Conditions & Treatment

WHI specialises in the treatment of all injuries and conditions affecting the hand and wrist. The list below has been compiled for ease of reference. Should your injury or condition not be listed, please contact our rooms to book an appointment.


  • Arthritis

    Arthritis is a common condition affecting many joints of the body. It can be caused by damage to the joints through wear and tear as we age, previous injuries and various autoimmune diseases.

    The base of the thumb is a common joint for arthritis to affect. Treatment options depend on the joints involved and the severity and duration of symptoms. Non-operative treatment options include splinting and exercises. There are many different surgical options available for trapeziometacarpal joint (basal thumb) arthritis.  While many surgeons remove the entire trapezium, we have found that partial resection of the trapezium produces the best functional outcome with resolution of pain. This procedure is done through 2 small ‘keyhole’ (arthroscopic) portals.

  • Carpal Tunnel Syndrome

    Carpal tunnel syndrome is caused by compression of the median nerve by the transverse carpal ligament of the wrist. It causes numbness in the thumb, index finger, middle finger, radial side of the ring finger and palm. These symptoms often cause people to wake at night. Treatment comprises of splinting, steroid injection or surgery via an open incision or a supraretinacular endoscopic technique devised by Mr Ecker. Surgery can be performed as a day case under local anaesthetic.

  • Cubital Tunnel Syndrome

    Cubital tunnel syndrome is caused by compression of the ulnar nerve on the medial side of the elbow, or the ‘cubital fossa’. It can cause weakness and lack of dexterity in the hand with numbness or altered sensation in the small and ring fingers. In severe cases there can be wasting of the intrinsic muscles of the hand. Elbow flexion often precipitates the onset of symptoms. Surgical treatment options include endoscopic ‘keyhole’ release of the ulnar nerve or open transposition of the ulnar nerve via a larger incision.

  • De Quervain’s Tenosynovitis

  • Distal Radioulnar Joint Instability

    Distal radioulnar joint instability is caused by a deficiency in the triangular fibrocartilage complex. It results in mechanical ulnar sided wrist pain. Depending on the anatomy of the tear, the triangular fibrocartilage can be repaired arthroscopically using a suture. Rarely the repair requires a tendon graft.

  • Distal Radius Fractures

    The radius is one of two bones that make up the forearm. A distal radius fracture is a fracture of the radius that has occurred near the wrist. 

    Distal radius fractures are common and are often associated with a fall on an outstretched hand. They are diagnosed based on history, examination and imaging (x-ray and/or CT scan). 

    Distal radius fractures vary in severity.  Some can be successfully managed with splinting while others require surgery to realign the fractured bone in the correct anatomical position to heal.  Surgery may be performed via open incision or arthroscopically depending on the fracture configuration.  Most distal radius fractures unite at 6-8 weeks.

  • Dupuytren’s Contracture

    Dupuytren’s fibrosis is a genetic condition with variable penetrance, meaning it can ‘skip’ generations. It causes an over-production or under-resorption of the normal retinacular system in the hand and fingers, which gradually ‘pulls’ the finger into the palm. There are multiple treatment options for Dupuytren’s fibrosis depending on the severity of the contracture; percutaneous needle aponeurotomy, collagenase injection, limited fasciectomy, fasciectomy with Z-plasty and dermatofasciectomy and full thickness graft.  Your surgeon will discuss the best treatment options for you based on the severity of the contracture and the joint/s affected. 

  • Finger Dislocations

    Finger dislocations are common, particularly in sports people. The most common joint to injure is the proximal interphalangeal joint (the middle joint of the finger).

    Joints are surrounded by soft tissue that allows the joint to move with stability. When a joint is dislocated some of the soft tissue structures are damaged. Once enlocated, most dislocations can be managed with splinting and therapy.  However, some dislocations require surgery.

  • Fractures

    There are many different types of fractures that affect the hand, wrist and fingers. Some can be treated by splinting and therapy, while others require surgery to ensure correct alignment of the fractured bone.  Depending on the fracture, surgery could be performed via open incision or arthroscopically via ‘keyhole’ portals.

