Dramatic advances have been made in recent years in treating patients with hand injuries, degenerative disorders, and birth defects of the hand. Orthopaedic surgeons who specialize in hand surgery undergo additional medical training in hand surgery, and they can treat patients with a wide range of hand problems. After examination and review of the medical history of your hand, the surgeon will discuss possible methods of treatment for your problem and let you know if surgery is necessary.
The most common procedures in hand surgery are those done to repair injured hands, including injuries to the tendons, nerves, blood vessels, and joints; fractured bones; and burns, cuts, and other injuries to the skin. The information below highlights some of the most common procedures hand surgeons perform and is intended for informational purposes only.
Carpal Tunnel Syndrome: The carpal tunnel is a passageway through the wrist, carrying tendons and one of the hand’s major nerves. Carpal tunnel syndrome (CTS) is a problem that affects the wrist and hand when pressure builds up within the tunnel because of disease (such as rheumatoid arthritis), injury, fluid retention during pregnancy, overuse, or repetitive motions. The resulting pressure on the nerve within the tunnel causes a tingling sensation in the hand, often accompanied by numbness and aching, and can make simple tasks hard to do.
In some cases, non-surgical treatment can relieve the problem. For that reason, it’s a good idea to see a doctor for a complete examination and analysis if you suspect you have carpal tunnel syndrome.
If surgery is required, your results from surgery can vary depending in part on how long the condition has existed and how much damage was done to the nerve.
After surgery you will spend a few hours in recovery and then you will be sent home. While recuperating, you should:
- Keep your hand raised above heart level to reduce swelling
- Limit hand and wrist use
- Take all medication as directed
- Do hand exercises as instructed
Rheumatoid Arthritis: An inflammation of the joints, rheumatoid arthritis is a disabling disease that can affect the appearance and the function of the hands and other parts of the body. It often deforms finger joints and forces the fingers into a bent position that hampers movement.
Disabilities caused by rheumatoid arthritis can often be managed without surgery by wearing special splints or using physical therapy to strengthen weakened areas. For some patients, however, surgery offers the best solution. Whether or not to have surgery is a decision you should make in consultation with your surgeon.
While your hand may not regain its full use, you can generally expect a significant improvement in function. Remember that surgical repair doesn’t eliminate the underlying disease. Based on your situation, your doctor will discuss the best treatment plan for you.
Dupuytren’s Contracture: Dupuytren’s Contracture is a disorder of the skin and underlying tissue on the palm side of the hand. Thick, scar-like tissue forms under the skin of the palm and may extend into the fingers, pulling them toward the palm and restricting motion. The condition usually develops in mid-life and has no known cause, although it appears to be hereditary.
Surgery is the only treatment for Dupuytren’s Contracture. The results of the surgery will depend on the severity of the condition. You can usually expect significant improvement in function, particularly after physical therapy.
Since the hand is a very sensitive part of the body, you may have mild to severe pain following surgery. Your surgeon can prescribe injections or oral medication to make you more comfortable. How long your hand must remain immobilized and how quickly you resume your normal activities depends on the type and extent of surgery and on how fast you heal. To enhance your recovery and give you the fullest possible use of your hand, your surgeon may recommend a course of physical and occupational therapy. Keeping all follow-up appointments and adhering to instructions will maximize the results of your hand surgery.