Hand Surgery & Treatment FAQs

At Summit, Dr. Todd Pitts brings his expertise in orthopedic surgery to treat a wide range of hand conditions, helping patients return to the activities they love with less pain and greater function. Whether you’re struggling with everyday tasks, experiencing locking or stiffness, or recovering from an injury, we offer both surgical and non-surgical options tailored to your needs.

Conditions We Treat:

  • Trigger Finger

  • Hand Fractures (including Boxer’s Fracture)

  • Dupuytren’s Contracture

  • Tendon injuries and overuse

  • Joint stiffness or locking

  • Post-traumatic deformities

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Treatment Options

  • For patients experiencing painful finger locking, a simple 10-minute procedure can release the affected tendon sheath, allowing for immediate motion and relief.

  • Depending on the severity and position of the fracture, treatment may involve casting, pinning, or internal fixation with screws or plates—always aiming for the best balance between healing and early mobility.

  • Using enzyme injections (like Xiaflex) or surgical excision, Dr. Pitts offers personalized options to release contracted cords and restore finger motion, often with no major incision.

  • Recovery time depends on your condition and treatment plan, but in most cases, patients begin moving the hand immediately to avoid stiffness and maintain function. Hand therapy may be recommended as part of your rehab plan.

Understanding Hand Fractures

Because our hands are constantly in motion—grasping, lifting, pushing, and pulling—they’re especially vulnerable to injury. One of the most common fractures we treat at Summit is called a boxer’s fracture, which affects the metacarpal bone at the base of the pinky or ring finger.

  • Not always. In fact, many hand fractures can heal without surgery if the break is stable and the finger is aligned properly.

    We consider surgery if:

    • The bone is significantly displaced or angled

    • There’s rotation of the finger (causing it to cross over or twist when making a fist)

    • You have an unstable or crushed fracture that can’t heal correctly on its own

    • A break in the neck of the metacarpal (just below the knuckle)

    • Commonly caused by punching a hard surface or falling on a closed fist

    • Can cause visible hand deformity, swelling, bruising, and pain when gripping

  • If surgery is needed, we choose the most effective option based on your injury:

    • Intramedullary screw fixation: A screw is inserted inside the bone to stabilize it

    • External pins: Temporary pins placed through the skin to hold the bone in place

    • Plates and screws: Used for more complex or unstable fractures

    All techniques aim to preserve movement, reduce pain, and return you to function as quickly as possible.

  • Recovery is a careful balance between immobilization and early motion. Move too little, and you may develop stiffness and scar tissue. Move too soon, and you risk damaging the repair.

    Your treatment plan may include:

    • Splinting or casting early on

    • Guided hand therapy to restore movement

    • Follow-up X-rays to monitor bone healing

    We’ll work closely with you to tailor your recovery plan for the best results.

What Is Dupuytren’s Contracture?

Dupuytren’s contracture is a hand condition that can slowly limit finger motion over time. Dr. Todd Pitts explains what causes this skin-based condition, how it’s different from tendon problems, and what treatment options—from enzyme injections to surgery—can help restore movement and relieve tension. Unlike tendon injuries, Dupuytren’s contracture is a skin and connective tissue disorder, not a problem with the tendons or muscles.

    • Genetics play a large role. It tends to run in families, especially of Northern European descent.

    • Over time, the fascia forms nodules and cords under the skin that can slowly tighten.

    • These cords can develop mild to severe contractures in the fingers, especially the ring and pinky fingers.

  • Non-Surgical Approaches

    • Bracing: Used early on to slow progression, especially at night.

    • Xiaflex Injection (Collagenase Enzyme):

      A minimally invasive injection that breaks down the cord’s collagen. After 48–72 hours, we manipulate the hand to release the contracted cord, restoring finger motion without the need for open surgery.

    Surgical Treatment

    • For advanced or recurring cases, we may perform a fasciectomy, where the cord is surgically removed through a zig-zag incision.

    • While effective, this creates new scarring and may require a longer recovery process.

  • Whether through injection or surgery, you’ll likely work with a hand therapist to regain range of motion. Some patients may have lingering joint stiffness if the contracture was longstanding, but early treatment improves outcomes.