  • Gamekeeper’s Thumb

    Gamekeeper’s thumb is the term used to describe an injury to the ulnar collateral ligament (UCL) of the metacarpophalangeal (MCP) joint of the thumb. It can be treated surgically by re-attaching the ligament to the bone with a small ‘anchor’.

  • Keinbock’s Disease

    Keinbock’s disease is not something which can be treated alone with hand therapy. If you suspect you have Keinbock’s disease you should see your GP and ask for a specialist hand surgeon referral. Your GP may also suggest an X-ray to assess the health of your lunate (a small moonshaped carpal bone).

  • Lacerations

    Lacerations can affect intricate structures of the hand such as tendons, pulleys, nerves and vessels. It is important that these injuries are properly evaluated and treated to prevent longterm disability and reduce the risk of infection. Mr Ecker is skilled in complex microsurgery and offers an emergency service for trauma patients.

  • Mallet Injuries

    Mallet injuries are common and often caused by a ball or blunt force hitting the end of the finger.  This results in damage to the tendon that straightens the ‘tip’ (or the distal interphalangeal joint) of the finger.  The injury is characterised by an inability to actively straighten the tip of the finger, which rests in a flexed position. 

    Mallet injuries can be caused by injury to the tendon or bone.  Those affecting the tendon and treated early often respond successfully to splinting.  Those affecting the bone can require surgery. It is important that these injuries are diagnosed and treated early. 

  • Nail Bed Injuries

    Nail bed injuries can be the result of a laceration or crush-type injury (like a car door). If not treated adequately, damage to the germinal matrix can cause longterm problems with the nail. Our surgeons are skilled in plastic and microsurgery.  Our team offers an emergency trauma service for these injuries.

  • Scaphoid Fractures

    Scaphoid fractures are often associated with high impact sports or a fall on outstretched hands. Pain can be transient and the injury may be dismissed as a ‘wrist sprain’.

    Fractures of the scaphoid can be easily missed on x-ray and have a relatively high rate of non-union which can result in long-term wrist problems.  For this reason, wrist pain should be adequately investigated to identify a cause. An accurate diagnosis should be made based on history, examination and CT or MRI scan. 

    It is important that scaphoid fractures are identified and treated early to prevent non-union.  Surgery can often be performed percutaneously through a few small ‘keyhole’ portals.  Our surgeons work closely with trained hand therapists in the post-operative period to ensure an optimal splinting and therapy program is implemented.

  • Scaphoid Non-Union

    If a scaphoid fracture is undiagnosed or untreated, it can result in a ‘non-union’.  A non-union occurs when the bone fails to heal. Because of the anatomy of the vessels supplying the scaphoid, a non-union can cause disruption in blood supply to a portion of the scaphoid, causing the bone to die and disintegrate.

    Scaphoid non-union can be treated arthroscopically by excising the non-union, correcting the deformity, fixing the scaphoid using wires and packing the defect with bone graft harvested from the iliac crest. This treatment option has a high rate of success and is performed via small ‘keyhole’ portals. 

  • Swan Neck Deformity

    The term ‘swan neck’ deformity is characterised by hyper-extension of the proximal interphalangeal (PIPJ) joint and flexion of the distal interphalangeal (DIP) joint. It can be associated with a ‘snapping’ motion of the finger on flexion. It is important that mallet injuries are treated early to avoid this deformity developing. Once established, splinting may improve the functionality and motion of the affected digit.

  • Triangular Fibrocartilage (TFCC) Injuries

    Distal radioulnar joint instability can be caused by a deficiency in the triangular fibrocartilage complex. It causes painful mechanical clicking and symptoms in the ulnar side of the wrist. Depending on the severity of the injury, the triangular fibrocartilage can be anatomically repaired using arthroscopic suture techniques. If the deficit is large the repair may require a tendon graft, which can be performed via a small incision.

