Hand Surgery

Hand surgeons are specialists in hand care.

The human hand is a complex organ, lined with specialized skin, with a multitude of small bones and joints. It has a vast network of nerves and blood vessels all encased in a small and vulnerable space. When hand injuries or hand deformities occur, they are best treated by a qualified hand surgeon.

Dr. Mondolfi served as a resident and then as instructor of hand surgery at Temple University in Philadelphia, He became chief of the pediatric hand surgery service of SJDD hospital where he provided care, did clinical research and trained orthopedic residents in the art and science of hand surgery.

His practice includes acute hand injuries, such as fractures, dislocations, severed tendons and nerves. Also thermal, chemical or electrical burns of the upper limb as well as managing severe infections. He deals the long term consequences of injuries such as malunited fractures, stiff joints, painful hands, adhered tendons or nerve loss.

Workers compensation injuries that require surgical care are also treated by Dr. Mondolfi.

Common conditions of the hand treated by Dr. Mondolfi include:

Trigger finger is an irritation of the digital sheath that surrounds the flexor tendons. When the tendon sheath becomes thickened or swollen it pinches the tendon and prevents it from gliding smoothly. In some cases the tendon catches and then suddenly releases as though a "trigger" were released.
Ganglion cysts which are the most common mass or lump in the hand. They are most common on the back of the wrist. These non-cancerous, fluid-filled cysts arise from the ligaments, joint linings, or tendon sheaths when they are irritated or inflamed.
Carpal tunnel syndrome is a compresion of the median nerve causing symptoms such as numbness and tingling in the hand, especially at night; pain with prolonged gripping such as holding a steering wheel; or clumsiness in handling objects. Sometimes the pain can go all the way up to the shoulder. Other nerves in the upper limb may be entrapped such as the ulnar nerve at the wrist or elbow.

These symptoms are caused by pressure on the median nerve as it enters the hand through a narrow space in the wrist. Mild cases can be treated with a splint or brace to rest the wrist. Steroid injections into the carpal canal to decrease swelling may be used in addition to splinting. Those cases that do not respond to nonsurgical treatment and those that are diagnosed late often require surgery. This is generally done in an outpatient setting under local anesthesia.
de Quervain's tenosynovitis is an irritation and swelling of the sheath or tunnel which surrounds the thumb tendons as they pass from the wrist to the thumb. Pain when grasping or pinching and tenderness over the tunnel are the most common symptoms. Sometimes a lump or thickening can be felt in this area.
Arthritis of the base of the thumb: Wear and tear arthritis is very common at the base of the thumb, pain localized to the base of the thumb, particularly with use, is a very common early symptom. Early disease can be treated with anti-inflammatory medication, steroid injections into the joint, or splinting, but as the wear and deformity progress, surgery is frequently required. There are very effective procedures to relieve pain and improve function.
Arthritis of the fingers: Lumps and bumps frequently occur at the last joint of the finger or thumb due to wear and tear arthritis (osteoarthritis). As the joints deteriorate, small bone spurs form over the back of the joints and may become tender
Dupuytren's contracture is a hereditary thickening of the tough tissue called fascia that lies just below the skin of your palm. This condition may vary from small lumps or bands to very thick bands which may eventually pull the fingers into the palm.
Congenital hand deformities such as extra, missing, deformed or webbed fingers often require reconstructive plastic hand surgery. In syndactyly procedures where webbed fingers are surgically separated, plastic surgery is necessary. In these procedures, the fingers are split using a zigzag cut and the new web space is created by using a flap of skin from the back of the fingers or groin area.

For additional information about hand conditions and hand surgery, click here:

American Society for Surgery of the Hand

Website Copyright ©2013 Paul E. Mondolfi, MD
Dr. Paul E. Mondolfi is a credentialed, qualified and experienced plastic surgeon serving the Houston,
Victoria, Sugar Land, San Antonio, Austin and Corpus Christi areas of Texas.
Dr. Mondolfi specializes in facial plastic surgery, breast and body contouring, and liposculpture.

605 E. San Antonio St. • Suite 450 • Victoria, Texas 77901 • (361) 580-1574
Fax: (361) 570-3709
Email: plastics@tisd.net