions that affect your hands. His mastery-combined expertise to complete all kinds of hand surgery with latest technology minimally invasive, including:

CARPAL TUNNEL RELEASE— we perform surgery only after trying non-surgical treatments such as supportive splints. When surgery is needed, it is done under minimal anesthesia on an outpatient basis and leaves a small scar on the wrist to treat the tingling in the fingers and severe pain and numbness brought on by the condition.

CUBITAL TUNNEL RELEASE – alleviates pressure/irritation of the ulnar nerve as it travels through the elbow. A simple Cubital Tunnel Release consists of incising the cubital tunnel at the elbow thus eliminating the restriction or pressure that was irritating the nerve. Recovery from this procedure usually includes edema control, range of motion exercises, and eventually strengthening of the muscles in elbow, wrist and hand.

JOINT REPLACEMENT (ARTHOPLASTY) — treats rheumatoid arthritis or traumatic arthritis by replacing a damaged or diseased joint with a new joint made of man-made material or your own tissue.

WRIST ARTHROSCOPY – uses a tiny camera and surgical tools to examine or repair the tissues inside or around your wrist. The camera is called an arthroscope. The procedure allows the doctor to detect problems and make repairs to the wrist without making larger cuts in the skin and tissue. This means that you may have less pain and recover more quickly than open surgery.

FRACTURE REPAIR — treated through surgery, or the bone can be set and splinted or casted to hold it in place to heal. Fractures can be the result of weak bones or trauma.

TRIGGER FINGER RELEASE — pain, stiffness, and locking of the digits can be treated by a single steroid injection, or when that fails, a simple outpatient procedure under local anesthesia can permanently correct the locking.

CONGENITAL DEFORMITY REPAIR (fused fingers, absent fingers, extra fingers) — surgery balances the tendons and stabilizes joints to achieve normal hand function and may involve rebuilding missing digits, including the thumb. The surgeon may perform a toe-to-thumb transfer. Also used to correct conditions in children such as webbed fingers (syndactyly) and extra digits (polydactyly).

GANGLION AND TUMOR REMOVAL — using minimally invasive techniques, involves small open incisions to remove ganglions (benign, fluid-filled tumors of the wrist) and other tumors.

NERVE REPAIR — corrects nerve damage caused by injury. If the nerve is severed or cut completely, your surgeon may reattach the nerve directly to the other end or use a nerve graft, taking nerves from other parts of the body, to repair the damaged area.

TENDON REPAIR — repairs the damaged or cut tendons that attach muscle to bone and may include tendon grafts, which replace the damaged tendon with fibers from other parts of the body. Your follow up care will be supervised by a hand therapist.

REPLANTATION — replaces fingers or hands that have been severed. This complex procedure uses microsurgery to repair your blood vessels and nerves.

FASCIOTOMY – a surgical procedure where the fascia is cut to relieve tension or pressure commonly to treat the resulting loss of circulation to an area of tissue or muscle. It’s a limb-saving procedure when used to treat acute compartment syndrome. It is also sometimes used to treat chronic compartment stress syndrome. The procedure has a very high rate of success, with the most common problem being accidental damage to a nearby nerve.

HAND RECONSTRUCTION SURGERY – a common procedure needed to relieve pain in the hand or restore function, improve appearance of the hand after injury, disease or birth deformities. Reconstructive surgery for traumatic cases can involve simple repair of an injured structure to reattachment of the severed limb, to actually transplanting a portion of the limb.

CARPAL TUNNEL SYNDROME

Carpal tunnel syndrome is a pinched nerve in the wrist caused by increased pressure on the nerve. Symptoms of carpal tunnel syndrome include pain, numbness, tingling, weakness, clumsiness, and a tendency to drop things. The numbness and/or tingling most often affects the thumb, index, middle, and ring fingers. Electrodiagnostic studies are often used to confirm the diagnosis and rule out other conditions. Treatment options include wrist splints, activity modification, steroid injections, and surgery.

CUBITAL TUNNEL SYNDROME

Cubital tunnel syndrome is entrapment of the ulnar nerve as it travels across the elbow. Symptoms may include numbness and tingling in the ring and small fingers as well as the hand. Diagnosis is based on clinical examination as well as electrodiagnostic studies. When identified early, symptoms may be managed with conservative treatments such as activity modification, anti-inflammatory medication, and steroid injection. If conservative methods fail to provide relief, or if muscle weakness develops in your hand, surgery may be necessary to relieve pressure along the nerve. The results of surgery are generally good. However, if the nerve is badly compressed or if there is muscle loss, the nerve may not return to normal function and some symptoms may remain even after the surgery. Nerve recovery can take a prolonged period of time.

