Convenient London hospital locations for hand and wrist surgery with Mr Philip Mathew. Access world-class facilities and expert orthopaedic care. Hospitals Please contact the private hospitals where I consult directly for fixed session clinical consultation appointments through the numbers listed below. If you are unsuccessful obtaining an appointment at the time of your choice and require a bespoke appointment or if you need specific information, please contact my practice manager on 020 8194 8613 or click here to email. The Lister Hospital part of HCA Healthcare UK The Lister Hospital, Chelsea Bridge Rd, London SW1W 8RH, United Kingdom Phone: 020 3993 7566 Open 24 hours View Direction Chelsea Outpatient Centre 280 King’s Rd, London SW3 5AW, United Kingdom. Phone: 020 3993 1852 Time: 8 am–8 pm View Direction Lips Battersea Clinic 1st Floor, Turbine Hall B, Battersea Power Station, London SW11 8DD, United Kingdom phone: +44 20 7164 6114 View Direction Chelsea and Westminster Hospital 369 Fulham Road, London, SW10 9TU Phone: 00208 150 8290 View Direction Spire Hartswood Hospital Eagle Way, Great Warley, Brentwood, Essex CM13 3LE, United Kingdom Phone:01277 232 525 Hours: Monday am 8:00 to 10:00 View Direction Spire London East Hospital Roding Lane South, Redbridge, Ilford. Phone: 020 8551 1100 ad hoc appt available on request View Direction

Explore advanced hand and wrist surgery procedures in London, from carpal tunnel release to fracture repair, with orthopaedic surgeon Mr Philip Mathew. Procedures The Top 10 Reasons for Stiff Fingers... Your hands are essential instruments for interacting...... Read More Skier’s Thumb: An injury to the ulna collateral... Is There Anything I Should Know Regarding...... Read More Treatment options for hand and wrist sports... There are a variety of hand and wrist sports injuries that can... Read More Do you have fingers bent it with thick cords in... Overview Dupuytren’s contracture is a... Read More Do you get tingling, numbness or pins and needles... What is cubital tunnel syndrome, and how does it... Read More Do you get pain in your wrist when lifting your... The tendons in your wrist are affected by De... Read More Are there surgical options for painful Arthritis... Arthritis in the hands may be debilitating, causing... Read More Carpal Tunnel Surgery: What To Expect What is carpal tunnel release surgery, and how does... Read More Causes And Treatment Of Trigger Finger, A Common... With the internet at your fingertips, most adults use... Read More Simple Hand Rehabilitation Exercises Hand injuries provide a distinct set of problems... Read More Managing whilst one-handed If you are recovering from a hand/wrist injury, or having... Read More Trigger finger release surgery This leaflet will help answer some of the questions you may have... Read More Wrist Arthroscopy This is a form of minimally invasive surgery which allows the... Read More Wide Awake Local anaesthetsia no tourniquet... Local anaesthesia with adrenaline has been shown to be safe and... Read More Ligament repair and reconstructions A ligament is a thick band of tissue that connects two bones.... Read More

Book a private consultation with Mr Philip Mathew, a leading London hand and wrist surgeon. Expert diagnosis and treatment for your condition. Contact Us Practice Manager 020 8194 8613 Email Us mathew.admin@lips.org.uk LIPS payments team 020 8194 8613 Please contact your insurer directly for insurance related questions.If you have agreed to a package deal with the hospital, please contact the hospital directly.If you have any billing or payment queries regarding my fees alone and not related to your insuranceor package deals with the hospital please contact my billing company directly. First Name Last Name Email Message Send Thanks for submitting!

