Types of Hand Surgery

Different surgical approaches are used depending on the condition:

• Tendon Repair: Reattaching or reconstructing torn flexor or extensor tendons in the hand or wrist.
• Fracture Fixation: Stabilizing broken bones in the fingers, hand or wrist using pins, plates or screws.
• Nerve Repair or Decompression:
  • Carpal Tunnel Release: Relieves pressure on the median nerve.
  • Ulnar Nerve Release: Treats nerve entrapment at the elbow or wrist.
• Joint Reconstruction or Fusion: Used in cases of arthritis or joint instability.
• Dupuytren's Contracture Surgery: Removes thickened tissue causing finger contracture.
• Congenital Defect Correction: Surgery to repair hand abnormalities present at birth.

Key Takeaways

• Procedure Type: Surgical
• Duration: 1 to 4 hours, depending on the condition
• Anesthesia Used: Local, regional or general anesthesia
• Recovery Time: 2 to 12 weeks
• Success Rate: Over 90% for functional and pain-relief outcomes

Indications of Hand Surgery

Here are some of the key indications and purposes of hand surgery:

• Traumatic Injuries: Hand surgery is often necessary to repair fractures, dislocations, tendon and ligament injuries, and other traumatic injuries caused by accidents, falls, sports-related incidents, and workplace mishaps.
• Carpal Tunnel Syndrome: Surgery may be recommended when conservative treatments fail to lessen the symptoms of carpal tunnel syndrome, a condition characterized by pressure on the median nerve in the wrist.
• Tendon and Ligament Repairs: Surgical intervention is required to repair damaged tendons and ligaments, restoring proper hand and finger movement and strength.
• Nerve Compression and Injuries: Hand surgery can relieve nerve compression conditions like cubital tunnel syndrome and address nerve injuries, often involving delicate microsurgical techniques.
• Arthritis: Surgical options, including joint replacement or reconstruction, may be considered when conservative treatments no longer effectively manage the pain and functional limitations caused by arthritis in the hand and wrist.
• Congenital Anomalies: Surgery is often performed to correct structural abnormalities present at birth, such as syndactyly (webbed fingers) or polydactyly (extra fingers).
• Reconstructive Surgery: Following trauma, tumor removal, or congenital deformities, reconstructive hand surgery aims to restore function, aesthetics, and overall hand performance.
• Microsurgery: Hand surgeons utilize microsurgical techniques to reattach severed fingers, repair blood vessels, and reconnect nerves in intricate procedures.
• Tumors and Masses: Surgery is employed to remove benign or malignant growths, cysts, and other soft tissue masses in the hand and upper extremities.
• Dupuytren's Contracture: Surgical procedures, such as fasciectomy, help correct the contracture and restore finger mobility in this condition.
• Burn and Trauma Rehabilitation: Hand surgeons play a crucial role in the rehabilitation of burn patients and those with complex hand injuries, working to improve both function and aesthetics.
• Cosmetic Procedures: Hand surgery can address cosmetic concerns such as age-related volume loss, wrinkles and prominent veins, helping individuals achieve more youthful and aesthetically pleasing hands.
• Rheumatoid Hand Surgery: For individuals with rheumatoid arthritis, surgery may be performed to correct deformities, restore function, and reduce pain.
• Nail Bed and Fingertip Injuries: Surgical procedures can repair and reconstruct damaged nail beds and fingertip injuries, promoting healing and optimal appearance.

Who Is a Candidate for Hand Surgery?

You may be a good candidate for hand surgery if:

• You have a hand injury or condition that limits daily function.
• Conservative treatments like splinting or medication have not helped.
• You are in generally good health and can tolerate anesthesia
• You have realistic expectations about outcomes.
• You are motivated to complete post-operative rehabilitation.

Preparing for Hand Surgery Procedure

Proper preparation improves surgical outcomes and recovery:

• Consultation: A thorough evaluation by a hand surgeon to determine the best treatment option for better results and faster recovery.
• Diagnostic Tests: X-rays, MRI or nerve studies may be performed to assess the internal structures.
• Medication Review: You may need to adjust or stop certain medications, like blood thinners.
• Smoking Cessation: Your doctor will ask you to avoid smoking, as it can delay healing and increase the risk of complications.
• Pre-Op Instructions: Follow all guidance regarding fasting, hygiene and arranging assistance post-surgery.

