Hand Surgery

A hand injury can severely impact the quality of a person's life. Hand surgeons specialize in treating conditions and injuries of the hand, the wrist, and the forearm. They diagnose and manage various skin, muscle, or bone conditions depending on the patient's injury. Hand surgeons are experts in handling fractures, tendon injuries, nerve issues, and joint replacement depending on the severity of each case. Hand surgery can also involve reconstructive surgeries to improve function and appearance after a traumatic event that damaged it.

 

What is a Hand Surgeon?

Hand surgeons are specialists who diagnose and treat any injury to the hand, wrist, and forearm. Hand surgery is a subspecialty that can be acquired by plastic surgeons and orthopedists after 2 years of training. It is one of the most complex organs in the body with its bones, joint ligaments, tendons, muscles and complex nerves. All these elements must work together in order for the hand to fully perform its task.Microsurgery is a technique which requires a microscope to attach very small nerves and vessels in the hand. Hand surgeons can operate using these surgical microscopes.  Any injury or damage may affect one or all of these structures and the function of the hand may be impaired. A hand surgeon who is an expert in his field is needed to treat such conditions.

 

What Diseases Does Hand Surgery Treat?

Hand surgery can treat problems in the bones, nerves and tendons of the hand. Common conditions treated by hand surgeons include:

 

Carpal Tunnel Syndrome

The carpal tunnel is a passage surrounded by bones and ligaments from the palm to the wrist. When the median nerve in this area is compressed for various reasons, numbness, tingling and weakness may occur in the hand and arm. Disorders in the anatomy of the wrist and repetitive hand movements may cause compression of the square nerve.

 

Tennis Elbow

This disease, which occurs in the elbow, can occur as a result of repetitive hand and wrist movements of the tendons in the elbow. Repetitive tendon movements may cause excessive load on the elbow and damage may occur in this area. The reason why the name of the disease is tennis elbow is that it is mostly seen in tennis players. However, it can also be seen in other individuals. It can also be seen especially in carpenters, butchers and painters. Pain in the elbow, wrist and forearm are also typical symptoms.

 

Trigger Finger

Trigger finger causes the finger to contract and pinch as if pressing the trigger. This condition, usually seen in the ring finger and short finger, can suddenly resolve on its own. Trigger finger is caused by the tendon in that finger not working normally. Trigger finger usually occurs when part of the tendon in the finger swells or a lump forms in the tendon. Finger stiffness, clicking noises when moving the finger, and a sudden pinching of the finger are typical symptoms.

 

Wrist Pain

Wrist pain can occur for many reasons. In particular, sudden injuries, sprains and fractures can cause damage to the wrist. Moreover, wrist pain can also be caused by long-term problems such as repetitive stress, cardiac tunnel syndrome or arthritis. There are many conditions that cause wrist pain, it can be difficult to clearly diagnose the cause of the pain. An appropriate treatment plan and an accurate diagnosis are essential for a correct recovery.

 

Fractures of the Hand, Wrist, and Forearm

The forearm and wrist parts can be broken as a result of sudden injury and a direct blow to the area. Fracture symptoms are usually severe pain, swelling, and inability to use the fractured area. Depending on the degree of the fracture, plaster or surgical treatment may be required.

 

Hand and Wrist Sports İnjuries

Sports branches where the hand is at the forefront can cause damage to the hands and wrists. Especially contact sports such as hockey and lacrosse can cause damage to the hands, wrists and fingers. Although hand and wrist injuries are more common in athletes, they can also be seen in non-athletes. Common hand and wrist injuries can be listed as follows:

• Tennis Elbow
• Bowler’s Thumb
• Tendonitis
• Golfer’s Elbow
• Finger Jams
• Wrist Fractures
• Handlebar Palsy
• Boxer’s Fracture

 

Nerve Damage

Nerve damages cause symptoms like tingling sensations, numbness at the tips of fingers, weakness in holding weights, or loss of function. Some common types of nerve damage include:

 

• Peripheral nerve injuries cause the nerves that carry signals to and from the brain and spinal cord to the rest of the body to get damaged due to an injury, severe diabetes, or a nerve compression syndrome like carpal tunnel syndrome. Hand surgeons can repair peripheral nerve damage through nerve grafting.
• Brachial plexus injuries cause the network of nerves running from the spine through the shoulder and down the arm to be damaged due to sports or a car injury. It can cause a loss of control and function in the affected arm. Hand surgeons can repair the injuries using nerve transfer.
• Median nerve injuries damage the nerve that runs through the carpal tunnel in the wrist and provide sensation to the thumb, index, middle, and parts of the ring finger. Median nerve injuries are caused by physical trauma like lacerations and carpal tunnel syndrome. Hand surgeons can repair this nerve injury through finger surgery using nerve decompression.

 

What Are the Different Kinds of Hand Surgeries?

There are different types of hand surgeries and specific procedures that depend on the patient's condition, health, and treatment goals. Some common types of hand surgeries include

 

Wrist Joint Replacement

It is also called wrist arthroplasty. It is a surgical procedure involving replacing a damaged wrist joint with an artificially reconstructed one that suits your needs. The wrist joint allows motion up and down and side to side, making it complicated to image and create the artificial. The wrist replacement is done to treat chronic conditions such as osteoarthritis, where the cartilage between the joints gradually starts wearing off, causing pain, stiffness, and mobility loss.

