Ask a Hand Surgeon: Dr Tan Ter Chyan from Mount Elizabeth Novena Hospital Singapore

Ask a Doctor ForumCategory: Hand SurgeryAsk a Hand Surgeon: Dr Tan Ter Chyan from Mount Elizabeth Novena Hospital Singapore
Dr Tan Ter Chyan asked 10 months ago
I am Dr Tan Ter Chyan, Hand Surgeon based in Mount Elizabeth Novena Hospital Singapore. Ask Me Anything!

I graduated from the Royal College of Surgeons in Ireland, Dublin in 1995, and became a Member of the Royal College of Surgeons of Edinburgh in 2001.

I was awarded the Master of Medicine, Orthopaedics by the National University of Singapore in 2002. I obtained my specialist accreditation by the Ministry of Health (Singapore) as a Hand Surgeon in 2005.

I was awarded the Higher Manpower Development Program for 2006 and was clinical fellow at the Royal North Shore Hospital in Sydney in 2007 with the Department of Hand Surgery and Peripheral Nerve Surgery, University of Sydney.

I worked as a surgeon in the Department of Hand and Reconstructive Microsurgery, National University Hospital from 2002 to 2012. I was a specialist hand surgeon in the Department of Hand and Reconstructive Microsurgery (HRM) from 2005 to 2007 and consultant from 2007 to 2012. I was the Postgraduate Director and was involved in training the advanced Hand Surgery trainees in the national program. I was also the first Associate Program Director for the national residency program in Hand Surgery.

I have a clinical interest in peripheral nerve surgery, especially brachial plexus surgery, stroke, cerebral palsy and surgical rehabilitation of the upper limb in tetraplegia. My other clinical interest is in minimally invasive surgery of the hand and upper limb especially wrist arthroscopy and endoscopic peripheral nerve surgery.

I have been an invited speaker for local, regional and international meetings. I am currently the Chairman of the Chapter of Hand Surgeons, College of Surgeons, Singapore.

Learn more about me here: https://patients.smarterhealth.sg/specialist-doctor/tan-ter-chyan/

I am excited to be here to share/discuss Hand & Wrist conditions with everyone. I will be actively sharing questions. Whether you’ve got questions about hand and wrist injuries, hand surgery, hand therapy or prosthesis, ask me anything!

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136 Answers
Robert Wong answered 10 months ago

During the lockdown last year, I started to work out at home. And I realize, as I lift the dumbbells 3 times a week, the bone below my right thumb is bulging. It hurts when I press it. Do I need to be concerned about this?

Dr Tan Ter Chyan
replied 10 months ago

Hi Robert, it depends on where the bulge is. if its on the palm side where you grip, that is most likely the A1 pulley. This can hurt from overuse and might be the beginnings of a trigger thumb. If it is more towards the wrist, it might be other injuries. If there is pain, perhaps it is good to rest and if it does not get better, you might need to get it examined

Leonard T. answered 10 months ago

My right palm, just below the fingers, is stiff and it hurts when I clench it into a fist. I have compressed it with ice but it only gets better temporarily. What should I do?

Dr Tan Ter Chyan
replied 10 months ago

Hi Leonard, if it is on the palm side of the hand and if it has a nodule or lump, it might be the A1 pulley being inflamed, this is likely also a trigger digit. If icing helps, you could also see your GP and get a stronger anti-inflammatory medications to help with the pain and swelling. If it is not better, it would be pertinent to get the hand examined by your GP as well.

T. K answered 10 months ago

My hands are numb and tingle if I lift something heavy. As minutes go by, I feel the sensation turning into heat. But after resting for a while, the sensation is gone. What condition is this?

Dr Tan Ter Chyan
replied 10 months ago

Hi T.K
It sounds like you might have some symptoms of carpal tunnel syndrome. Please monitor the situation, if it gets more persistent and does not go away, it might be safe to see a doctor

Teoh Chu Peng answered 10 months ago

There are some hard lumps growing on the side of my fingers. Should I worry about this?

Dr Tan Ter Chyan
replied 10 months ago

Dear Chu Peng,

Lumps come in all shapes and sizes in the hand. These might be from the bone, the tendon, ligaments and soft tissue and the skin. The common ones include osteophytes ( in osteoarthritis of the joints) or ganglions. These need to be reviewed by a doctor with possible X rays done to ascertain what they might be. Most lumps are not dangerous nonetheless a doctor should see it to confirm the cause.

