Melbourne Hand Surgery 

Coronavirus update: Melbourne Hand Surgery has mechanisms to protect our patients and staff while we continue to provide healthcare services. All consultations are now conducted via telehealth (phone or videoconference), except where we have previously confirmed the requirement for an in-person physical examination or wound care management.  Only emergency surgery is being conducted in hospitals for the foreseeable future, in keeping with Government directives. 

If our practice is unable to physically open for business at any point in the coming weeks or months we will communicate this to existing scheduled patients via email and SMS (please do not attempt to reply other than with Y or N to an SMS, as the automated system does not facilitate this). Incoming telephone calls and receipt of voicemail messages may be temporarily affected by such a change. We will use this website banner to update you on changes to our practice and the availability of non-urgent procedures and surgery in the weeks and months ahead. Thank you for your understanding as our entire community works through these unprecedented and rapidly evolving times together (last updated: 4 April 2020).

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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