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Hand Surgery

We use our hands in almost all of our daily activities. This is why when injury, disease, or deformity affects our hands it can be difficult to complete daily tasks and it is often debilitating to a normal way of life. Plastic surgeons, orthopedic surgeons, and general surgeons can all be trained to specialize in hand surgery techniques.
Hand surgery is the field of medicine that helps to alleviate health problems involving the wrists, hands, and forearms, and sometimes the shoulders and elbows. There are many problems involving the nerves, joints, tendons, bones, and muscles of these areas that may be helped by hand surgery.

When is hand surgery needed

Traumatic injury to the hand area can include:

  • crush injuries
  • burns
  • detached digits and limbs
  • injury to the blood vessels and nerves

Hand surgery to treat these injuries often involves a plastic surgical specialist who can reset and repair fractures and dislocations, reattach severed limbs and digits, repair nerves and blood vessels, and reconstruct lost skin, bones, muscles and nerves.

There are many types of disease that may require hand surgery. The most commonly acquired diseases of the hand include:

  • carpal tunnel syndrome
  • arthritis
  • trigger finger
  • ganglion cysts
  • tendonitis
  • other problems with the tendons, joints, and nerves

Hand surgery may also be used for congenital defects that cause hand deformities. These include syndactyly, deformed or missing fingers, absent thumbs, or abnormal development of nerves, blood vessels, or tendons. Often hand surgery is the best treatment for these problems.

Treatment options

Often there are several non-surgical techniques a hand surgery specialist will employ before resorting to surgical options. These include:

  • physical therapy
  • modification of activity
  • anti-inflammatory medications
  • corticosteroid injections
  • restricted mobility measures  

When other treatments are exhausted, hand surgery may be the ultimate outcome. Often these procedures are successful in repairing the injury and alleviating pain. Reconstructive plastic surgeons specialize in micro skin grafting techniques and other types of hand surgery that restore proper form and functioning to the affected areas.

Reconstructive Hand Surgery

Reconstructive hand surgery is the procedure by which form and function of the hand is restored after injury, disease or deformity. General, orthopedic, and plastic surgeons who receive special training are qualified to perform reconstructive hand surgery. Reconstructive hand surgery may be necessary in cases where injury, congenital deformity, or disease cause significant harm or inhibits the normal hand use and functioning. The technique involves reconstructing, repairing or replacing different parts of the hand including bones, muscles, tendons, joints, skin, and other tissues.

When is hand reconstructive surgery needed

Traumatic injury to the hands resulting in extensive burns, crushed parts, deformity or loss of digits may require reconstructive hand surgery. Common procedures to treat these types of injuries include:

  • resetting and repairing dislocations and fractures
  • repairing nerves and tendons
  • caring for burns
  • reattaching missing digits

After the initial repairs are completed, full reconstructive hand surgery may also include replacement of hand skin through skin grafting, skin and muscle flap procedures, and microsurgical reconstruction of skin, muscle, bone, or nerve by means of tissue transplantation.

Congenital hand deformities can require reconstructive hand surgery as well. Syndactyly is when children are born with webbed fingers. This is more common in boys than girls and affects one in two thousands babies. Reconstructive hand surgery in these cases should be performed when the child is young in order to prevent permanent deformities and to allow normal development of hand function.

This operation requires that the webbed skin be cut in a zigzag shape and reconstructed to form two separate digits. Skin flaps from the back of the fingers or groin area are often taken and grafted into the new web spaces. Other deformities that often require reconstructive hand surgery include:

  • missing digits
  • extra digits
  • short digits
  • curved digits
  • deformed digits

There are many instances where hand-related diseases will require reconstructive hand surgery. Patients suffering from severe arthritis of the hands or wrists are often successfully treated with arthroplasty or joint replacement surgery. Rheumatoid joints can also be reconstructed. Treatment of infections and tumors in the hands can also be achieved through reconstructive hand surgery. There are several other diseases that will require hand reconstructive surgery, including:

  • Carpal Tunnel Syndrome
  • Tennis Elbow
  • Dupuytren's Contracture
  • Tendonitis

The complexity of reconstructive hand surgery can vary from the more common procedure of Carpal Tunnel release to the more complex procedures of limb reattachment or tumor removal. Reconstructive hand surgery is usually done on an out-patient basis under a local or a general anesthesia. Physical therapy is often a significant part of the recovery process. A well-trained reconstructive plastic surgeon will discuss with you recovery time, risks and complications, and the expected results of surgery prior to the procedure. Often hand surgery is covered under health care insurance when the procedure is necessary to restore health and proper functioning of the hands.

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