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:
Replacing or attaching skin to a part of the hand that has missing skin.
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.
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.
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.
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.
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.
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.
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.
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.