Treatment options for hand and wrist sports injuries – Online video

Simple Hand Rehabilitation Exercises Hand injuries provide a distinct set of problems. Hand injuries may be highly inconvenient, in addition to the discomfort they cause. There are easy actions you may do to hasten your recovery while minimizing pain. Exercises for the Hands First it is extremely important to ensure that there is no underlying fracture (broken bone), joint dislocations, nerve or tendon injury before commencing any exercises. Early identification and correct treatment at the right time be it splinting, guided hand therapy or surgery if necessary can ensure optimal outcomes. Speaking with your hand surgeon or hand therapist to identify the best physical therapy program is critical for people with unique hand problems. Depending on your specific injury, one or more of these hand exercises may be required for a speedy recovery. Delayed identification of more serious problems in these seemingly minor injuries can often lead to adverse outcomes that may significantly affect the function of your hand. Whether you’re a student-athlete, an office worker with carpal tunnel syndrome, or someone who has recently been diagnosed with arthritis, one of these exercises might help you get back on your feet. The workouts mentioned below are some of the most often suggested. These are also excellent exercises for anyone wanting to increase their hand mobility in general. Again if you are in pain or have a swollen, or recently injured hand please consult a hand specialist before commencing any of the exercises below. It’s as easy as it sounds to make a fist. Begin with your hand spread out in front of you, then create a fist. Stretch your fingers by starting with your hand in a natural posture on a flat surface and gradually straightening them. Hold this stance for roughly a minute before switching hands. Place your palm flat on the table and slowly raise each individual finger to increase your flexibility. For each hand, repeat this exercise 8-12 times. Stretch each of your fingers to contact your thumb while holding your hand in an upright posture. For 30-60 seconds, move your fingers into a claw-like stance with your palm facing out. With each hand, squeeze a grip-strengthening ball as tightly as possible 10-15 times. Pinch a soft foam ball between the tips of one of your fingers and your thumb to strengthen your grip. Do this for approximately a minute, then do it again for a total of 10-15 times. Elevate your wrist by draping it over the edge of a folded towel or other similar-sized items. Move your hand up and down completely, starting with your palm facing down and ending with your palm facing up. Place your wrist/forearm on a folded-up towel, this time with your hand sideways and your thumb pointing up, like in the last exercise. Then, in a complete range of motion, wave your hand up and down. Rotate your arms by placing your palms up, then down, and so on while standing or sitting with your elbows bent at a 90-degree angle. Extend your thumb from its natural position to the palm’s center and back. Tendon Gliding is an activity that involves placing your hand in various postures and then returning it to a flat position. Make a hook fist first, then a full fist, and finally a straight fist. Speak with a fellowship-trained Hand Surgeon who specializes in this area right now. You can traverse the healing phase of your hand injury with relative ease if you follow the advice of a hand surgeon. He/She can assist you in overcoming these obstacles and moving toward long-term recovery. For additional information on how we can help you recover, please contact us.

