Hand surgery

Hand surgery is a specialised field of medicine dedicated to diagnosing, treating, and rehabilitating disorders and injuries of the hand, wrist, and forearm. This branch of surgery addresses a wide array of conditions, from common issues like carpal tunnel syndrome and Dupuytren’s contracture to intricate injuries and congenital deformities. Hand surgeons are highly trained professionals who possess the precision and skill required to operate on the hand, a complex and delicate instrument. The primary goals of hand surgery are to alleviate pain, restore function, and enhance the appearance of the hand, enabling patients to regain their quality of life.

The human hand is a marvel of complexity and precision, composed of many bones, joints, ligaments, tendons, nerves, blood vessels, and muscles. It includes the wrist, palm, and fingers, all connected to the forearm via the wrist joint. The hand contains 27 bones, 34 muscles, and over 100 ligaments and tendons, all working in harmony to facilitate a wide range of movements and functions. Central to the hand’s operation is the median nerve, which runs from the forearm into the hand, playing a crucial role in controlling both movement and sensation. The intricate network of blood vessels ensures that the hand receives the necessary nutrients and oxygen to function effectively.

Hand trauma surgery is a specialised surgical procedure performed to treat injuries and trauma to the hand, wrist, and forearm. Hand trauma can result from a variety of causes, such as accidents, sports injuries, or work-related workplace injuries.

Hand trauma surgery is performed by a trained and experienced hand surgeon, who is specialised in treating hand injuries and conditions. The goal of the surgery is to restore the function, strength, and appearance of the hand and wrist by repairing damaged tissues, bones, nerves, and blood vessels. Tendons of the fingers pass through various sheaths, and these structures can become swollen or irritated, leading to conditions like Trigger Finger and Carpal Tunnel Syndrome. In such cases, surgical interventions may be necessary when nonsurgical treatments fail.

There are several different types of hand trauma surgery, depending on the type and severity of the injury. Some of the most common procedures include:

1. Fracture repair: If a bone is broken, the surgeon may use pins, screws, or plates to hold the bone in place while it heals.
2. Tendon repair: If a tendon is cut or torn, the surgeon may reattach it to the bone or use a graft to replace the damaged tissue.
3. Nerve repair: If a nerve is cut or damaged, the surgeon may repair or replace it to restore feeling and movement to the hand.
4. Soft tissue repair: If the skin or other soft tissues are damaged, the surgeon may use a variety of techniques, such as skin grafts or flaps, to repair the area.
5. Joint reconstruction: If a joint is damaged, the surgeon may use a variety of techniques, such as joint replacement or fusion, to restore function and mobility.

Hand trauma surgery is typically performed under local or general anaesthesia, depending on the complexity of the procedure. Recovery time can vary depending on the extent of the injury and the type of surgery performed. Patients may require physical therapy or occupational therapy to regain strength and function in the hand index finger and wrist after surgery.

Dupuytren’s fasciectomy is a surgical procedure performed to treat Dupuytren’s contracture, a condition that causes thickening and tightening of the connective tissues in the hand, resulting in the bending of the fingers and the inability to fully straighten them. Dupuytren’s contracture is a hand condition characterised by the thickening of fibrous tissues in the palm, leading to an inward bending of the fingers, typically affecting the ring and little fingers.

During Dupuytren’s fasciectomy surgery, the surgeon makes an incision in the palm of the hand to access the thickened tissue. The surgeon then removes the thickened tissue, along with any nodules, ligaments or cords that are causing the fingers to contract. In some cases, skin grafts or other procedures may be necessary to replace the tissue that is removed.

Dupuytren’s fasciectomy surgery is typically performed under local or general anaesthesia and takes several hours to complete, depending on the extent of the contracture. Patients may need to stay in the hospital overnight, but can usually go home the next day.

After the surgery, patients will need to wear a splint or cast to immobilise the hand and wrist while wounds heal. They may also need to undergo physical therapy to regain strength and function in the hand and fingers.

Dupuytren’s fasciectomy surgery is generally considered safe and effective, with a high success rate in relieving the symptoms of Dupuytren’s contracture. However, as with any surgery, there are risks associated with the procedure, such as infection, bleeding, nerve damage, and recurrence of the contracture. Patients should discuss the risks and benefits of Dupuytren’s fasciectomy surgery with their surgeon to determine whether it is the right option for them.

Congenital hand anomaly surgery is a surgical procedure to correct hand deformities that are present at birth. Congenital hand anomalies can range from mild to severe and can affect the structure and function of the hand. Surgery is usually recommended for more severe anomalies that affect the child’s ability to use their hand or for cosmetic reasons.

Some common types of congenital hand anomalies that may require surgery include:

1. Syndactyly: This is a condition where two or more fingers are fused together. Surgery involves separating the fused fingers and reconstructing the soft tissues and bones.
2. Polydactyly: This is a condition where a child is born with extra fingers or toes. Surgery involves removing the extra digit and reconstructing the surrounding soft tissues.
3. Radial club hand: This is a condition where the radius bone in the forearm is missing or underdeveloped, leading to a shortened, curved forearm and hand. Surgery involves reconstructing the forearm bones and correcting the hand deformity.
4. Thumb hypoplasia: This is a condition where the thumb is underdeveloped or absent. Surgery involves reconstructing the thumb and surrounding soft tissues.
5. Ulnar club hand: This is a condition where the ulna bone in the forearm is missing or underdeveloped, leading to a deformity of the hand and wrist. Surgery involves reconstructing the forearm bones and correcting the hand deformity.

Congenital hand anomaly surgery is typically performed under general anaesthesia and may involve a team of specialists, including plastic surgeons, orthopaedic surgeons, and hand therapists. The specifics of the procedure will depend on the type and severity of the human hand anomaly, and recovery time will vary depending on the complexity of the surgery and the child’s age and overall health.

It is important for parents to discuss the risks and benefits of surgery with a qualified hand surgeon and to have a full understanding of the potential outcomes and recovery process.