Melbourne Hand Surgery 

melbhandsurgerydoxymedrjilltomlinson

We recommend that adults and children over 12 wear face masks when attending our clinic, but no longer provide masks to patients and carers. Videoconsultations are conducted via telehealth at our dedicated virtual clinic. We are experiencing high demand for appointments hence require that all patients provide a referral prior to booking an appointment so that we can identify and manage urgent and emergency conditions in a timely manner, and so that our surgeons can assess your suitability for a telehealth appointment and identify any further information or tests that might be required before your consultation. If our surgeons assess that your condition (especially recent injuries) is best managed with hand therapy rather than surgery we may recommend that you see a qualified hand therapist (physiotherapist or occupational therapist) rather than schedule an appointment with our surgeons. Dr Tomlinson does not offer consultations and surgical services where a Medicare Rebatable Item Code does not apply; this includes injections for palmar hyperhidrosis. Dr Tomlinson has scheduled sabbatical leave during much of October, November and December 2023 so will not be available for urgent or emergency referrals during that time. 

Gout is predominantly treated with medications, rather than with surgery. Nonetheless there are instances where surgery is helpful for individuals who have gout. 

Acute gout

Acute gout can present in a similar way to an infected joint or an infection of the soft tissues. In this instance surgery may be performed to "wash out" the area, obtaining tissue and fluid samples that are sent for testing to exclude the possibility of infection and confirm the diagnosis of gout. The wash out can also speed the resolution of the gout attack, by washing out the uric acid crystals.

Surgery is only performed in acute gout when it is not possible to confirm whether there is concomitant infection. In such circumstances surgery is performed because it is safer to proceed on the assumption that infection is present when it is not, than to assume that it is "just gout" when there may be an infection destroying the joint.

Chronic gout

Chronic gout can have multiple effects. Most individuals are aware that they have suffered recurrent acute attacks of gout, but it is possible to have chronic low grade gout that creates significant problems without acute attacks of pain, redness and inflammation. 

Chronic gout can lead to the deposition of uric acid crystals in tendons, resulting in

These conditions can be treated with carpal tunnel release and trigger finger surgery

Chronic gout can also lead to the deposition of uric acid crystals in tophi that distort the fingers and in ways that destroy joints. Surgery can be beneficial in such circumstances, although it is not a cure for gout and must be combined with medical treatment under the care of a specialist physician.

 

FRACS

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