Steps Involved In the Hand Surgery Procedure

During hand surgery, a skilled hand surgeon will perform a carefully planned procedure to address your specific hand or upper extremity condition. The details of what happens during hand surgery can vary widely depending on the type of surgery you're undergoing, but here's a general overview of the process:

• Anaesthesia: Before the surgery begins, you will be administered anesthesia to ensure that you are comfortable and pain-free throughout the procedure. The type of anesthesia used will depend on the specific surgery and your medical condition. Options may include local anesthesia, regional anesthesia (such as nerve blocks), or general anesthesia.
• Incision: During the procedure, the surgeon will carefully create one or possibly multiple incisions in the skin above the area requiring attention. The precise location and dimensions of these incisions are determined by the specific requirements of the surgery and the particular anatomical structures that need to be addressed.
• Accessing the Area: Once the incision is made, the surgeon will carefully separate or move aside the surrounding tissues to gain access to the area requiring treatment. This allows them to visualize and work on the underlying structures, such as bones, tendons, ligaments, nerves, and blood vessels.
• Procedure Execution: The surgeon will perform the necessary steps of the procedure based on the specific goals of the surgery. This could involve repairing tendons or ligaments, removing tumors, repositioning bones, releasing constricting tissues, or any other procedure tailored to your condition.
• Suturing or Closure: After completing the surgical steps, the surgeon will close the incision using sutures, staples, or adhesive strips. The closure method will depend on the surgeon's preference, the location of the incision, and the nature of the surgery.
• Dressing and Bandaging: The surgical site will be dressed with sterile dressings and bandages to protect it and promote healing. Depending on the surgery, a splint or cast may also be applied to immobilize the hand and aid in recovery.
• Recovery and Observation: You will be moved to a recovery area where medical staff will closely monitor your condition as you wake up from anesthesia. Your vital signs, pain levels, and overall well-being will be carefully assessed.
• Postoperative Instructions: Before you are discharged, your surgeon or medical team will provide you with specific postoperative instructions. These instructions may include guidelines for wound care, medication management, physical therapy and any restrictions or precautions to follow during your recovery.
• Follow-Up Care: You will have to consult with your surgeon regularly to monitor your progress, remove sutures or staples, and assess the healing process.

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Recovery After Hand Surgery

Recovery is essential for regaining function:

• Immobilization: The hand may be splinted or cast initially to protect healing tissues.
• Pain Management: Pain and swelling are managed with medication and elevation.
• Physical Therapy: An important part of the recovery process, therapy helps restore movement, strength and function.
• Activity Restrictions: Avoid heavy lifting, gripping or fine hand tasks during early healing stages.
• Avoid Complications: Be vigilant for signs of complications, such as infection, excessive bleeding, or changes in sensation or circulation. Contact your surgeon if you notice any concerning symptoms.
• Nutrition and Hydration: Maintain a balanced diet and stay hydrated to support the healing process.
• Patience and Rest: Hand surgery recovery takes time. Be patient with yourself and allow your body the rest it needs to heal.
• Follow-ups: Regular visits are required to monitor progress and adjust recovery plans.

Benefits of Hand Surgery

• Pain Relief: Resolves chronic pain from nerve compression, arthritis or injury.
• Improved Mobility and Strength: Enhances daily hand and finger movement.
• Restored Function: Enables return to work, hobbies, and routine tasks.
• Aesthetic and Structural Repair: Corrects deformities and improves appearance.
• Prevent Further Damage: Stops disease progression in chronic conditions.

Hand Surgery Side Effects and Complications

Though the surgery is considered safe, you might experience the following complications after the hand surgery. Which can be eliminated by following doctors instructions:

• Infection: Managed with antibiotics and proper wound care.
• Stiffness or Scar Tissue: May require extended therapy to improve mobility.
• Bleeding or Hematoma: Uncommon but may occur in the first few days.
• Nerve Damage: Can result in temporary numbness or tingling.
• Failure to Relieve Symptoms: Rare but may require revision surgery.
• Poor Healing: Especially in smokers or those with chronic illnesses.