Lumps and Bumps

What are they?

Lumps and bumps in the hand are very common. They can cause pain, stiffness and cosmetic problems for patients. Thankfully, cancers in the hand are very rare, and as such, the vast majority of these lesions are not dangerous and are easily treated.

What causes them?

Most lesions in the hand have no known cause, some are caused by an overgrowth of normal tissues, and some may be precipitated by injury or trauma.

What are the symptoms?

Most patients present with symptoms of pain, stiffness and an unsightly lump or bump. Occasionally the lesion may be pressing on a nerve, and this may cause tingling or “electric shock” sensations in the hand and fingers. Sometimes the lesions may become infected, causing redness, pain and occasionally discharge.

Do I need any further investigations?

In general, most lesions in the hand are easily diagnosed clinically. In difficult cases, an ultrasound scan or MRI is required to confirm the diagnosis or help Prof Imam define the involved structures.

What is the treatment?

Depending on the location and nature of the lesion, they are generally removed surgically, either under local or general anaesthetic, as a day case procedure. The tissue removed is sent to the laboratory to confirm the diagnosis.

How long will it take to recover?

Recovery from surgery generally takes 1-2 weeks, depending on the nature, location and size of the lesion removed.
A bandage/ dressing will be applied to the hand after the operation. A hand therapist will see you at two days who will remove this, clean and redress the wounds for you. The hand therapist will get you moving your hand very early after surgery to avoid stiffness. 
The stitches are removed at around ten days, and Prof Imam will review you at two weeks with the laboratory results.
Following your two week appointment, your hand therapist will get you moving your hand more and more and will also advise how to help soften and desensitize the scars.

What are the potential complications?

Infection – Uncommon and usually treated very successfully with antibiotics
Delayed healing – Smokers and those with diabetes are more prone to this
Painful/ Tender Scars – Rigorous wound care and desensitization as directed by your hand therapist help prevent this.
Stiffness – Operations to the hand may cause stiffness; this can be minimized by working closely with your hand therapist and getting your hand moving as early as possible.
Recurrence of the lesion – some lesions are prone to recurrence. Prof Imam will discuss this with you at the time of consultation. 
CRPS – An uncommon but potentially serious complication of hand surgery leading to pain, swelling and discomfort. It is impossible to predict this problem, but working closely with your hand therapist and getting your hand moving early has been proven to reduce the risk of this significantly.
Damage to nerves – Occurs in less than 1% of patients and would require surgical repair. Despite this, numbness of the finger may still persist.

When can I get back to normal activities?

The hand MUST be kept clean and dry for ten days until the sutures are removed. You should be able to return to “desk job” type activities within a few days of the operation. Any manual work, heavy lifting or sporting activities should be avoided for at least 3-4 weeks. 
You may return to driving in about a week. 

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