J.W answered 10 months ago

My left arm has been feeling stiff for almost six months now. It started when I weight lifted during the lockdown. Now it hurts to grip something tightly and to rotate my arm in either direction. Could it be a nerve or muscle problem? Should I be worried and seek medical treatment, or would you recommend a particular exercise or therapy I could do at home?

Dr Tan Ter Chyan
replied 10 months ago

Dear J.W. You have not indicated which part of the arm is stiff. However from what you have described, it seems to amount the grip area which involves the wrist and hand. From that It is likely a ligament injury from lifting of weights. If the pain has been there for that long ( assuming lockdown ended in June 2020) it would be pertinent to get the problem assessed and diagnosis made before the relevant therapy can be started.

RJ answered 9 months ago
My child is an high performance athlete, they have fractured their Scaphoid bone in their right hand. The bone is not displaced and I cant see a break in the x-rays taken on the first day and the second X-ray on week 4. We have been told our child will be in a cast for up to six months. While in the cast they have trouble writing and can’t train. I’m also aware due to poor blood flow to the bone it can take a long time to recover and there is also a risk where the bone doesn’t fuse and surgery is required. At what point is it determined surgery is required? Is it better to have surgery now or wait another 6 weeks? What risks are there with surgery?
Dr Tan Ter Chyan
replied 9 months ago

Dear RJ,

It would be good to know the age as this will determine the ideal management. Scaphoid fractures are usually casted to about 6-8 weeks. 6 months is too long. The sport you take part in will determine what training can continue.

Surgery indication is determined on a myriad of reasons, including delayed healing, instability and also relatively the needs of the athlete. The indication for surgery vs non surgical management really depends on those above and others. The risks are not major and include infection and the anaesthetic risk.

Daniel G answered 9 months ago

I had a fracture in my left arm 2 years ago. It was treated back then. However, recently whenever I do drumming, I feel the pain again. Is it possible for the fracture pain to have recurred after two years or is it a different problem I should be worried about?

Dr Tan Ter Chyan
replied 9 months ago

Dear Daniel,

It is unlikely the fracture recurs unless you have a similar type of injury happening again. The likelihood is more of a concomitant soft tissue injury or a malunion that has contributed to some imbalance of the muscles and ligaments. It is likely a different problem or a consequence of the fracture showing up later.

If the pain persists, it is best to have the condition reviewed

KC answered 9 months ago

My father is 63 years old. He is now recovering from a stroke. His right palm is still numb. When I press on it to massage it, he tells me it hurts. I usually give his palm a massage every morning and flex it to relax his joints. Is there any medication he can take for this?

Dr Tan Ter Chyan
replied 9 months ago

Dear KC,

Post stroke upper limb pain can result from several causes. The most common is from the spasticity and when the muscle is tight. Numbness can be a result of the stroke as well.

Daily stretching and massage is a good option, however if there is pain and there’s increase spasticity, it can be treated with certain drugs but will depend on the presentation and cause. If spasticity is a chronic problem, injections and surgery is indicated. Certain procedures can be performed and can increase the function as well, allowing the hand to be placed in a better position and also help in hygiene.

Jerome answered 9 months ago

On my right hand, my little finger sticks to my ring finger. And my palm looks crooked as a result. Although it doesn’t hurt, this condition does affect my confidence especially when it comes to hand-shaking. Is there any procedure to fix my condition? And is there anything to consider before making a decision?

Dr Tan Ter Chyan
replied 9 months ago

Dear Jerome,
It sounds like you have “scissoring” of the digits. Does it happen to the left hand as well? This could be the result of growth or an old fracture. Most times this does not affect function but can if they are severely crossed. Yes surgery can perhaps solve it but it may not be worth the risk especially if the condition is not painful and affects hand function. It will probably need a through review before that decision should be taken. Hope this helps.

L.W answered 9 months ago

I am 27 years old. I lost two of my fingers on the right hand when I was 8, the little finger and the ring finger. Are there any procedures to implant prosthetic fingers, similar to prosthetic legs? If yes is there anything I should consider beforehand?

Dr Tan Ter Chyan
replied 9 months ago

Dear LW, yes there are prosthetic fingers that can be used, however they are mainly for aesthetic purposes. The use of these depend on the stumps that are available and if it compromises function. They need a hand surgeon to assess the suitability. There are also more complex procedures like toe to finger transfers but these are usually reserved to restore function there is severe loss.

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