Skier’s Thumb: An injury to the ulna collateral ligament of the thumb Skier’s Thumb: An injury to the ulna collateral ligament of the thumb • A ligament is the strong tissue that joins the bone of a joint together, provides stability and is commonly injured in skier’s thumb. • This pathology was first identified in 1955 as a persistent ligament condition in Scottish poachers who regularly twisted the necks of hares, causing damage to their thumbs. At the time, the injury was known as “gamekeeper’s thumb.” • Because of the rising popularity of downhill skiing and injuries to the thumb sustained following a fall, the phrase “gamekeeper’s thumb” has been supplanted with the more modern word “skier’s thumb.” • A considerable proportion of skiing injuries include skier’s thumb. • This damage must be surgically treated in extreme situations when the ligament has completely ripped. • Because the ligament contributes to the thumb’s gripping function, its ultimate stability is critical. • With adequate therapy, individuals with skier’s thumbs may be able to go to work or even ski in a short time. Injuries Many of the components of a finger might become stiff if they are damaged. Inflammation of or injury to the tendons around the joint are caused by finger joints dislocations and “jammed fingers.” These injuries can induce permanent or even permanent alterations in the supporting ligaments’ typical flexibility, limiting joint mobility. Swelling and bleeding from broken fingers (fractures) may be irritant to the tendons that run along the bones. The sharp edges of the broken bone can sometimes injure the tendons. This may cause the tendons to scar to the bone, restricting their mobility and so affecting the joints that those tendons move. Extensor tendons (straightening) and flexor tendons (bending) injuries in the finger might reduce their range of motion. The tendons’ control joints may lose motion or become stiff as a result. Temporary plaster slabs/ casts or thermoplastic splints, early hand therapy and range of movement and in certain situations surgery to fix the fracture can help treat the injury. Skier’s Thumb Causes Accidents on the slopes are the most prevalent source of injury to the tendon that produces skier’s thumb. Injuries to this ligament account for 8% to 10percent of total of all skiing incidents. A fall on to an open palm with a skiing pole in the palm, for example, generates the force required to strain the thumb and strain or rupture the ligament. A simple landing on an extended hand with an open palm does not normally produce much impact. The thumb, on the other hand, can be hurt if it slides into compacted snow at a fast speed. A car accident in which the driver’s thumb is draped alone so over steering wheel is a less prevalent source of this injury. Skier’s thumb can be caused by any injury that causes the thumb to bend unusually backwards or to the side. Symptoms of a Skier’s Thumb These clinical signs may appear minutes to an hour after the damage has occurred. • Pain in the web area between the thumb and the index finger at the root of the thumb • Thumb swelling at MCP joint • there is an inability to grip or a weakening of grasp; between thumb and index finger, • Skin discoloration above the thumb that is blue or black in hue. • Thumb ache that becomes worse as you move it in any direction Diagnosis of a Skier’s Thumb It’s important to see an hand surgeon if you have injured your thumb in a similar fashion. Your surgeon will initially assess if you had any additional limb-threatening injuries before performing a more thorough examination of the thumb. The surgeon will inquire as to how the injury occurred and add further questions like: • Have you ever been injured in a similar way before? • Have you ever undergone any form of hand or wrist surgery? • Are there any pain relievers that you’re allergic to? • Have you ever sustained a previous wrist or hand fracture? • Are you a right- or left-handed person? • What do you do for a living? After that, the surgeon will conduct a physical examination. • Its ligaments of the thumb close to the index finger side that are tested for laxity (looseness) in the following way: This test will include keeping the root of the thumb in place while delivering a lateral (sideways) push to the tip of the thumb to observe how far it will move. The motion of the damaged thumb will be contrasted to the motion of the unaffected thumb. This may be difficult to accomplish just after the injury due to pain (in which case the injury may be treated and then re-examined in a few days) and may be assessed after a local anaesthetic injection. Treatment of skiers thumb The initial management of this injury depends entirely on the severity of the injury and degree of ligament damage . Partial ulnar collateral ligament injuries are normally immobilised for 4-6weeks, however full ligament rupture frequently necessitates surgery. They may also be associated with a fracture/ boney injury and is best assessed with an x-ray. A important variation seen with a severe injury , where the ligament gets trapped above other soft tissue and these do not heal unless treated surgically. If suspected clinically this is best assessed with an ultrasound scan. Early identification can be treated satisfactorily with surgical repair, delayed presentations ( beyond 6 weeks) may necessitate ligament reconstruction using tendon grafts which is a bigger procedure. After surgery and or a period of immobility in a plaster, your hand therapist and hand surgeon will then organise a bespoke splint and rehabilitation program. It usually takes a period of 6-10 weeks for this to heal fully. Prevention of Skier’s Thumb During all falls, skiers should be trained to intentionally drop the ski pole. When skiing without a ski pole in hand, falling on with an outstretched hand should reduce the risk of harm. • Riders also should be encouraged to utilise poles with finger groove grips rather than those with wrist straps or closed grips. • If you keep your thumbs and fingers outside the steering wheel during a car collision, you can avoid getting skier’s thumb. Since most drivers are conditioned to grasp the steering wheel like a ski pole, this new pattern will need deliberate effort. When Should You Seek Medical Help? If a person develops any of the signs of skier’s thumb after an accident, they should seek immediate medical care and follow the surgeons recommendations for further management. If you have injured your thumb please organise a review with a hand surgeon and book your consultation.

Visit Mr Philip Mathew at Chelsea & Westminster Hospital in London for expert hand and wrist surgery, consultations, and follow-up care. Private Hand & Wrist Surgeon at Chelsea & Westminster Hospital Expert Hand & Wrist Care within a World-Class Teaching Hospital Mr. Philip Mathew offers exceptional hand and wrist care within the private patient facilities of Chelsea and Westminster Hospital, a leading NHS teaching hospital. This unique setting provides you with the benefits of world-class clinical expertise and cutting-edge technology, combined with the comfort of the private clinic. Mr. Mathew is dedicated to providing personalised, high-quality care, guiding you through all available treatment options with shared decision-making. Comprehensive Hand & Wrist Services in London Mr. Philip Mathew provides a full spectrum of hand and wrist services (Internal link to clinical services page) at Chelsea and Westminster Hospital, from non-operative treatments to advanced surgical interventions. ● Fracture Management: Expert care for hand and wrist fractures. ● Degenerative Conditions: Treatment for arthritis and other degenerative issues. ● Nerve Compression Syndromes: Including Carpal Tunnel Syndrome and Cubital Tunnel Syndrome. ● Tendon Injuries: Comprehensive care for tendon problems. How to Find Chelsea & Westminster Hospital Chelsea and Westminster Hospital (external link to Chelsea and Westminster hospital page) is located in Fulham Road, London, SW10 9NH. The hospital is easily accessible by public transport. ● Tube: Numerous tube stations are within 15-20 minutes walk (Fulham Broadway, Earls Court, South Kensington) ● Rail: Imperial Wharf and West Brompton train stations are within walking distance from the hospital. ● Bus: Many bus routes stop near the hospital including: 14, 214, 328 and C3 ● Driving: Parking is available at the hospital’s underground car park which is accessed via Nightingale Place. Seeking expert hand and wrist care in a world-class setting? Book a consultation with Mr. Philip Mathew at Chelsea and Westminster Hospital Private Clinic Benefit from his expertise and the hospital's exceptional facilities. Book Now

