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The Effect of Hand
Surgery
Hand surgery is a broad term
that incorporates a vast array of different
types of surgery on the hand. Plastic surgeons
who perform hand surgery attempt to restore
not only the function of the hand, but also
try to maximize the cosmetic appearance of the
hand.
Hand Surgery Procedures
Hand surgery encompasses a
broad range of procedures that are used to correct:
• Hand injuries
• Carpal Tunnel Syndrome
• Rheumatoid Arthritis
• Dupuytren's Contracture
• Congenital defects
Procedures involved in hand surgery
can include:
Skin grafts
Replacing or attaching skin
to a part of the hand that has missing skin.
Skin flaps
Similar to a skin graft, however,
with a skin flap, the skin that is retrieved
has its own blood supply. The section of skin
used includes the underlying blood vessels,
fat, and muscles.
Closed reduction and fixation
This type of surgery realigns
fractured bone and then immobilizes the area
during the healing phase.
Tendon repair
Repair of a tendon may be classified
as primary, delayed primary, or secondary. Primary
repair of an acute injury is usually completed
within 24 hours of the injury. Delayed primary
repair is usually performed a few days after
the injury, but while there is still an opening
in the skin from the wound. Secondary repairs
may occur two to five weeks or longer after
the injury. Primary repairs usually involve
direct surgical correction of the injury, while
secondary repairs may include tendon grafts
(inserting tendons from other areas of the body
in place of the damaged tendon) or other more
complex procedures.
Nerve repairs
There are three main nerves
that innervate the hand, including the ulnar
nerve, the median nerve, and the radial nerve.
Damage to these nerves from injury may result
in decreased ability to move the hand and experience
feeling. Some nerve injuries may heal on their
own, while others require surgery. If severed,
the nerve may be repaired by reattaching it
directly to the other end of the nerve, or by
using a nerve graft.
Fasciotomy
Treats compartment syndromes
- a compartment is a three-dimensional space
in the body that is surrounded by fascia or
bone and contains arteries, nerves, and veins.
A compartment syndrome is a condition that arises
when there is an increase in intracompartmental
tissue pressure within a space in the body,
usually caused by trauma, which can interfere
with the circulation to the body tissues and
destroy function.
Surgical drainage and/or debridement
Infections of the hand are
a common reason people seek treatment. The treatment
for infections to the hand may include rest,
use of heat, elevation, antibiotics, and surgery.
Surgical drainage may be used if there is an
abscess in the hand to help remove the collection
of pus. Debridement, or cleansing of a wound
to prevent further infection and to help promote
healing, may be used if the infection or wound
is severe.
Arthroplasty
Also known as "joint replacement",
may be used in people with severe arthritis.
This involves replacing a joint that has been
destroyed by the disease process with an artificial
joint. The artificial joint may be made out
of metal, plastic, silicone rubber, or the patient's
own body tissue (such as a tendon).
Candidates for Hand Surgery
Best candidates are those who
are suffering from hand injuries; Carpal Tunnel
Syndrome; Rheumatoid Arthritis; Dupuytren's
Contracture; Congenital defects.
Risks
All surgery carries risk, and
you should be fully aware of the medical risks
associated with this procedure before you consent
to surgery. Your surgeon will discuss these
risks with you during your consultation, and
you are encouraged to ask questions if there
is anything you do not understand.
You will be required to sign
a consent form before surgery stating that you
have been informed of the risks involved; that
you understand those risks; and that you accept
those risks. This is standard hospital protocol
and surgery will not be performed if you do
not sign..
It is your obligation to inform
your surgeon of key medical information that
may influence the outcome of your surgery or
may increase the level of risk. These include
medications you are taking, history of disease,
medical complications, etc.
Risks and risk rates vary from patient to patient
depending on a range of factors. No two people
are alike. The risks listed below are possible
risks associated with this type of surgery and
are mentioned regardless of how remote the possibility:
Infection. Incomplete healing. Loss of feeling
or movement of the hand or fingers. Formation
of blood clots.
Surgery
Time required: Variable depending
upon the particular procedure and specifics
of the individual case.
Anesthesia: General anesthetic for the main
operation. Follow-up procedure may only require
local anesthetic.
Recovery
Since the hand is a very sensitive
part of the body, mild to severe pain may be
experienced following surgery. How long the
hand must remain immobilized and how quickly
normal activities are resumed depends on the
type and extent of surgery and on how fast the
healing occurs.
To enhance your recovery the surgeon may recommend
a course of rehabilitation (physical and occupational
therapy) under the direction of a trained hand
therapist.
Please note that this information should
be used only as a guide to your treatment. All
specifics will be discussed with your Physician
at your consultation.
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