WRIST FRACTURES

The wrist is made up of eight small bones and the two forearm bones, the radius and ulna. A fracture may occur in any of these bones when enough force is applied, such as when falling down onto an outstretched hand. Severe injuries may occur from a more forceful injury, such as a car accident or a fall off a roof or ladder. Osteoporosis, a common condition in which the bone becomes more brittle, may make one more susceptible to getting a wrist fracture. Examination and x-rays are needed so that your doctor can tell if there is a fracture and to help determine the treatment. Sometimes a CT scan or MRI may be used to get better detail of the fracture fragments and associated injuries. In addition to the bone, ligaments (the structures that hold the bones together), tendons, muscles, and nerves may be injured as well when the wrist is broken. These injuries may need to be treated in addition to the fracture.

WRIST PAIN

Wrist pain is often caused by sprains or fractures from sudden injuries. But wrist pain can also result from long-term problems, such as repetitive stress, arthritis and carpal tunnel syndrome. Because so many factors can lead to wrist pain, diagnosing the exact cause can be difficult, but an accurate diagnosis is essential for proper treatment and healing. Dr. Wu will examine your wrist, to check its flexibility and stability and to see where it hurts. X-rays are taken to check the alignment of the wrist bones and to check for any fractures. Occasionally other studies such as Magnetic Resonance Imaging (MRI) may be performed.

WRIST ARTHROSCOPY

Arthroscopy is a minimally invasive technique of visualizing the inside of a joint. The wrist is a complex joint made up of many bones and ligaments, which hold the bones together. Wrist arthroscopy allows the surgeon to diagnose and treat many problems of the wrist through a series of very small incisions (portals). In the last 5 years, the wrist has become the third most common joint to undergo arthroscopy, after the knee and shoulder. Because the incisions used with wrist arthroscopy are smaller and disrupt less soft tissue than conventional open surgery, pain, swelling and stiffness are minimized and recovery is often faster.

TRIGGER FINGER

Trigger finger occurs when normal tendon gliding is prevented by swelling and inflammation. Trigger fingers are more common with certain medical conditions such as rheumatoid arthritis, gout and diabetes. Repetitive tasks may aggravate the condition. In most cases, however, the cause of the trigger finger is unknown. Trigger finger may start with discomfort felt at the base of the finger or thumb. Other symptoms may include pain, catching or locking, and stiffness. Treatment options include anti-inflammatory medications, night splinting, steroid injections, and surgery. The goal of surgery is to open the tunnel at the base of the finger so that the tendon can glide more freely. Finger motion can return quickly, or there can be some stiffness after surgery. Occasionally, hand therapy is required after surgery to regain motion.

DE QUERVAIN’S TENDONITIS

First dorsal compartment tendonitis is a condition brought on by irritation or inflammation of the wrist tendons at the base of the thumb. The inflammation causes the compartment around the tendon to swell and enlarge, making thumb and wrist movement painful. Making a fist, grasping or holding objects—often infants—are common painful movements with de Quervain’s tendonitis. It usually caused by taking up a new, repetitive activity. New mothers are especially prone to this type of tendonitis: caring for an infant often creates awkward hand positioning, and hormonal fluctuations associated with pregnancy and nursing further contribute to its occurrence. A wrist fracture can also predispose a patient to de Quervain’s tendonitis, because of increased stresses across the tendons. Tenderness directly over the tendons on the thumb-side of the wrist is the most common finding.

TENDON REPAIR

Tendon repair is surgery done to treat a torn or otherwise damaged tendon. Tendons are the soft, band-like tissues that connect muscles to bone. When the muscles contract, the tendons pull the bones and cause the joints to move. When tendon damage occurs, movement may be seriously limited. The damaged area may feel weak or painful. Tendon injury may occur anywhere in the body where there are tendons. The joints that are most commonly affected by tendon injuries are the shoulders, elbows, ankles, knees, and fingers. Tendon repair surgery may be helpful for people who have tendon injuries that are making it difficult for them to move a joint or are very painful.

THUMB BASAL JOINT ARTHRITIS

Arthritis is thinning of the cartilage, which is the smooth surface of the joint. Thumb arthritis can result from a genetic predisposition and can also occur with age and long-term wear and tear. Patients with thumb arthritis report pain and weakness with pinching and grasping, opening jars, writing, and turning doorknobs or keys. X-rays can aid the diagnosis of arthritis, demonstrating narrowing of the joint space, bone spurs, and deformity. Initial options for treatment can include conservative methods such as ice/heat, anti-inflammatory medications, splinting, hand therapy, and injections. Surgical treatment is an option when conservative methods fail to provide adequate relief.

