Hand Surgery

Both surgeons at the Cape Joint Surgery maintain a keen interest in hand surgery, a sub-speciality in orthopedics which overlaps with plastic surgery to some extent and requires meticulous technique and soft-tissue management. Dr Engela was involved with the Groote Schuur Hospital hand clinic for many years and was the driving force behind the establishment Read on … !

Hand Problems in Adults

Non-traumatic hand problems in adults are extremely numerous and both diagnosis and management are challenging. Some of the most common conditions are discussed below. Even these fairly straightforward problems are unfortunately prone to misdiagnosis and injudicious surgery.

Ganglion Arthritis of the thumb and fingers Carpal tunnel syndrome Dupuytren’s contractures Trigger finger Tendonitis/ de Quervain’s

Nerve Read on … !

Hand Problems in Children

Children may be born with hand problems, defects or extra digits. These are best treated by super-specialized combined plastic surgical or orthopedic surgical congenital hand units such as the one at Red Cross Children’s Hospital.

Trigger fingers is one type of hand problem that can occur in children and are usually managed non-surgically until the Read on … !

Hand Clinic

The Constantia hand clinic was established more than 15 years ago. The hand clinic has been specifically set up in order to provide a comprehensive service to patients with acute and chronic hand conditions. This is done in conjunction with hand therapists.


The Cape joint surgery continues to provide a extensive elective hand service, Read on … !

Finger Dislocation

Finger dislocation is one of the most underrated injuries in the hand mostly by rugby players that “just pull it back into position”. The injury is more serious and is associated with ligament damage and often bone damage that may require more treatment.

If Finger dislocation is left untreated the fingers tend to become Read on … !

Thumb Arthritis

Thumb Arthritis or Arthritis of the base of the thumb (carpo-metacarpal arthritis or CMC OA) is the most common site in the hand to be affected and has a good outcome after surgery should conservative treatment with splinting and cortisone injections not be successful.

All other joints of the wrist and hand can be involved Read on … !

Subacute Osteitis

Subacute osteitis is a rare condition, which may occur around the hip in young children. This usually results after a bone infection has been partially treated with antibiotics, which were discontinued too early. The diagnosis may not have been made in this case is often when antibiotics were prescribed empirically for a child which was Read on … !

Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis consists of a spectrum of inflammatory arthropathys which affects children (girls in the early teenage years more often than boys). The patients present with synovitis of various joints (usually a polyarthropathy (more than one joint involved), although initial presentation may be in the form of a monoarthropathy). The wrist-, knee-, and ankle Read on … !