Trigger Finger – Facts and Treatment with Dr. Carmella Fernandez

  • Health & Beauty   •   October 30, 2018

Dr. Fernandez became a doctor to make a difference in people’s lives. Today she is owner of The Fernandez Upper Extremity Institute in Naples where she focuses on conditions affecting the hand, wrist, and elbow.

Dr. Fernandez chose Southwest Florida to establish her career and left a large practice nearly one year ago to start her own practice in the heart of Naples, Florida. She says, “We love the area. My godparents have a house down here, so we would come down often and visit.”

Her path to becoming a physician began as a young girl, when her father was diagnosed with a brain tumor. “I was exposed to medicine at an early age because of him.” The experience was not a good one for more than the obvious reasons. Besides the trauma of losing her father, she was disappointed with some of her family’s experience with the medical professionals caring for and treating her father. She says, “I wanted to be a different kind of doctor.

Dr. Fernandez was a competitive gymnast growing up. Her gymnastic abilities earned her a scholarship to the University of Illinois. It was there that she suffered an injury that sidelined her gymnastics, giving her pause to reflect on her career path. During this time, she committed to pursuing a career in medicine, with a strong interest in orthopedic surgery.

She remembers, “Through that experience, I realized I wanted to be a surgeon.” Narrowing her focus on orthopedics, she took a liking to the intricacies of the hands and upper extremity saying, “It is very detail oriented and that’s what I enjoy. I love it.

She received her Doctor of Medicine degree from Robert Wood Johnson Medical School, known today as Rutgers Medical School in New Jersey, and is a dual fellowship trained orthopedic surgeon specializing in surgery of the hand, wrist, and elbow.

CARPAL TUNNEL SYNDROME

When it comes to hands, carpal tunnel syndrome is a common problem. Occupations requiring the use of vibratory tools, or activities involving high force repetitive movements, can predispose an individual to develop carpal tunnel syndrome. Carpal tunnel is also more common in individuals with diabetes and other underlying illnesses and can be associated with the hormonal changes brought on by pregnancy.

The carpal tunnel is a well-defined space within the wrist and hand, where the tendons that move our fingers and one nerve, the median nerve, pass through. If the tunnel becomes smaller, most often due to inflammation, then the nerve can become compressed,” explains Dr. Fernandez. Over time the compressed nerve produces numbness and tingling in the hand, as well as pain and weakness when trying to grip objects.

Positional changes of the wrist involving excessive flexion or extension can also predispose to increased pressure on the median nerve within the carpal tunnel. “Patients often admit that their symptoms seem to worsen in the evening making it difficult to sleep. This is due to the tendency for our wrists to fall into a flexed posture while sleeping. If carpal tunnel syndrome is diagnosed early, then symptoms can occasionally be addressed with night splinting“, she explains. If however, a patient has findings consistent with moderate or severe carpal tunnel syndrome, then surgical decompression of the nerve is a reliable and successful mode of treatment.

Dr. Fernandez Wrist Surgeon Naples, Florida

Surgery for carpal tunnel syndrome is the second most common type of musculoskeletal surgery in the United States. It is performed by one of two ways, either an open technique or endoscopic. Dr. Fernandez says, “I typically perform my carpal tunnel surgery using the endoscopic technique, which involves a 1cm incision at the flexion crease of the wrist. Studies show that endoscopic release allows individuals to return to their work and activities earlier than the open technique. I find this to be beneficial to the active patients I see here in Southwest Florida.

If you think you might be suffering from carpal tunnel syndrome Dr. Fernandez says, “It never hurts to get information. If you have any concerns come in; it could be something else.” She adds, “The first line of treatment isn’t always surgery. I’m here to provide you with the information and knowledge to comfortably reach a decision regarding your care.

ADDITIONAL TREATMENTS

Besides her expertise in treating carpal tunnel syndrome, Dr. Fernandez can address trauma and arthritis in the hand, wrist, and elbow. She also treats painful fractures, along with flexor tenosynovitis, also known as trigger finger.

Most important to her practice, “I always put my patients first. Being on my own, I can make that a priority along with treating my employees well. I’m a firm believer in treating others the way you want to be treated.

Her favorite part of the job is meeting and connecting with her patients. She says, “I don’t have to operate on someone to make a difference. People come to physicians when they are in pain or nervous. It’s nice to make them laugh and reassure them that it’s going to be OK. I’m very fortunate that I get to do that.