HAND FRACTURES

The hand is made up of many bones that form its supporting framework. A fracture occurs when enough force is applied to a bone to break it. When this happens, there is pain, swelling, and decreased use of the injured part. A fracture may cause pain, stiffness, and loss of movement. Some fractures will cause an obvious deformity, such as a crooked finger, but many fractures do not. Because of the close relationship of bones to ligaments and tendons, the hand may be stiff and weak after the fracture heals. Fractures that involve joint surfaces may lead to early arthritis in those involved joints. Medical evaluation and x-rays are usually needed so that your doctor can tell if there is a fracture and to help determine the treatment. Depending upon the type of fracture, Dr. Wu may recommend one of several treatment methods. A splint or cast may be used to treat a fracture that is not displaced, or to protect a fracture that has been set. Some displaced fractures may need to be set and then held in place with wires or pins without making an incision. This is called closed reduction and internal fixation. Other fractures may need surgery to set the bone (open reduction). Once the fracture has enough stability, motion exercises may be started to try to avoid stiffness.

GANGLION CYSTS

Ganglion cysts are common lumps within the hand and wrist that occur adjacent to joints or tendons and are filled with clear fluid or gel. The cause of ganglion cysts is unknown however joint strain and tendon irritation may play a role in their formation. Ganglions occur in patients of all ages. Ganglions may increase or decrease in size or even disappear altogether. They may or may not be associated with pain. The diagnosis is usually based on clinical examination. Treatment can include observation, aspiration or drainage, and surgical removal. Surgical treatment is generally successful although cysts may recur.

MICROSURGERY

Reconstructive microsurgery is a surgical field where specialized operating microscopes and precision instrumentation are utilized to perform intricate operations on tiny structures. The magnification of a microscope is needed to complete the complex task. Advances in reconstructive surgery have made it possible to reliably transfer a wide range of tissues and body parts from one location to another to correct fingers/hand and breast reconstruction. Dr. Wu specializes in hand and microsurgery to provide patients with complete care and current surgical techniques. He understands that trauma and breast reconstructive defects affects the patients ability to work, participate in activities that patients enjoy, and, in some cases, it affects the ability to perform normal, daily routines.

FAQ

What are the non-surgical treatment options?

The non-surgical treatment options include rest, medications including analgesics and antibiotics, injections, and physical/occupational therapy.

Will physical therapy be required after surgery?

Getting full range of motion, strength, and flexibility back after surgery usually takes time. That is where pre-operative exercise, education, and post-operative physical therapy programs come in – to ensure you are physically and emotionally prepared for surgery and to maximize your recovery after surgery.

What are the risks associated with surgery?

As with any surgery, risks include reactions to anaesthesia, bleeding, infection, stiffness and nerve damage. Your doctor will discuss the risks associated with your specific procedure.

When can I return to daily activities?

This varies depending on the type of procedure undergone, and can range from a few days to a few months. Return to all activities, sports and exercise can take up to four to six months. Your doctor will advise you depending on your particular health condition.

What can happen if surgery is avoided?

Some complications of not undergoing an orthopaedic surgery for your condition include pain, loss of joint motion, joint weakness, numbness and an early onset of arthritis.

What are the most common injuries?

The most common orthopaedic injuries are sprains and strains, fractures, and dislocations. Injuries can occur when playing indoor or outdoor sports or while exercising. Sports injuries can result from accidents, inadequate training, improper use of protective devices, or insufficient stretching or warm-up exercises.

What to bring for your initial consultation?

For your initial consultation you will need to bring a referral letter from your physician if necessary.

Here is check list for your initial consultation:

  • Referral letter
  • Insurance or Medicare card
  • List of medications
  • X-ray and scan results
How long do I need time off work after the surgery?

The post-operative recovery period varies based on the particular surgery. Generally it is recommended patients take two weeks off work to recover from any surgery and to resume light duty following resumption of work. Your surgeon will give you specific instructions to follow for a successful recovery.

Financing YOUR PROCEDURES

Making the investment in your personal appearance and well-being shouldn’t be a barrier to any of our patients. Dr. Wu offers financing as an alternative to obtain the procedure of your choice.

Dr Chadwick Wu Plastic Surgeon
Procedure

Hand surgery

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