Lewis Plastic Surgery
2331-A Robious Station Circle
Midlothian, VA 23113
In addition to cosmetic and reconstructive surgical procedures, we also are specialists in hand surgery. Dr. Lewis who has completed a fellowship in Hand Surgery at Duke University and continues to help patients manage various issues with their hands. This sometimes involves non-operative modalities such as hand therapy, but sometimes requires surgical intervention.
Dr. Lewis is experienced in treating these common issues and other less common issues, including:
- Carpal tunnel syndrome
- Cubital tunnel syndrome: Ulnar nerve compression at the elbow
- Trigger fingers
- Dupuytrens contracture
- Arthritis in the hand or wrist
- Wrist pain
- Trauma: skin, bone, nerve, tendon, ligament injury
Carpal & Cubital Tunnel
Carpal Tunnel syndrome is a condition arising from the compression of the median nerve as it crosses though the “carpal tunnel” of the wrist. This is a tight space and the median nerve experiences dysfunction due to compression in this area. It is characterized by pain, numbness, and weakness of the hand. The pain and numbness is usually in the thumb, index, middle and ring fingers, but can radiate to other fingers or up the arm. The weakness can be more difficult to isolate, but in advanced cases it can cause significant loss of strength and dexterity of the thumb.
Treatment options can be either surgical or non-surgical. Non-surgical options include splinting the wrist, steroid injections and hand therapy. When these do not resolve the issue, surgical options are offered.
Dr. Lewis primarily offers endoscopic carpal tunnel release. This release is performed through a small incision in skin of the distal forearm, just next to the wrist. This approach allows less postoperative pain and a faster return to work. The recovery is fast and most people are back at full duty in one week. There may be a small amount of residual soreness that takes a few weeks to resolve.
Trigger fingers are a very common problem. Patients with trigger fingers report pain on the palm at the base of a finger or thumb as well as clicking or popping on moving this finger. This results from a small bump that can develop on the tendon or tendons that move each finger. As this bump moves through the “pulley” at the base of the finger it catches and clicks. In advanced cases, patients will have to grab the finger and pull to straighten it. In early cases, this can usually be repaired with a steroid injection around the tendon. If this fails to resolve the symptoms, or in more advanced cases, a small surgery may be offered to release the pulley that is causing the problem.
Cubital tunnel syndrome (ulnar nerve compression at the elbow) is a problem similar to carpal tunnel syndrome, but it involves the ulnar nerve, and the compression occurs at the elbow. Numbness and tingling in the small and ring fingers as well as weakness in much of the hand characterizes this problem. The treatment varies depending on the extent of the problem. Often a small incision can be used to release bands of tissue around the elbow that can compress the nerve. However, sometimes a bigger surgery is used in which the nerve is re-routed to a more protected location. Dr. Lewis will help guide this decision.
Dupuytrens Contracture is a progressive problem with the skin and fascia in the palm of the hand. In this disorder, the skin and fascia (underlying tissue) can thicken and shorten. This can decrease patients’ ability to straighten their fingers. Traditionally, the surgery to repair this is a very large surgery requiring weeks or months of postoperative therapy. Dr. Lewis has been trained on the newer technique of percutaneous needle aponeurotomy. With this, the procedure is performed in the office, and using needles, the bands of tissue that pull down the fingers are sharply divided. This usually results in immediate straightening of the finger and usually does not need post-procedure therapy. Dr. Lewis is very happy with the results of this procedure and will discuss this procedure with patients to assess their needs and indications.
Arthritis of the hands and wrist has many causes and locations. In some locations, there are great options to decrease the pain associated with arthritis. Dr. Lewis can help assess your issues and recommend treatment options as needed.
Wrist pain can result from arthritis, fracture, ligament injury or tendonitis. The specific treatment regimen will be determined by each patient’s symptoms, workload, and results of x-rays. Sometimes this involves surgery; sometimes the issues can be resolved without surgery.
Trauma to the hand can result in some devastating injuries. Luckily, most injuries to the hand are relatively small. Even the smaller injuries often take several months to recover from. The recommended treatments depend greatly on the tissue or bone that is injured. Dr. Lewis is proficient at repairing injury to the bones, tendons, ligaments, and nerves of the hand. Often, these patients will require post-injury or postoperative hand therapy.
Surgical procedures are performed at an accredited outpatient surgical center or a local hospital. Dr. Gordon Lewis is affiliated with several local medical centers where his patients undergo surgery. He primarily operates at these locations:
Stony Point Surgery Center
Parham Surgery Center
He also has privileges at St. Mary’s Hospital and Henrico Doctors Hospital, but he operates there less frequently.
Initial consultations, follow-up appointments, and all non-surgical treatments and minor surgical procedures are performed at Lewis Plastic Surgery practice, which is located on the grounds of Johnson-Willis Hospital in Richmond, Virginia.
Every patient is required to attend an initial consultation before a procedure can be booked. Once you decide to proceed with surgery, we will assist you in finalizing a date and getting everything ready for surgery. We try to be as flexible as possible and will make arrangements to see you at Lewis Plastic Surgery on the grounds of Johnston-Willis Hospital within a few days after you contact us.
Will hand surgery be covered by insurance?
Yes, the vast majority of hand surgeries are covered under health insurance policies.
Gordon Lewis, M.D.
Dr. Lewis, a native of Richmond, prioritizes building honest, trusting relationships and providing personalized care for his patients.Meet Dr. Lewis