  • Ulnar Carpal Impaction

    Ulnar carpal impaction is a common cause of wrist pain. It is caused by the ulna (one of the bones of the forearm) being long in relation to the radius and impinging on the carpus (in particular the lunate). This may be a normal anatomical variation or occur as a result of injury (i.e. a mal-union after a fracture). It is easily diagnosed using x-rays which measure the ulnar variance and, depending on the degree of symptoms, most often treated with a ulnar shortening osteectomy.

  • Ulnar Nerve Compression in Guyon’s Canal

    The ulnar nerve supplies sensation to the small finger and the ulnar side of the ring finger. Compression of the ulnar nerve in Guyon’s canal in the wrist may cause sensory symptoms in the ulnar nerve distribution of the hand. It can be treated with an ulnar nerve decompression or ‘release’ from Guyon’s canal in the wrist.

  • Wrist Ligament Injuries

    An injury to the ligaments in the wrist is often dismissed as a ‘sprain’. A disruption to these ligaments can result in instability or dissociation of the carpal bones. It is important that wrist pain following an injury is investigated to exclude carpal instability (most commonly ‘scapholunate instability’, or instability between the scaphoid bone and the lunate bone). Depending on the type and degree of instability present, treatment options may include a proprioceptive exercise program, an arthroscopic dorsal capsulodesis, tendon weave procedure or partial fusion.

Business Manager

Sabeeqa Khan

Sabeeqa has completed Bachelor’s in Public Health, followed by a master’s degree in biomedical sciences, providing her with a well-rounded understanding of both the macro and micro aspects of healthcare. With over a decade of experience, she has honed her management skills across various healthcare settings, including laboratories, general practitioner (GP) clinics, and specialist facilities. With her blend of academic achievement and practical experience, she stands as a capable leader poised to drive innovation and positive change in the healthcare industry.

Wrist + Hand Surgeon (Fellow)

Dr David Dyer

Dr David Dyer is an orthopaedic surgeon qualified through the Royal Australasian College of Surgeons and the Australian Orthopaedic Association with subspecialty fellowship training in complex wrist and hand surgery. Dr Dyer has interests in acute wrist and hand trauma, arthroscopic and endoscopic wrist surgery, arthritis of the wrist and hand, and nerve compressions of the wrist and forearm (e.g. carpal tunnel).

Wrist + Hand Surgeon (Fellow)

Dr Eleanor Houghton

Dr Houghton has joined the Wrist + Hand Institute team in 2023 whilst completing her Post-Fellowship Education and Training (PFET) Programme through the Australian Hand Surgery Society with Mr Jeff Ecker.

Wrist + Hand Surgeon (Consultant)

Dr Humza Khan

Dr Humza Khan completed his medical training at the University of Western Australia and has spent ten years in the public health sector working in all the major hospitals across Western Australia.

Dr Khan completed his orthopaedic specialist training with the Royal Australian College of Surgeons and the Australian Orthopaedic Association. He completed further subspecialty training with the Jeff Ecker Hand and Wrist Fellowship Program. Dr Khan works with the Wrist + Hand Institute managing hand and wrist trauma and elective surgery.

Founder - Wrist + Hand Surgeon

Dr Jeff Ecker

Jeff Ecker is an expert hand and wrist surgeon who completed his orthopaedic fellowship in Australia and trained in microvascular and arthroscopic surgery at Oxford University in the United Kingdom, Duke University in North Carolina and the University of Southern California in Los Angeles.

He is the Immediate Past President of the Australian Hand Surgery Society, the President Elect of the Asia Pacific Wrist Association and the Past President of the West Australian Hand Surgery Society. Jeff is an adjunct professor at Curtin University School of Medicine and the Director of the Hand and Upper Limb Centre in Western Australia.

Jeff's commitment to research is recognised internationally. His findings have been published in peer-reviewed journals, including the Journal of Wrist Surgery, Hand Clinics and the European Journal of Hand Surgery. Jeff is regularly invited to present his research and teach at national and international scientific conferences. He has a special interest in complex wrist injuries, including triangular fibrocartilage complex (TFCC) injuries, scaphoid fractures and non-union and perilunate ligament injuries.