Hand Surgery

Hand surgery refers to the orthopedic and aesthetic treatment of a broad range of problems affecting the hand. Hand surgery is usually performed to treat the loss of function in the hand due to diseases or traumatic injuries.

Some problems of the hand include:

• Cuts, burns, crushing, repetitive stress, and close-fist injuries
• Infections – including paronychia, felon, suppurative tenosynovitis, animal bites.
• Congenital deformities or malformations – refers to syndactyly and polydactyly.
• Joints deformities due to arthritis
• Nail problems
• Tendon repair
• Tumors – ganglion cyst, giant cell tumors, lipomas.
• Fractures and dislocations
• Nerve compression syndromes – due to anatomic problems, infection or trauma. This category includes carpal tunnel syndrome and ulnar nerve compression.
• Some hand surgery centers offer microsurgical reconstruction, to deal with problems such as transmetacarpal amputation and adactyly condition for children who suffer from amniotic band syndrome.

Hand surgery focuses on the adequate reconstruction of all hand tissues (joints, tendons, nerves, bones and skin), proper repair of cuts, burns or tears in the skin in order to avoid infection and to provide protection for the anatomical structures.

Essential parts of the procedure for hand surgery specialists are:

• Early repair of the nerves – delaying may affect sensation recovery and functionality
• Bones stabilization
• Joint mobility restoration
• Grafting

Hand Surgery Preparation, Diagnosis and Aftercare

At the hand surgery center or general surgery department the patient usually lies on his back while the hand surgery specialists perform the procedure. For the diagnosis of injuries and disorders, physical examination is performed and medical history is revised. Range of motion is evaluated in wrists and fingers. For broken bones or joint injuries, X-ray is taken.

Special tests may be requested, for example radiographic imaging and Doppler flowmeter.

Several procedures are involved in hand surgery:

• Operative planning
• Preparing and draping
• Hair removal
• Tourniquet usage for minimizing blood loss
• Surgical instruments usage (knife, small forceps, mosquito hemostats and dissecting scissors)
• Magnification (wire loops and microscopes)
• Post-operative care

After hand surgery, some common procedures include:

• Oral medication (painkillers, anti-inflammatory, antibiotics).
• Splinting
• Traction (weights to correct dislocations)
• Special dressings
• Heat therapy
• Massage therapy

Orthopedic Surgery

In order to manage hand infections, orthopedic surgery is performed followed by a medical therapy. It also requires the use of antibiotics and a close follow-up for several weeks after the infection.

After the resolution of the infection, hand therapy regimen is started. Patients are encouraged to use their hands as much as possible, because immobilization can lead to significant formations of adhesions and joint stiffness.

Hand Surgery Specialists

Also called hand surgeons, these specialists are specifically trained to:

• Deal with problems of the forearm, writs and hand.
• Treat those problems without surgery when possible
• Diagnose and care for shoulder and elbow conditions
• Work along with orthopedic, plastic, general surgeons, therapists, electrodiagnosticians, psychiatrists, pain management specialists.

Hand surgery specialists are required to complete a full year additional hands-on training in this specialty and pass a certifying examination.

Besides hiring hand surgeons, every hand surgery center should provide multidisciplinary teams for comprehensive and innovative treatments to hand conditions in order to help patients regain integrity and function. Hand surgery centers provide also direct supervision to all patients.