🇸🇬 MOH Registered Plastic Surgeon | Dual-Accredited (UK & Singapore)
Same Day Hand Surgery in Singapore Without the Hospital Wait
Direct access for specialist hand treatment.
No referrals needed, no fasting required.
In-clinic assessment for answers and solutions on the same day.
The majority of hand problems present with symptoms, so instead of worrying about medical terminology (like tenosynovitis or nerve entrapment), let's start with what you actually feel.
1. Pain
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Common signs: A deep ache when opening bottles, sharp pain at the base of the thumb when pinching, or generalised pain around the wrist and joints.
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Potential causes: Arthritis, trigger finger, or underlying nerve and tendon inflammation.
2. Numbness & Weakness
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Common signs: Waking up with "frozen hands," tingling in the fingers, burning feeling, or accidentally dropping cups and objects.
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Potential causes: Nerve compression issues like carpal tunnel and cubital tunnel syndrome
3. Can't Move / Locking
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Common signs: A finger that clicks, gets stuck in a bent position, or cannot be straightened without stretching it;
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Potential causes: Trigger finger or other tendons catching
4. Lump or Bump
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Common signs: A new swelling, soft or hard lump appearing on your wrist or near a finger joint.
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Potential causes: Ganglion cysts, mucous cysts, skin lesions or joint arthritis (bony growths).
The Next Step: Clear Answers, Right in the Clinic
Guessing online only goes so far. An accurate diagnosis requires an in-person specialist assessment.
To save you the cost and delay of external imaging centres, your consultation will usually include investigations with:
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Point-of-Care Ultrasound (POCUS): High-resolution imaging performed right during your visit to visualise tendons, nerves, and cysts in real-time movement.
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X-Rays: To check for underlying bone spurs or joint wear if necessary.
Once we identify the exact cause, we map out a straightforward solution - whether that is a precise ultrasound-guided injection or a same day minor surgical procedure under WALANT (Wide Awake Local Anaesthesia No Tourniquet). No hospital admissions, no fasting, and no unnecessary facility fees.
Read on below to learn more about common hand and wrist conditions.
1. Trigger Finger
Trigger finger, or stenosing tenosynovitis, occurs when the tendon sheath surrounding a finger flexor tendon becomes inflamed and thickened, causing the tendon to catch or lock as the finger bends. It presents as clicking, catching, or a finger that locks in a bent position and requires passive straightening (by the patient manually). Traditionally, surgery utilises an arm tourniquet, which can cause much pain and discomfort during the procedure, which is also limited to 15 minutes or so when the patient is awake.
Trigger finger is more common in individuals with diabetes, rheumatoid arthritis, or repetitive hand use, but can occur without any underlying condition.
Treatment options include:
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Steroid injection: A corticosteroid injection into the tendon sheath reduces inflammation and resolves symptoms in the majority of cases. This is performed in clinic under ultrasound guidance and takes but a few minutes. More than one injection may be required, and usually up to 2 or 3 as a maximum otherwise there is a risk of tendon rupture.
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Surgical release under WALANT: Where injection has not provided lasting relief, or where the triggering is severe, a minor surgical procedure to release the constricting tendon sheath (at the A1 pulley) is performed under WALANT. This is done entirely without a tourniquet to eliminate arm discomfort, does not require pre-operative fasting, and allows patients to actively flex and extend the finger during the procedure to verify the release instantly. The procedure takes approximately 15-20 minutes and does not require hospital admission. Scarring is barely visible once healed (see picture below)
2. Ganglion Cysts
A ganglion cyst is a benign, fluid-filled swelling that arises from a joint or tendon sheath, most commonly on the back of the wrist, the base of a finger, or the fingertip. Ganglions are one of the most common soft tissue swellings of the hand and wrist; other differentials include osteophytes (bony growth) or benign growths such as a giant cell tumour of the tendon sheath.
Many ganglions are asymptomatic and can be observed without treatment. Those causing pain, weakness, or functional limitation, or those that are cosmetically bothersome, can be treated.
Treatment options include:
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Aspiration: The ganglion is drained with a needle under local anaesthesia with ultrasound guidance. This is a simple in-clinic procedure with a reasonable short-term success rate, though recurrence is possible.
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Surgical excision: Complete excision of the ganglion and its root, performed under local anaesthesia, carries a lower recurrence rate than aspiration. For wrist ganglions, this is performed through a small incision with careful attention to the underlying joint structures.
3. Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through the carpal tunnel at the wrist. It typically presents as numbness, tingling, or pain in the thumb, index, middle, and part of the ring finger, often worse at night or with prolonged hand use. In more advanced cases, weakness of grip and thenar muscle wasting may be present. Other differentials include lacertus syndrome and other areas of compression along the path of the median nerve.
Nerve conduction studies are arranged where the diagnosis is uncertain or where surgical planning is required.
Treatment options include:
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Steroid injection: A corticosteroid injection into the carpal tunnel can provide temporary symptomatic relief and is useful for mild to moderate cases or as a bridge to surgery. This is done under ultrasound guidance to avoid unnecessary injury to the median nerve itself.
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Surgical release: Surgical decompression of the median nerve is performed under WALANT, avoiding the need for general anaesthesia or hospital admission. The procedure takes approximately 20 to 30 minutes to release the transverse carpal ligament. Patients retain full use of their fingers immediately after the procedure, which also helps with recovery. Most patients notice improvement in night symptoms promptly, with return of sensation over weeks to months depending on the duration of compression. Scarring is also barely visible once healed (see picture below).
4. De Quervain's Tenosynovitis
De Quervain's tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist. It causes pain and swelling just above the wrist, aggravated by thumb and wrist movements - particularly gripping, pinching, and lifting. It is common in new parents and those with repetitive thumb use. Other differentials include intersection syndrome and 1st metacarpal base osteoarthritis.
