Dr Dirk van der Spuy

01/07/2024

24/06/2024

Read more in the link in bio 👐🏻

18/06/2024

At Cape Hand Surgery, we are dedicated to helping patients from around the globe 🌍 Read more in the link in bio to find out how we can help, no matter where you are 👐

07/06/2024

Read more in the link in bio to delve into the intricacies of Focal dystonia, a condition that affects the control of muscles in our hands 🖐️.

04/06/2024

Read about various hand conditions, treatment options, post-operate care and much more! Read more by clicking the link in bio ✋

31/05/2024

Did you know that the hand has 27 bones?
Find out more by visiting the link in our bio ☝️

27/05/2024

Have you taken a look at our new website yet? 👀👋
https://capehandsurgery.co.za/

27/05/2024

Have you looked at our new website yet? 👀 👋 https://capehandsurgery.co.za

08/12/2023

Dorsal Ganglions.

Ganglions found in the hand are considered to be common masses and those that appear at the back of the wrist are called dorsal wrist ganglions. They are usually a fluid filled cyst that arise from a specific ligament in the wrist joint called the scapholunate ligament.

It is now better understood that these cysts, which are often cause pain, are associated with a weakness or attenuation of this ligament which change the kinematics and movements of the wrist and may therefore be more than just a fluid filled cyst. Generally, these cysts tend to grow back even if they have been aspirated or burst and therefore it is best to have it seen to.

Dorsal wrist ganglions cause wrist pain, especially in loaded extension, like when doing a push up, and are usually accompanied by some form of ligament insufficiency. It is therefore best to have these ganglions evaluated by a specialist.

In some cases, where a surgical excision is considered, the ganglion is excised and part of the procedure involves very meticulous attention to detail to close the defect of the stalk of the ganglion and to reconstruct the ligaments, to achieve a good outcome.

Please feel free to come see us if you are struggling with a dorsal ganglion.

For more on ganglions, visit our website:https://capehandsurgery.co.za/non-trauma-conditions/ganglion/

19/09/2023

Joint Replacements in Hand Surgery

Don't miss Dr Dirk van der Spuy, specialist orthopaedic hand surgeon, explaining hand surgery and osteoarthritis of the proximal interphalangeal joints and the joint replacement technique that he uses.

Tune in at 21h00 Tuesday 26 September and again at 17h00 Friday 29 September on Channel 145.

03/09/2023

Proximal Interphalangeal (PIP) joint injuries of the hand

The PIP joint is the first joint of the fingers and are generally more at risk as the ligaments proximal and distal to them are more protected and are anatomically more stable. These injuries of the hand are by far the most common and generally create a lot of problems for a very long time. This specific joint can be seen as the same type of joint as a knee, as it is also a hinge joint. Injuries of these joint are very much on the spectrum of a knee injury with a range of multiple soft tissue injuries and in general we treat these injuries all the same as they form part of a spectrum of a dislocation of this type of joint.

This specific joint is a strongly supported as a hinge joint by two condyles that create a bony stability. It also has two very strong collateral ligaments on the sides and a very strong volar plate that is a thick ligament on the palm side of the joint that prevents hyperextension. On the top side is the extensor tendon that stabilizes the joint and is in congruence with the collateral ligaments.

For any dislocation spectrum type of injuries, what usually happens is that one or two of the collaterals are torn and if the third stabilizer, usually like the volar plate, tears the joint pops out of position and the finger will have an obvious deformity. When this is not the case and especially when reduction wasn’t needed, it is important to note that the finger is probably gone through a dislocation type high energy injury and that the healing of it will take equally as long.

Generally, the most important first step is to do a reduction of the dislocation then to see a hand surgeon with a therapist as soon as possible as these needs very guided rehabilitation. These are typically treated conservatively as far as possible with an initial period of splinting for the swelling to settle and then guided mobilization. It is very important to know that a big enemy with PIP injuries is stiffness and flexion deformities and it can take very long to address these and therefore it is imperative that you see a doctor as soon as possible.

PIP injuries are very common, and it is a very long journey of up to a year for these to recover in full. Please feel free to contact us.