Ligament repair and reconstructions A ligament is a thick band of tissue that connects two bones. Wrist ligament injuries are commonly missed following falls, sports injuries. Early recognition and guided management can help early return to function. Find out more: Scapholunate ligament injury | TFCC injury

Do you get tingling, numbness or pins and needles in your little and or ring finger?…. you may have Cubital Tunnel Syndrome What is cubital tunnel syndrome, and how does it affect you? Cubital tunnel syndrome occurs when the ulnar nerve becomes inflamed, swollen, and or irritated. Ulnar nerve is an important nerve starting in your neck which passes through the “cubital tunnel” (a ligament and bone tunnel on the inner aspect of your elbow) as it makes it way from your upper arm into your forearm and eventually into your hand. Cubital tunnel syndrome generates pain that is similar to the sensations you get when you strike your elbow’s “funny bone.” Causes of cubital tunnel syndrome? Cubital tunnel syndrome can develop if a person frequently (repetitive) bends their elbows for example, when pulling, reaching, or lifting, leaning heavily on their elbow, or suffers an injury to the area. Cubital tunnel syndrome can be caused by arthritis, bone spurs, or past elbow fractures or dislocations or sometimes by the presence of abnormal muscle in the region of the tunnel. What are the symptoms of cubital tunnel syndrome? Cubital tunnel syndrome manifests itself in a variety of ways. The most prevalent symptoms of cubital tunnel syndrome are as follows: Numbness and tingling in the hand, especially in the ring and little fingers, when the elbow is bent. Hand pain. Aching pain on the inside of the elbow Muscle weakness in the affected arm and hand causes clumsiness and a weak grasp. Numbness and tingling at night. How can you know if you have cubital tunnel syndrome? In addition to a comprehensive medical history and physical examination, diagnostic tests for cubital tunnel syndrome may include: Nerve conduction tests: This test determines how quickly signals flow down a nerve to determine whether the nerve is compressed or constricted. Electromyogram (EMG): This test examines nerve and muscle function and can be used to assess the ulnar nerve-controlled forearm muscles. If the muscles aren’t working properly, it could be a symptom of an issue with the ulnar nerve. X-ray: This procedure is used to examine the bones of the elbow to see if you have arthritis or bone spurs. Clinical examination is key however and its important you consult a surgeon for this. What is the treatment for cubital tunnel syndrome? Stopping the activity that is causing the issue is the most effective treatment for cubital tunnel syndrome. The following non operative treatments are generally recommended as first line treatment : Rest and avoid any activity that aggravates the problem, such as bending the elbow. A nighttime splint or foam elbow brace. The use of an elbow pad. Medicines that reduce inflammation. Gliding exercises for the nerves. It is essential that you see your surgeon and the therapist who can then guide you on the appropriate treatment plan tailored for you. If these therapies don’t have the desired result, your surgeon may recommend surgery to you. When do I need to contact Hand and Wrist Surgeon? If you have any of the following symptoms, contact your Hand and Wrist Surgeon: Pain or difficulty moving that interferes with your normal everyday activities. Treatment either does not help or makes the pain worse. Arm or hand numbness, tingling, or weakness

Access trusted hand and wrist surgery resources, patient support groups, and recovery guidance curated by Mr Philip Mathew in London. Useful Links Patient Information from American Society for Surgery of the Hand Patient Information from BritishSociety for Surgery of the Hand Royal Osteoporosis Society Arthritis Research UK British Dupuytren Society Guide to various conditions Rehabilitation exercises Exercise App App Store Google Play Store Water Proof covering