 

Skin Grafts

Damage to the hand can lead to deterioration of the skin of the hand. In such cases, skin addition or skin replacement can be performed on the parts with skin deficiency.

Skin grafting is the transfer of a healthy piece of skin from another part of the body to the

missing place.

 

Reduction and Fixation

This method is used for fractures and dislocations in the hand. In this process, the broken bone is realigned and the bone remains immobilized. Fixing can be done with the help of plaster, rods and wires. A reduction is the alignment of a broken bone. Fixation is to fix the aligned bone so that it fuses.

 

Tendon Repair

Tendons are the cords of tissue that connect muscles to bones. Tendon damage can happen due to sprains, tears, strains, or tendonitis in hand and microsurgery might be the way to approach the problem. During a tendon repair, the doctor sews back the tendon using sutures. The patient typically needs physical therapy to regain strength in the limb. There are three types of tendon repair:

• Acute primary repair: This repair is usually done within 24 hours of injury. Depending on the type of injury, it can be in the form of direct surgery.
• Delayed primary repair: This repair is usually done within a few days of the injury.
• Secondary repair: These repairs are done within 2 to 5 weeks after the injury. Tendon grafts or more complex procedures are examples of this repair.

 

Nerve Repairs

Injury or blows can damage the nerves in the hand. Some nerve injuries can heal on their own over time. However, some nerve injuries are treated with surgery. If the nerve is in a very complex location, surgery is done 3 to 6 weeks after the injury. However, if it is not associated with complex wounds, surgery can be performed immediately after the injury. Surgery performed immediately after injury increases the chance of recovery. If the nerve is cut or severed, it can be fixed by gluing the ends together. If the nerve is damaged too much, the nerve is removed from other parts of the body and replaced.

 

Replantation

Replantation is the joining of a completely severed limb back to the body. The aim of the replantation process is to restore the broken limb to its former function as much as possible. Replantation, a complex type of surgery, is performed using microsurgery.

 

Arthritis Treatment

Arthritis is a painful disease; there are two ways a doctor can treat it in your hands: arthroplasty and arthroscopy. The recommendation depends on the patient's condition, health, and treatment goals.

• Arthroplasty (surgery orthopedic) recommends replacing a damaged joint with an artificial one, especially for patients with advanced joint degeneration. Joint erosion and degeneration cause severe pain and impaired function.
• Arthroscopy involves using a small camera to visualize the joint's internal structures. The arthroscope is a small camera inserted through an incision so the surgeon can view the inside of the joint. The method can treat various wrist conditions, like meniscus tears, arthritis, and deep and superficial ligament injuries.

 

What are the Risks of Hand Surgery?

Hand surgeries are performed under general anesthesia. Therefore, there may be risks of anesthesia and bleeding. Other risks may vary depending on the type of surgery. In general, the risks of hand surgery can be listed as follows:

• Infection
• Incomplete healing
• Loss of sensation in hands and fingers

 

Infections after surgery can negatively affect the healing process. As a vital part of trauma surgery, wound cleansing helps remove debris and bacteria from the wound to prevent infection. If a wound becomes infected, a hand surgeon can treat the wound using a variety of methods. Some common examples include-

• Antibiotics are for killing or inhibiting bacteria growth; they are prescribed either orally or intravenously.
• Debridement is a microsurgery for removing dead or damaged tissue from a particular wound. A hand surgeon may perform debridement to prevent the spread of infection and promote easier healing.
• Wound dressings are materials applied to a wound to protect it from exposure and promote healing. Dressings like hydrogel and foam dressings are at the forefront of this treatment.
• Hyperbaric oxygen therapy helps increase the concentration of oxygen levels in the bloodstream, killing bacteria and promoting healing in infected wounds. It involves breathing 100% oxygen in a pressurized chamber.

 

When Should You See a Hand Surgeon?

It is important to seek a doctor's opinion as soon as you feel any symptoms in your arm like-

• Persistent pain, swelling, or stiffness in the hand, wrist, or forearm
• Noticeable loss in mobility and lack of grip
• Numbness and tingling in the hand
• Abnormalities or deformities in the shape or appearance of the hand
• Carpal tunnel syndrome, trigger finger, or osteoarthritis showing signs on the wrist

 

Hand Surgeon: What to Expect in a Consultation

A hand surgeon typically understands the patient's medical history and tries to understand the injuries they had in the past to identify a pattern, if possible. A physical examination follows, where the surgeon examines the hand to assess the strength, range of motion, and sensation in the hand and wrist. If there is an issue, the surgeon will recommend diagnostic tests like X-Rays, MRIs, or CT scans to help diagnose the condition and get to the underlying cause of pain. Based on the examination and the diagnostic results, the surgeon may recommend a treatment plan to alleviate the pain and gradually restore mobility. If there is a severe issue, the surgeon suggests the kind of treatments and surgeries that can be most effective.

 

Get the Best Care Now

The Republic of Türkiye affiliated with the Ministry of Health has initiated HealthTürkiye. They work to promote and coordinate medical tourism in Türkiye. Health Türkiye is a great resource for those seeking top-notch medical care from experts in various fields, including hand operations.

Get all the expertise you need in one place for treating and curing all your hand-related issues with experienced doctors across orthopedic, general, and plastic surgery domains.To get a treatment plan from hospitals which serve on this branch, please click here.