Hand Surgery Berlin: Dr Michael Lehnert & Dr Tobias Topp

Dr Michael Lehnert and Dr Tobias Topp, specialists in orthopedics and trauma surgery and recognized hand surgeons, head the hand surgery department at ATOS MVZ meviva Berlin.

Under the direction of Dr Lehnert and Dr Topp, around 1450 hand surgeries are carried out every year at the MVZ meviva for congenital, acquired, and injury-related diseases of the hand. Standardized and optimal postoperative treatment is a requirement for a successful surgery, for which the entire team around Dr Lehnert and Dr Topp is available.

Percutaneous Needle Fasciotomy (PNF) for Dupuytren's Disease

Dupuytren's disease is characterized by thickened connective tissue and scar tissue in the palm area. The deformity can lead to restricted mobility, a daily challenge for patients.

The reduced ability to stretch the hand, which manifests as increased flexion of the fingers, is diagnosed by the specialists at ATOS MVZ in a detailed medical history and physical examination.

The minimally invasive procedure of percutaneous needle fasciotomy can be used for surgical treatment, which has been continuously refined and improved by Dr Lehnert over the years. The specialists use a needle that is placed into the connective tissue at various points, resulting in the loosening and separating of the connective tissue and strands.

The outpatient procedure is particularly successful in earlier stages and superficial locations and is carried out with great skill and experience by the treating team. The patients do not have to plan an inpatient stay and can usually use their hands again immediately.

In more advanced cases, however, a surgical procedure with larger incisions is usually chosen, which involves inpatient treatment and more intensive aftercare.

Hand therapy carried out by experienced hand therapists should follow the surgery, and a splint should be worn to protect the hand. The necessary and essential treatment steps are discussed in detail with the patient in advance and discussed again during aftercare.

Most Extraordinary Expertise in Treating Benign and Malignant Hand Tumors

Long-lasting, painless swelling in the area of the hand and fingers should be clarified in hand surgery. These can be benign tumors, such as lipomas, cysts, and cartilage growths, or malignant tumors.

Malignant tumors should be diagnosed and treated quickly, primarily as timely treatment determines the prognosis. However, malignant osteosarcoma, for example, occurs rarely. The surgical team led by Dr Lehnert and Dr Topp will discuss the further procedure with the patient depending on the diagnosis. In the case of benign tumors, a wait-and-see and conservative procedure can also be chosen; surgical treatment is not always necessary.

In the case of more severe symptoms and restrictions, and especially in the case of malignant tumors, surgical treatment with removal of the tissue growth should be carried out.

State-of-the-Art Therapy for Arthrosis of the Hand and Finger Joints

Arthrosis of the hand and finger joints can occur due to long-term degeneration of the joints or unhealed bone fractures, but also due to systemic diseases. Patients experience pain during everyday activities due to joint degeneration, which can make everyday tasks a burden.

Arthrosis can involve swelling and redness of the affected joint, and movement restrictions may occur. An X-ray examination can visualize the changes caused by arthrosis. The goal of treatment by the hand surgery team led by Dr Lehnert and Dr Topp is to improve mobility and increase the quality of life of those affected.

Initially, the condition can be treated using conservative therapy. Pain medication, hand therapy, and physical therapy methods are used here. If the symptoms cannot be sufficiently alleviated in this way, the specialists recommend a surgical procedure.

The choice of procedure depends on the severity, the patient's age, and individual needs and is determined by the hand surgeons based on the latest scientific findings. Options include artificial joint replacement (prosthesis), removal of degenerative bone (resection arthroplasty), or (partial) stiffening of one or more joints. Surgical treatment of the hand and finger joints should be followed by hand therapy to maintain and further improve mobility.

Precise Hand Surgery for Nerve Compression Syndromes such as Cubital and Carpal Tunnel Syndrome

The carpal tunnel is an area of the carpus bordered by connective tissue ligament. In particular, nerves and tendons make their way here to innervate the hand muscles and skin and to allow the fingers to move.

If the connective tissue in the carpal tunnel thickens, this can result in a bottleneck syndrome. The pressure on the structures running through it causes an unpleasant tingling sensation, numbness, and pain. In advanced stages, movement restrictions, loss of sensitivity, and muscle atrophy can occur. Therefore, early therapy is very important.

Similar symptoms occur with a narrowing of the cubital tunnel in the elbow. Due to the innervation of the fingers by different nerves, hand surgery specialists can find exactly where the bottleneck is located.

Initially, conservative methods are chosen for treatment, including hand therapy methods, immobilization, or injections. If the symptoms are very severe, the hand surgery team plans a minor surgical procedure with the patient to relieve the pressure mechanically. The surgeons cut through the thickened tissue during the surgery to create space for the constricted nerves.

The procedure can be minimally invasive, using tiny skin incisions, and usually only requires local anesthesia of the affected arm. Subsequent follow-up treatment allows the team to assess the improvement in symptoms accurately.

In addition to the two bottleneck syndromes already mentioned, other and much rarer bottleneck syndromes can also occur. Recognizing these and treating them accordingly requires a high level of specialist expertise, which the hand surgery team led by Dr Lehnert and Dr Topp offers.

Many Years of Experience in the Treatment of Hand, Finger, and Wrist Injuries and Signs of Degeneration

Accidents involving broken bones in the hand or wrist, as well as nerve and tendon injuries to the hands and fingers, are not uncommon and require specialist treatment to prevent any consequential damage. The orthopedic and trauma surgery team at ATOS MVZ meviva in Berlin has extensive experience and expertise in this field, with additional qualifications in hand surgery.

The gentle surgical approach of the experienced hand surgeons at ATOS MVZ helps achieving the best possible result. Regular check-ups by the doctors ensure intensive aftercare.

The pros and cons of a surgical procedure are weighed up with a great deal of experience, or conservative therapy is attempted. The hand specialists prove their many years of surgical experience in treating even the most severe hand injuries, immobilizing and splinting the affected area, and surgical fixation and reconstruction.

The outstanding expertise of Dr Lehnert and Dr Topp's team is not only in the treatment of acute injuries but also in the treatment of complex consequences of injuries such as residual malalignment, non-healing, or improperly healed fractures (pseudarthrosis), tendon adhesions, scar contractures and, last but not least, arthrosis caused by the fracture and the accident (post-traumatic arthrosis). There is also a high level of expertise in treating ligament injuries to the carpus and hand (e.g., ski thumb, scapholunate ligament injury). In addition, motor replacement surgeries (tendon repositioning) following complex tendon injuries or nerve damage are also part of the experts' spectrum.

Individual Treatment

Different demands on everyday hand function require individual therapy concepts for musicians, professional athletes, or craftsmen. Dr Lehnert and Dr Topp's team plan an individual therapy regime for each patient, adapted to the cause of the complaints, possible therapeutic success, individual needs, and requirements. It is, therefore, not only these professional groups that rely on the experts to treat their hands.

Please visit the ATOS MVZ meviva Berlin website for more information.