Hand Surgery Information | Plastic Surgery Information

Hand surgery is generally needed for two different and specific reasons. Either a patient is born with a congenital defect that requires reconstruction, or a patient is injured or develops a disease that inhibits normal hand functions.

There are five main defects, injuries and debilitating diseases that would cause a patient to undergo hand surgery. Each have different surgeries that are performed to correct the specific problems. The five hand ailments include Hand Injuries, Carpal Tunnel Syndrome, Dupuytren's Contracture, Congenital Defects and Rheumatoid Arthritis.

The most common hand surgery procedures are performed because of hand injuries. There are several hand injuries that can lead to hand surgery. These include injuries to the tendons, nerves, blood vessels, and joints; fractured bones, burns, cuts, and other injuries to the skin. There are three different procedures that surgeons use in order to treat these hand injuries.

Flap Surgery – This procedure involves surgeons taking healthy skin from a donor site in order to replace damaged skin on the hand. The surgeon will move the flap of skin along with its underlying fat, muscle and vessels. This allows the skin to be reattached to the underlying muscle, fat and vessels at the injury site.
Grafting – This procedure involves moving skin, bone, tissue or nerves from a healthy donor site to the injured area of the hand.
Transplantation or Replantation – This procedure uses various forms of microsurgery in order to reattach amputated fingers or hands. For optimal results, this form of surgery may require more than one procedure.

After surgery, full recovery could take months. Many patients will have to partake in physical therapy in order to regain full use of their hand(s). Many will lose feeling and sensation, but for most, this is just temporary.

The carpal tunnel is a passageway through the wrist that carries tendons as well as one of the hand's major nerves. Disease, injury, overuse and/or fluid retention can all cause pressure to build within the tunnel. This pressure against the nerve results in a tingling sensation in the hand. This tingling is often accompanied by aching, numbness and impaired hand function. This is known as carpal tunnel syndrome.

Doctors will always begin treatment by splinting the hand and prescribing anti-inflammatory medications. Sometimes this will relieve the problem, but if it doesn't, surgery may be required.

The carpal tunnel procedure involves making an incision that ranges from the middle of the palm to the wrist. This will allow the surgeon to cut the tissue that is pressing against the nerve in order to relieve the pressure. Following the surgery, dressing and a splint are used to restrict motion. As the hand heals, the scar will gradually fade. Surgery results will depend on how long the condition existed and how much nerve damage had been done. It is beneficial for anyone suffering carpal tunnel syndrome symptoms to see a doctor as soon as possible.

Dupuytren's contracture is a disorder that affects the underlying tissue under the palm of the hand. This condition usually develops mid-life. Though it has no known cause, it does have a tendency to run in families. Thick, scar-like tissue forms underneath the skin that can extend into the fingers. When this happens, the fingers are pulled towards the palm and motion is restricted.

Hand surgery is the only way to treat Dupuytren's contracture. The surgeon will cut and separate the bands of thickened tissue, which will free the tendons and allow for better finger movement. This operation is a very precise procedure because nerves are often bundled up within the thickened tissue. The abnormal tissue can sometimes cause the skin of the palm to take on a tight, puckered appearance. In this case, skin grafts will also be needed to replace the skin.

The results of the surgery will depend on the severity of the condition. After time, scars should fade to thin white lines, making them less noticeable. Patients can expect significant function improvement, especially after physical therapy, but oftentimes hand movement will not return to 100%.

Congenital deformities of the hand can cause many problems concerning hand use. Improper hand growth inhibits many children born with hand deformities. Today, modern surgical techniques have been able to correct most birth defects at a very early age; some even during infancy. Performing these surgeries early allows children to develop normal hand functions.

There are several hand deformities, but one of the most common congenital defects is Syndactyly. This is when children are born with two or more fingers fused together. Syndactyly corrective surgery involves cutting the excess tissue between the two fingers in order to separate and repair the digits. Surgeon's most often take skin grafts from a donor area of the body in order to repair the skin damage.

Along with skin tissue, Syndactyly sometimes also involves the bones being fused together. This makes the surgery more complicated. This surgery can most often result in full range finger motion as well as an almost normal appearance. The skin pigmentation may be slightly off because of the skin provided by the donor area. After surgery, children's hands are almost always able to grow and function normally.

Some other common congenital hand defects include short, missing or deformed fingers, immobile tendons, and abnormal nerves or blood vessels. In almost all cases, these defects can be treated surgically and result in considerable improvement.

Rheumatoid arthritis is a disease that causes an inflammation of the joints. It is a disabling disease that can greatly affect the appearance and the function of the hands as well as other parts of the body. This form of arthritis can deform finger joints which can hinder hand movement. If patients wear special splints or undergo physical therapy in order to strengthen their weakened areas, rheumatoid arthritis can be managed without surgery. However, for many patients, surgery offers the best solution.

Rheumatoid arthritis surgeries can repair almost any area of the hand or wrist. Surgeons will remove tissue from inflamed joints, implant artificial joints or reposition tendons. After surgery, patients may not regain full use of their hand(s) but they will notice a great improvement in overall appearance and function. It is important for patients to remember that this surgery does not cure rheumatoid arthritis; the disease can continue to cause damage to your hand which may require further surgery. Regular checkups will ensure that patients stay ahead of their disease.

Like any surgical procedure, surgeries involving the hands will carry a certain amount of risk. The most common risks associated with hand surgeries are:

All of these risks are rare but treatable. Discussing each with your surgeon before your procedure will ensure that your hand surgery will be as successful as possible.

The hands are two very sensitive parts of the body, so it may take a while for them to fully heal following hand surgery. Following your doctors post surgery suggestions as well as committing to serious rehabilitation will allow you to regain as much motion and strength in your hands as possible. Patients suffering from any of these hand abnormalities can have a real chance at living completely normal, functioning lives.