> Hand Surgery

 

Hand Surgery

 

 

 


If your hand is impaired in any way, surgery may improve your condition.

If your hand is impaired in any way, surgery may improve your condition. This type of very specialized surgery can treat diseases that cause pain and impair the strength, function and flexibility of your wrist and fingers. Surgery seeks to restore to near normal the function of fingers and hands injured by trauma or to correct abnormalities that were present at birth.


Carpal tunnel syndrome
A condition caused by pressure to the median nerve within the wrist, or carpal tunnel. You might feel pain, a tingling sensation, numbness of the fingers, weakness or aching. Carpal tunnel syndrome is associated with multiple conditions including: repetitive motion or overuse, fluid retention during pregnancy, injury to the nerve in the carpal tunnel or rheumatoid arthritis.

Rheumatoid arthritis
A disabling disease that can cause severe inflammation in any joint of the body. In the hand, it can deform fingers and impair movement.

Dupuytren’s contracture
A disabling hand disorder in which thick, scar-like tissue bands form within the palm and may extend into the fingers. It can cause restricted movement, bending the fingers into an abnormal position.     

Who is an Ideal Candidate?
Hand surgery is a highly individualized procedure which can be performed on people of any age and is a good option for you if:

  • You do not have additional medical conditions or other illnesses that may impair healing

  • You are a non-smoker

  • You have a positive outlook and realistic goals for your hand surgery

  • You are committed to following your plastic surgeon’s prescribed course of treatment

  • In some conditions, hand surgery is necessary to treat wounds and to help painful conditions


The Primary Consultation
You must be prepared to discuss why you want the procedure, your expectations and desired outcome any medical conditions, drug allergies and medical treatments, use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs and previous surgeries. Your  general health status and any pre-existing health conditions or risk factors will be evaluated. Your hand will be examined in detail. Your surgeon will discuss your options and recommend a course of treatment to restore hand function as well as discuss likely outcomes of hand surgery and any risks or potential complications.

Prior to surgery, you may be asked to:

  • Get lab testing or a medical evaluation

  • Take certain medications or adjust your current medications

  • Stop smoking well in advance of surgery

  • Avoid taking aspirin and certain anti-inflammatory drugs and herbal supplements as they can    increase bleeding


The Operation
The operation is performed in a major hospital or accredited centre under regional anaesthesia.

Treating trauma
The most common traumatic hand or finger injury requiring hand surgery is tendon repair. When a tendon is cut, it will retract from the original wound site. Tendon repair retrieves the retracted tendon and reconnects it using surgical techniques to restore function and movement.

Carpal tunnel syndrome relief
Pressure on the median nerve in the carpal tunnel must be relieved to repair this condition. An incision is made from the middle of the palm to the wrist, allowing access to the constricted tissue causing pressure on the nerve. An alternate procedure is referred to as an endoscopic carpal tunnel release, with smaller incisions (see blue dotted lines) and the use of a surgical microscope or endoscope, a small flexible tube that contains a light and lens, to release pressure.

Your plastic surgeon may recommend one or a combination of techniques to achieve your goals. Some of those techniques include: microsurgery, grafting of skin, bone, nerves or other tissue from healthy parts of the body, z-plasty and physical therapy.

The incisions are closed using removable or non-removable sutures.
 

Trigger Thumb
Trigger thumb occurs when a bump exists on the tendon that moves the joint at the tip of the thumb, causing the thumb to jump or “trigger” when it’s used. In other cases, the thumb might be locked in a bent position.


How Is Trigger Thumb Treated?
Treatment for trigger thumb involves a surgical procedure, called a trigger thumb release, to enlarge the tendon sheath and allow the thumb to move more normally. After the procedure, the child will wear a cast for one to two weeks.

Post operative Period
The results of hand surgery will appear gradually as swelling subsides. Your final outcome may not be realized for several months. In the initial period of 3 weeks your hand maybe be kept immobilized if tendon repair has been done. Patients are instructed to undergo intensive physiotherapy under supervision for the next 2-3 months in order to gain maximum hand function.

Risks and Potential Complications
The decision to have hand surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Your plastic surgeon will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo, the alternatives and the most likely risks and potential complications.

Some of the risks include: Bleeding (hematoma), Infection, Anesthesia risks, Unfavorable scarring, Change in skin sensation, Skin contour irregularities, Skin , discoloration/swelling, Poor healing of incisions, Unexpected hand swelling, Deep vein , hrombosis, cardiac and pulmonary complications, Damage to deeper structures — such as nerves, blood vessels, muscles, and lungs — can occur and may be temporary or permanent, Pain, which may persist and Possibility of revisional surgery

  • Additional incisions necessary where scarring occurs or to make new incisions to release scar   tissue that is limiting tendon motion

  • Inability to restore function

  • Recurrent tendon scarring

  • Rupture of tendon

  • Seroma (fluid accumulation)

  • Wound breakdown