Hand surgeons are specialists in hand care.
The human hand is a complex organ, lined with specialized
skin, with a multitude of small bones and joints. It has a
vast network of nerves and blood vessels all encased in a
small and vulnerable space. When hand injuries or hand deformities
occur, they are best treated by a qualified hand surgeon.
Dr. Mondolfi served as a resident and then as instructor
of hand surgery at Temple University in Philadelphia, He became
chief of the pediatric hand surgery service of SJDD hospital
where he provided care, did clinical research and trained
orthopedic residents in the art and science of hand surgery.
His practice includes acute hand injuries, such as fractures,
dislocations, severed tendons and nerves.
Also thermal, chemical or electrical burns of the upper limb
as well as managing severe infections. He deals the long term
consequences of injuries such as malunited fractures, stiff
joints, painful hands, adhered tendons or nerve loss.
Workers compensation injuries that require surgical care
are also treated by Dr. Mondolfi.
Common conditions of the hand treated by Dr. Mondolfi
- Trigger finger is an irritation of the digital
sheath that surrounds the flexor tendons. When the tendon
sheath becomes thickened or swollen it pinches the tendon
and prevents it from gliding smoothly. In some cases the
tendon catches and then suddenly releases as though a "trigger"
- Ganglion cysts which are the most common mass or
lump in the hand. They are most common on the back of the
wrist. These non-cancerous, fluid-filled cysts arise from
the ligaments, joint linings, or tendon sheaths when they
are irritated or inflamed.
- Carpal tunnel syndrome is a compresion of the median
nerve causing symptoms such as numbness and tingling in
the hand, especially at night; pain with prolonged gripping
such as holding a steering wheel; or clumsiness in handling
objects. Sometimes the pain can go all the way up to the
shoulder. Other nerves in the upper limb may be entrapped
such as the ulnar nerve at the wrist or elbow.
These symptoms are caused by pressure on the median nerve
as it enters the hand through a narrow space in the wrist.
Mild cases can be treated with a splint or brace to rest
the wrist. Steroid injections into the carpal canal to decrease
swelling may be used in addition to splinting. Those cases
that do not respond to nonsurgical treatment and those that
are diagnosed late often require surgery. This is generally
done in an outpatient setting under local anesthesia.
- de Quervain's tenosynovitis is an irritation and
swelling of the sheath or tunnel which surrounds the thumb
tendons as they pass from the wrist to the thumb. Pain when
grasping or pinching and tenderness over the tunnel are
the most common symptoms. Sometimes a lump or thickening
can be felt in this area.
- Arthritis of the base of the thumb: Wear and tear
arthritis is very common at the base of the thumb, pain
localized to the base of the thumb, particularly with use,
is a very common early symptom. Early disease can be treated
with anti-inflammatory medication, steroid injections into
the joint, or splinting, but as the wear and deformity progress,
surgery is frequently required. There are very effective
procedures to relieve pain and improve function.
- Arthritis of the fingers: Lumps and bumps frequently
occur at the last joint of the finger or thumb due to wear
and tear arthritis (osteoarthritis). As the joints deteriorate,
small bone spurs form over the back of the joints and may
- Dupuytren's contracture is a hereditary thickening
of the tough tissue called fascia that lies just below the
skin of your palm. This condition may vary from small lumps
or bands to very thick bands which may eventually pull the
fingers into the palm.
- Congenital hand deformities such as extra, missing,
deformed or webbed fingers often require reconstructive
plastic hand surgery. In syndactyly procedures where webbed
fingers are surgically separated, plastic surgery is necessary.
In these procedures, the fingers are split using a zigzag
cut and the new web space is created by using a flap of
skin from the back of the fingers or groin area.
For additional information about hand conditions and hand surgery, click
American Society for Surgery of the Hand
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Website Copyright ©2013 Paul E.
Dr. Paul E. Mondolfi is a credentialed, qualified and experienced plastic
surgeon serving the Houston,
Victoria, Sugar Land, San Antonio, Austin and Corpus Christi areas of Texas.
Dr. Mondolfi specializes
in facial plastic surgery, breast and body contouring, and liposculpture.
605 E. San Antonio St. • Suite 450
• Victoria, Texas 77901 • (361) 580-1574
Fax: (361) 570-3709