Causes And Treatment Of Trigger Finger, A Common Hand Problem With the internet at your fingertips, most adults use this resource to get information about their perceived disorder or injury. Often the wealth of information can be overwhelming and at times misleading. It’s interesting however to note that not all patients comprehend what’s going on within their bodies to cause a particular disease or set of symptoms. This article will provide you with a better understanding of the anatomy and pathophysiology of the condition known as trigger finger, as well as a brief discussion of the causes and possible treatment options. A tendon is like a piece of rope that connects muscle to bone. Each finger has three tendons that work in harmony and permit precise movement of the finger to facilitate fine activities like writing, picking up a coin, turning a key and also more composite movements like gripping a hammer or lifting your shopping. If left unchecked, as you bend your finger the two tendons on the palm side of the finger would naturally bow string away from finger. To prevent this and improve the efficiency of the tendon, there are little pulleys along the finger. However at times this awesome mechanism runs into problems and the tendon that bends your finger has difficulty fitting through the tight sheath, or pulley, that holds it close to the bone near the base of your finger in the palm. When this happens the finger may lock or get stuck bent and you then have to physically straighten it and when this happens it is referred to as a “trigger finger”. This resembles the pulling and release of the trigger of a gun and hence the name. It occurs when inflammation narrows the space within the sheath that surrounds the tendon in the affected finger. When you bend your finger, you may feel a little bump in your finger at the level of the base of the finger, usually at the level of the distal crease in the palm. As you bend and straighten the finger and the tendon glides you may feel the little bump (nodule) glide up and down. This usually relates to a reactive nodule on the tendon which Hueston and Wilson proposed was due to chronic repetitive friction between the flexor tendon and the enclosing sheath They compared this with the fraying that occurs at the end of a piece of thread after it has been passed numerous times through the eye of a needle. Pathology studies have shown that the inner lining of the pulley also gets significantly thickened and narrows the space available for the tendon to glide and causes it to catch and lock. Triggering can also occur in the thumb. Morning symptoms appear to be the most severe. Nobody knows why trigger finger develops in some people but not others, or in one finger but not the others. Conditions like diabetes and thyroid disease, like rheumatoid arthritis, have an increased association with developing one or more trigger fingers. Trigger fingers can be quite painful, and most patients seek therapy because of the pain and loss of use of the finger. In the very severe cases the affected finger may stay locked and bent and can be very painful to straighten out. Splinting and hand therapy is the first step in the ladder of treatment options available. A good therapist can make a custom made splint that stops you bending the digit completely but permits glide of the tendon. This is effective in a large number of cases but requires up to 6 weeks of treatment. Combination with topical or oral anti-inflammatory medications( providing no contraindications like allergy, asthma or stomach ulcers etc) can help manage the pain and inflammation. If splinting fails or the symptoms have been present for a while, Long-acting corticosteroid injections are the next step up on the ladder in initial management of the symptomatic trigger digit. Injection of the involved flexor tendon sheath provides long-term relief of symptoms in 80% of affected digits with up to 2-3 injections. The injections can be done in clinic or by a radiologist under ultrasound guidance. A recent article in the bone and joint journal has suggested that the small dose of a single injection into the digit is acceptable and does not increase your susceptibility to COVID-19. It is however advisable to have a minimum 2 week interval between your vaccination and a steroid injection. The injection can be painful and it is not advisable to drive immediately after the injection. You may need some initial additional painkillers. If non-operative treatment fails, surgery is the final step in the ladder. This can be performed in a number of ways but the main goal is to release the so-called A1 pulley, which is where the tendon becomes caught. The tight pulley is separated after surgery, allowing your tendon to move without catching. The surgery can be performed using a local anaesthetic and a needle to divide the pulley through the skin (percutaneous trigger finger release) under ultrasound guidance by a radiologist in an outpatient room. This method has slightly better short term results in experienced hands but the long term outcomes are so far better in the open group. Open trigger finger release is performed in a procedure room or operating room using a local anaesthetic (with or without a tourniquet on the arm) and making an incision divide the pulley under direct visualisation. The procedure takes only a few minutes and stitches are usually applied to close the wounds. The wounds take about 2 weeks to heal up but may be sore for up to 6 weeks. It’s noteworthy to observe that different treatment strategies have different success rates. About 80% of the time, a series of up to two injections is deemed to be successful. If conservative treatment fails or you decide to proceed to surgery, open surgery has a success rate of about 95 percent, while percutaneous surgery has a success rate of roughly 80 percent. Infection, nerve damage (to the digital nerves that run next to the flexor tendons and supply sensation to your fingers), tendon damage, failure to relieve symptoms (due to incorrect diagnosis or unusual cause of the triggering), loss of motion after surgery, continued tenderness, stiffness and swelling and complex regional pain syndrome are all risks associated with trigger finger surgery, as are many other hand surgeries. The chances of developing any of these issues are low, (1-5%). The important points to remember after surgery, regardless of how it is done, are to keep the bandage clean and dry, and to begin bending your fingers as per the hand therapists advise. While awake, you’ll need to work on finger motion every hour. Elevate your hand as much as possible over the first 48 hours. You can immediately begin using your hand for light activities (up to 1-2 lbs of lifting). The sutures (if there are any) will be removed 10-12 days following the surgery. It is common for the area at the base of the finger to be uncomfortable for up to two months, although most people return to normal activities within two to three weeks. In summary, splinting and hand therapy are a good first line treatment for trigger finger. Long acting corticosteroid injections are the mainstay in the initial management of this pathology. Surgery is curative and has very good long term outcomes but is best reserved for when non-operative management fails. It is important to remember that we can’t speed up biology and that we have to respect the soft tissues and give them time to heal. Movement is good, heavy lifting however is not advised till the healing is complete.

