KH . ORG 15 By Kristina Orrego Our hands are parts of our bodies we can sometimes take for granted. They’re the tools with which we cook a delicious meal, create art or express how we’re feeling. But what happens when we can’t use our hands the way we once could? That’s when physicians like Caleb Netting, M.D., a new orthopedic surgeon at Kootenai Health, come into the picture. Here are two common conditions he sees in patients. Carpal tunnel syndrome and trigger finger Carpal tunnel happens when a nerve in the hand has become compressed, which often leads to pain and numbness. Carpal tunnel is often linked to doing certain activities or general overuse, but it can also be the result of an injury or certain medical conditions. Nonoperative ways to treat carpal tunnel, like steroid injections and wearing a night splint, can help relieve symptoms. In rare instances, Healing HANDS they can be fully effective. “In my experience, the symptoms usually recur or worsen despite these treatments,” Dr. Netting said. When those approaches fail to bring relief, Dr. Netting recommends a surgery called carpal tunnel release. “Because you have this one nerve that shares space in the wrist with nine other tendons, if there’s not enough room in there, it can get compressed,” he said. “At a certain point, the nerve can get permanently damaged. Then even if you do the decompression, you might not recover all of your nerve function.” Carpal tunnel release is usually successful as long as the nerve hasn’t suffered this permanent damage. Trigger finger is a condition that occurs when the tendons in the finger start to stick in the sheath they slide through. “The more they stick, the more inflamed they get,” Dr. Netting said. “And the more inflamed, the more they stick. A steroid injection is often useful to reduce the inflammation, breaking this vicious circle.” Generally, this steroid injection is the remedy for trigger finger. However, for some people, trigger finger release—a small surgery where part of the tendon sheath is opened up—is needed. “This surgery involves making a small incision in the palm over part of the tendon sheath called the A1 pulley,” Dr. Netting said. “Then a small portion of the tendon sheath is cut open to allow the tendon to glide freely.” Outcomes of surgery For both of these procedures, patients may have some soreness in their palms for up to three months. Generally after six weeks, they don’t have many limitations. It is reasonable for people to return to light duties anywhere from the next day to two weeks after these surgeries. For heavy labor, up to six weeks may be needed. For most patients, the discomfort or pain in the palm is more manageable than the conditions themselves. “For carpal tunnel release, the nighttime burning pain often resolves immediately after surgery,” Dr. Netting said. “For trigger finger, the finger shouldn’t catch or ‘trigger’ anymore after surgery.” Dr. Netting has taken an optimistic and realistic approach to his practice and aims to treat patients who need hand surgery sooner rather than later. “I can’t necessarily give you a perfect hand back after you have advanced damage, but there are certain options that will help provide improvements to where you are today,” he said. Seek relief To schedule a visit with Dr. Netting, call Kootenai Clinic Orthopedics at (208) 625-6111 or the Orthopedics office in Post Falls at (208) 625-6700. Help for two common conditions Caitlyn Kubale, MA, and orthopedic surgeon Caleb Netting, M.D., examine a skeletal hand at the Post Falls Orthopedics office.
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