Symptoms of Trigger Finger:

  • Finger stiffness—especially in the morning

  • A popping or clicking sensation when moving the finger

  • Tenderness or a bump (nodule) at the base of the finger

  • Pain when bending or straightening the finger

  • Locking or catching in a bent position

  • Trigger finger (also called stenosing tenosynovitis) happens when the tendon in your finger becomes inflamed and can no longer glide smoothly through its sheath (a tunnel-like structure that keeps the tendon aligned with the bone). When this happens, the finger may get stuck in a bent position and suddenly pop straight—like a trigger being pulled and released.

    It’s most common in people who perform repetitive gripping actions, but it can affect anyone.

    • Non-Surgical Options:

      • Activity modification: Avoid repetitive grip-intensive movements

      • Bracing: Keep the finger straight to rest the tendon

      • Anti-inflammatory medications: Reduce swelling

      • Steroid injections: Targeted relief at the problem site

    Trigger Finger Release Surgery:

    • If symptoms persist or locking becomes painful and frequent, a quick outpatient procedure can relieve the tendon.

      • A small incision is made at the base of the affected finger

      • The opening of the tendon sheath is gently released

      • This eliminates the catching point and restores smooth movement

    • Surgery time: ~10 minutes

    • Immediate motion encouraged to prevent stiffness

    • Mild soreness and stiffness for a few weeks

    • Most patients regain full use of their hand and experience no more locking

    Our goal is to help you return to full hand function without restrictions or pain.

What Causes Carpal Tunnel Syndrome?

The carpal tunnel is a tight space formed by the wrist bones and covered by the transverse carpal ligament. The median nerve and flexor tendons pass through this tunnel. When swelling or overuse compresses the nerve, it disrupts sensation and movement—like a pinched wire that can’t send signals properly.

  • Before considering surgery, Dr. Pitts recommends:

    • Wrist bracing, especially at night

    • Activity modification

    • Anti-inflammatory medications

    • Steroid injections to reduce swelling

    In many cases, these conservative treatments relieve symptoms and restore function.

  • If symptoms persist or progress—especially when confirmed by an EMG study (a nerve conduction test)—surgery may be recommended to avoid permanent nerve damage.

  • Carpal tunnel surgery involves cutting the ligament that forms the roof of the tunnel, relieving pressure on the nerve and allowing it to heal naturally. There are two techniques:

    • Endoscopic (minimally invasive)

    • Open release (small incision at the wrist)

    Both methods are effective, and recovery is typically quick.

    • Procedure time: ~5–10 minutes

    • Immediate hand use encouraged (light activity only)

    • Keep incision clean and dry

    • Most patients resume full function by 4 weeks

    • Nerve healing can continue for several months, often improving gradually from the palm to the fingertipsDr. Pitts emphasizes that nerve recovery takes time, often healing at about 1 millimeter per day. While full sensation may not return in every case, the goal is to prevent worsening symptoms and restore hand strength and function.

What Is CMC Arthroplasty?

  • CMC arthroplasty is a surgical procedure to treat arthritis at the base of the thumb. Unlike hip or knee replacements that use metal implants, this surgery involves removing a small bone called the trapezium to create space between the thumb and wrist bones—relieving the painful grinding caused by arthritis.

    • Significant pain relief at the base of the thumb

    • Improved grip and pinch strength

    • Preserved thumb motion

    • Durable, non-metal solution for joint preservation

    Most patients experience lasting improvement and return to normal hand function with minimal complications.

    • Chronic thumb pain that limits function

    • Failed response to bracing, NSAIDs, or steroid injections

    • Difficulty pinching, gripping, or using the hand for daily activities

    Dr. Pitts carefully evaluates each patient’s condition to determine whether CMC arthroplasty is the best option based on their lifestyle and severity of arthritis.

  • To support the thumb after removing the trapezium, Dr. Pitts performs a suspensionplasty, using a suture anchor to suspend the thumb and keep it from collapsing into the empty space. Over time, your body forms natural scar tissue—what one surgeon fondly calls “nature’s marshmallow”—to cushion the joint and preserve mobility.