Answers to common questions about hand and wrist surgery in London with Mr Philip Mathew. Learn about recovery, costs, and treatment options. What do I need for my first consultation? A referral letter from either your general practitioner or physiotherapist is required if you are paying with private health insurance. You should also bring your insurance policy number and pre-authorisation code for the consultation. Please call the hospital you are being seen at and kindly ask for any images done at external hospitals to retransferred across along with the reports as this will save considerable time. How much does a consultation cost? For insured patients, prices are set according to the scales produced by the major insurance companies, and Mr. Mathew is recognized by most major insurance providers. If you are a self pay patient Mr. Mathew’s fees vary according to the clinic location . Further pricing information can be provided upon request. The individual hospitals may have their own additional charges for investigations and medications. How long will the consultation last? The new patient consultation can last up to 30 minutes. It is important to note that some conditions are relatively simple and some complex and the timing may vary as necessary to make sure you have clearly understood the suspected pathology and the management plan. Follow up appointments can last up to 15 minutes but again can vary. What if I need Surgery? The decision for surgery is not always easy and adequate time will be offered to ensure you understand what is involved. Once you have decided on surgery you will be consented for the operation and Mr. Mathew will provide you with an OPCS code. Once you have been given the OPCS code you should inform your insurance company to obtain authorization. Occasionally multiple OPCS codes are required for one operation and this would represent two or more different procedures being performed in the one operation. In the days before your scheduled procedure, the hospital will contact you and give you the information you need for the day of surgery. Video Consultation with Mr Mathew Dear Sir/ Madam You are being invited to a Zoom or Teams video consultation. It inadvisable to do this on a lap top so you can have both hands free in case you need to self examine. Please check that you have a working camera and microphone pre meeting. Please click the join meeting link in the email You may need to download the zoom app or teams Here is the link: Zoom app – https://zoom.us/download Teams – https://www.microsoft.com/en-in/microsoft-teams/download-app Please note that video consultations are chargeable as per face to face consultations. These can be arranged by contacting My PA Best wishes PM Will I need any scans or x-rays? Most Insurance companies cover x-rays as part of the initial authorisation, but please check first. Most Orthopaedic conditions will require an x-ray, which can usually be done on the same day.Scans, however are usually performed on a separate day and a follow up appointment is required to discuss the results. Scans (MRI, CT, and ultrasound) are expensive and the insurance companies almost always require authorization. If however you are a self-pay patient the Hospital will charge you directly for x-rays and scans. What if things go wrong? Complications are fortunately quite rare in hand and wrist surgery. However they still can occur. A through close post-operative evalution and clinical review by Mr Mathew and his team will help identify any problems early so that they can be investigated and treated appropriately. In an emergency please call the hospital directly; and kindly inform Mr. Mathew directly through the practice manager