Considering the Major Types of Orthopaedic Hand Surgery

If you suffer from a hand issue, it may impede the daily conduct of activities you previously took for granted. This may range from tasks like brushing teeth, combing hair and doing laundry to running errands which become impossible because of pain and discomfort. Thus, there may come a time when hand surgery may be required to reduce pain and restore the functionality of your hand.

Hand surgery is a comprehensive discipline that treats various kinds of issues. Hand surgeons seek to restore the function of fingers and hands.

If you are experiencing pain or impairment with your wrist, hands or fingers the first step is to consult your general practitioner. They will likely refer you to a specialist hand surgeon who will determine whether surgery is required or not. If surgical procedures are recommended by the orthopaedic hand specialist, it may involve one of the following kinds of surgery:

Skin grafts

These involve attaching or replacing skin to a part of the hand with missing skin. Such surgery is mostly conducted for injuries or amputations of fingertips. Skin grafts are performed by removing a healthy piece of skin from other parts of the body (the donor site) and attaching it to the area of injury.

Skin flaps

Similar to a graft, skin flaps use skin from other body areas. But in this case, the skin used has its own supply of blood. This is because the skin section has its underlying fat, muscles and blood vessels intact. It is typical to use flaps when the area with missing skin does not have a good blood supply. This might be caused by deep tissue damage, damage to vessels and the location of the injury.

Closed reduction and fixation

This is used when there are bone fractures or broken bones in the hand and the fingers. This kind of surgery considers the realignment of broken bones and keeps them in place or immobilises them during the healing process. Implements such as casts, splints, rods and wires can be used to immobilise the hand.

Repair of tendons

Tendons are fibres that join bone to muscle. The repair of tendons in the hand requires specialist surgery, thanks to the structure of the tendon. Injuries in tendons can occur because of sudden rupture, trauma or infection. There are three kinds of repair:

Primary repair: As a result of a sudden or acute incident, often completed within 5 days of injury. This is typically direct surgery to fix the injury.

Primary repair that is delayed: It is conducted some 5-14 days following the injury, when there is an open wound in the tendons.

Secondary repairs: This may happen 2 - 5 weeks or more following the injury. It may include tendon grafts. In this case, tendons derived from other areas of the body may be inserted in place of non repairable tendons.

Repair of nerves

Injuries can damage nerves within the hand. This can result in loss of feeling and function. When a nerve is severed or cut, it may be repaired or there may be a graft. Certain nerve injuries can heal by themselves, but others may require surgery.

Fasciotomy

This is utilised to help in treating compartment syndromes. Such painful conditions occur when there is excessive pressure or swelling in a small space (compartment) in the body, usually because of an injury. This condition can cause muscle weakness and pain.

In this procedure, the surgeon will make an incision or cut in the arm or hand. This reduces the pressure, permits muscle tissue swelling, and restores blood flow. Tissues within the area that is damaged may be removed at this time. Further damage will be prevented, and reduced function in the affected hand will be prevented.

Carpal tunnel

If you sense a feeling of numbness and pins and needles in the fingers, it might be carpal tunnel syndrome. With the persistence of these symptoms, a hand and wrist surgeon may recommend undergoing surgery to release pressure on the nerve.

Trigger finger

Though this condition can be treated without surgery, sometimes it is needed to free the tendon, which has thickened and is stuck within the tunnel of the fingers, including the thumb. Nodules develop, which keep the tendons from sliding smoothly. Surgery widens the sheath via a tiny incision in the palm.

Dupuytren’s contracture surgery

In this condition, there is a thickening of tissue beneath the skin of the finger and palm. This hand deformity typically worsens with time. Thick bands of tissue make for the curling of fingers towards the palm. Through surgery, bands are released to restore movement.

Joint replacement

This surgery may be used for persons with severe arthritis in the hand. Arthritis often destroys the joints and may be replaced with metal, a patient’s tendon, rubber, plastic or silicone.

In summary, these are just some of the significant kinds of hand surgery available. The latest developments in the field involve minimally invasive surgery, which involves less pain in the post-operative stage, faster recovery, and less damage and scarring, which is great news for patients.