Wide-Awake Hand Surgery

Something as simple as drinking a cup of coffee became a challenge for Lisa Wimmer.  She suffered with a condition known as trigger finger.  Imagine, balling up your fist and when you release your fingers, your ring finger catches while the rest of your fingers straighten out.  Then, about a second later your ring finger pops loose and also becomes straight. Lisa described it as a painful pop and lock sensation.

“It is just the little things that you take for granted every day you use your hands," she explained. "Writing has become difficult now."

After doing some research, she scheduled an appointment with Peter Apel, M.D. Ph.D., and orthopaedic hand specialist at The Institute for Orthopaedics and Neurosciences at Carilion Clinic. 

When she learned that Dr. Apel could perform her surgery using only local anesthesia, she decided wide awake hand surgery was the best option.

"I have been in surgeries before where anesthesia is used and as you know it takes a while for some people to come out of anesthesia you don’t function as well for a few days afterward," she said.

Wide-awake surgeries allow for immediate communications between the patient and the surgeon, tend to be less expensive, provide an easier recuperation for patients and have fewer risks than surgeries with anesthesia.  

Lisa invited us into the operating room to observe her surgery. While we were there, we listened to the communication between Lisa and Dr. Apel. Because she was awake, Dr. Apel immediately knew the procedure had been a success.

"As soon as we release the area that is tight, Lisa will be able to move her thumb and forefinger again," explained Dr. Apel. "If she was asleep we wouldn’t know that until she woke up."

Lisa had her surgery on a Friday and returned to work the following Monday. Two weeks later, she came back to see Dr. Apel to have her stitches removed.

“Coming from where I was to where I am now is amazing," she said.

"Trigger fingers are very common," Dr. Apel added. "It is one of the most common conditions we see as hand surgeons.”

According to the American Academy of Orthopaedic Surgeons, trigger finger usually occurs in people who are 40 to 60 years old and is more common in women than men.

It is also is most common in people with certain medical conditions such as diabetes and rheumatoid arthritis and it can also happen after activities that strain your hand.