The Finkelstein test, tucking the thumb into the palm and bending the wrist toward the little finger, typically reproduces the pain and is used to confirm the diagnosis in clinic.
Treatment options include:
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Steroid injection: A corticosteroid injection into the first dorsal compartment is the first-line treatment in most cases and resolves symptoms in the majority of patients. This is done under ultrasound guidance to avoid administering steroid to the wrong compartment.
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Surgical release: Where injection has not provided sustained relief, surgical release of the first dorsal compartment is performed under local anaesthesia as a minor day procedure.
5. Mucous Cysts
Mucous cysts are small, fluid-filled cysts that arise from the distal interphalangeal (last) joint of a finger, typically in association with underlying osteoarthritis. They appear as a smooth swelling near the base of the fingernail and can occasionally cause grooving of the nail or, if they rupture, an entry point for infection into the joint.
Symptomatic or enlarging mucous cysts are best managed by surgical excision, which includes addressing the underlying osteophyte where present to reduce the risk of recurrence.
Why See a Plastic Surgeon for Hand Conditions?
Hand surgery requires an understanding of the intricate anatomy of tendons, nerves, and joints within a confined space. Dr Ng holds dual accreditation in plastic surgery (UK & Singapore) and hand surgery (FEBHS), and has completed dedicated hand and wrist surgery fellowships in Hong Kong and Switzerland. This level of specialist training is not required to perform these procedures but it informs the quality of assessment, the decision about when to operate and when not to, and the precision of the surgical technique when it is required. Dr Ng is also a strong proponent of point-of-care ultrasound (POCUS) which means that the majority of cases can be assessed in clinic by him, without the need for further imaging such as MRI scans, which adds further delay to definitive treatment.
For more complex hand conditions such as Dupuytren's contracture, complex trauma with fractures, tendon and nerve injuries requiring hospital-based surgery, continuity of care is available through ZNG Plastic Surgery.
Transparent Specialist Fees
We believe in clear, upfront pricing with no hidden facility fees or unexpected charges. A definitive cost estimate is always provided before any treatment begins.
Common procedures (with reference to MOH TOSP) and prices
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Point-of-Care Ultrasound (POCUS) Assessment = $150
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Ultrasound-Guided Steroid Injection = $100
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Trigger Finger Release = from $1400
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Carpal Tunnel Decompression = from $2400
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De Quervain's Release = from $2300
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Ganglion/Cyst Excision = from $1600
Frequently Asked Questions
1. Do I need a referral?
No referral is required. Contact us directly via WhatsApp to arrange an assessment. Sending a brief description of your symptoms in advance allows Dr Ng to advise on the likely management pathway before your appointment.
2. Can my condition be treated on the same day?
In many cases, yes. Steroid injections are routinely performed at the initial assessment appointment. Minor surgical procedures may require a separate booking depending on scheduling. You will be advised clearly at the time of assessment.
3. Will I need general anaesthesia?
No. All hand surgery procedures at Doctor Stitch are performed under WALANT (wide awake local anaesthesia no tourniquet), which is well-established as safe and effective and avoids the risks and recovery associated with general and regional anaesthesia.
4. How long is recovery after hand surgery?
Most patients return to light activities within a few days. Full recovery, including resolution of any residual stiffness, typically takes two to four weeks. You will be given clear guidance on hand therapy exercises after the procedure.
5. Do you work with International & Global Health Insurance?
Yes. While we choose to operate independently of restrictive local corporate panels to ensure fast-track scheduling, our minor hand operations are fully recognised as medically necessary specialist procedures. We routinely provide comprehensive, itemised medical billing, detailed clinical reports, and standard insurance memos to support seamless pay-and-claim reimbursement for premium global networks. This includes Cigna Global, Bupa International, Allianz Worldwide, Aetna, AXA PPP, and AIA Executive plans. (Note: For local residents, standard procedures remain eligible for partial Medisave claims under prevailing MOH guidelines).
6. How is carpal tunnel syndrome treated at Doctor Stitch?
For carpal tunnel syndrome, Dr Ng performs a specialised, micro-incision open carpal tunnel release under local anaesthesia using the WALANT technique. By utilising high-magnification surgical loupes, the transverse carpal ligament is precisely divided through a minimal incision to decompress the median nerve with further neurolysis as necessary. This anatomy-led approach provides structural relief, avoids the need for general or regional anaesthesia, sedation and hospital stays, and allows for rapid functional and sensory recovery in the hand.
7. Can a ganglion cyst of the hand or wrist be permanently removed?
While temporary needle aspiration is an option, permanent resolution of a hand or wrist ganglion cyst requires complete surgical excision of the cyst mass along with its underlying stalk or tissue base. At Doctor Stitch, this minor procedure is performed under local anaesthesia with microsurgical precision with the WALANT technique. Dr Ng carefully dissects the cyst capsule away from surrounding tendons and joint linings to minimise the risk of recurrence, utilising multi-layered plastic surgery suturing to ensure a clean, minimal scar line.
8. What if my condition needs more extensive surgery?
If your assessment reveals a condition requiring hospital-based surgery - for example, tendon repair or more complex reconstruction - this can be arranged through ZNG Plastic Surgery, Dr Ng's main hand and reconstructive surgery practice, ensuring continuity of care with the same surgeon.
To arrange an assessment, contact us via WhatsApp.
Same-day appointments are available subject to scheduling.
Back to Minor Surgery overview
Where complex reconstructive surgery is required, care may continue under Dr Ng Zhi Yang via ZNG Plastic Surgery
