General

• Hand Surgery

• Rehabilitation After Hand Surgery

Hand surgery is a specialized type of procedure that may be performed to correct a wide range of diseases, injuries and defects that may cause symptoms and/or affect the appearance of the hand. Hand surgery can be performed for both medical and cosmetic purposes. Your hand surgery procedure will be customized in order to repair your individual condition and leave your hands looking and feeling their best.

Because of their frequent use, the hands are a common location for injuries and degenerative disorders such as arthritis. Many people are born with birth defects of the hand as well. Hand surgery can restore function, relieve pain and improve the appearance of the hands for patients suffering from cysts, nerve conditions such as carpal tunnel syndrome, arthritis, birth defects and other problems. Hand surgery may also be performed to re-attach or reconstruct severed fingers after trauma.

Effective hand surgery requires the skill and precision of an experienced surgeon, in order to successfully treat the condition and restore full function to the hand. At Austin's Hand Surgery Experts, our surgeons have years of experience performing a full range of hand surgery procedures, and utilize the latest techniques while doing so.

Hand surgery can be performed on patients of any age to correct conditions and deformities within the hands. The ideal candidates for hand surgery include patients who:

• Do not smoke
• Do not have any other serious medical conditions
• Have made the decision for surgery on their own
• Have realistic expectations for their surgery

Risks of Hand Surgery

As with any type of surgical procedure, there are certain risks associated with hand surgery, including:

• Adverse reaction to anesthesia
• Nerve damage, loss of sensation
• Blood clots
• Postsurgical infection
• Limited range of motion

These risks are considered rare, especially when the surgery is performed by a skilled and experienced hand surgeon.

After hand surgery for the treatment of arthritis, patients may experience mild to severe pain for which oral medication is typically prescribed. Depending on which surgery has been performed, the hand usually requires immobilization for a few days to a few weeks as it heals. Patients typically require a course of physical therapy in order to restore as much function and range of motion as possible.

Hand Surgery Procedures

There are several types of surgical procedures performed on the hand. Depending on the type and the extent of the damage, injured tissue may be removed from the joint, tendons and ligaments may be repositioned, a joint may be fused, nerves of tendons may be repaired, or the entire joint may be replaced with a prosthetic.

Arthrodesis or Fusion
Arthroscopic arthrodesis (fusion) is a surgical procedure used to treat severe cases of degenerative osteoarthritis. This procedure involves fusing the bones of the affected joint in order to manage pain. During arthrodesis, all cartilage is removed from a joint and two or more bones are joined so they do not move. Fusions may be performed with screws, plates or pins or a combination of these materials. While the patient will have somewhat limited movement after arthrodesis, the surgery provides more joint stability and excellent pain relief.

Arthroscopy
Arthroscopy is a minimally invasive procedure that allows for careful examination and minor repairs of a joint. An arthroscope, a thin tube with a miniature camera attached to it, is inserted through a small incision, allowing the surgeon to view and treat the joint by removing torn cartilage or bone fragments.

Osteotomy
Osteotomy is a procedure used to remove a section of bone near a damaged joint. This procedure involves involves cutting or repositioning the bone to restore proper alignment and treat osteoarthritis.

Synovectomy
Synovectomy is a procedure that removes the synovium, or the tissue lining of the joints, to reduce pain and swelling. It is used to treat patients with rheumatoid arthritis and may also be effective at slowing the progression of the disease.

Repairing Flexor Tendons
Flexor tendons attach the bones of the fingers to the flexor muscles, the muscles that help the fingers to bend. When a flexor tendon is partially torn, the fingers may still bend, but the movement will be painful. There is increased likelihood that the flexor tendon may eventually tear all the way through, resulting in complete inability to move the finger joints.

In order for a cut tendon to heal, surgery must be performed. Even with surgery, complete normal function does not normally return. Physical therapy may assist in releasing scar tissue and increasing mobility after surgery.

Nerve Injury Repair
Hand nerves are delicate and may be damaged not only by cutting, but by pressure or stretching. Injured nerves disrupt transmission of signals between the hand and the brain, causing loss of feeling and muscle dysfunction. In order to repair a nerve, the hand surgeon has to sew the torn ends of the nerve together, a very delicate procedure in which every effort is made to line up nerve fibers precisely. At times, where there is missing nerve tissue, a nerve graft is necessary to re-establish contact between the two ends of the nerve.

When a nerve repair operation is performed, the nerve fibers eventually regenerate and function normally, but this may take a long time, sometimes years. When a graft has been done, there may be some permanent loss of feeling in the area from which the nerve graft was taken. During recovery from nerve injury repair, it is common to experience a pins and needle sensation which eventually passes as healing takes place.

Hand surgery, which is performed by orthopedic, plastic or general surgeons who have completed additional training, is used to treat problems involving the hand, wrist and forearm. Although the goal of hand surgeons is to treat problems nonsurgically, in certain instances, when other treatments have failed, surgery may be necessary. Setting fractures, treating rheumatoid arthritis, eliminating carpal tunnel pain, and correcting birth defects are four areas in which surgery may be required.

After hand surgery, the area operated on is usually immobilized in a cast or splint. When the cast or splint is removed, often after a number of weeks, physical therapy may be required to restore strength and range of motion.

Occupational therapy, which focuses on specific exercises to help patients recover the skills they use in daily living and at work, may also be performed. How long physical therapy continues depends upon the particular surgery and what it corrected.

Rehabilitation should take place only under the direction of a physical therapist specifically trained in the hand.

Depending upon the reason for surgery, treatment may include the following:

• Hand exercises
• Heat treatment
• Massage therapy
• Electrical nerve stimulation