Basics of Hand Surgery: What You Need to Know

Hand surgery is a specialized field of medicine that focuses on diagnosing, treating, and surgically addressing conditions affecting the hands, wrists, and forearms. Whether due to trauma, disease, congenital defects, or degenerative conditions, hand surgery plays a crucial role in restoring function and improving the quality of life for patients. In this article, we will delve into the basics of hand surgery, including common conditions treated, the surgical procedures available, and the recovery process. Basics of Hand Surgery: What You Need to Know

What is Hand Surgery?

Hand surgery is a branch of orthopedic surgery that deals with the correction of issues related to the bones, joints, tendons, ligaments, and nerves of the hand and upper extremities. It includes both reconstructive and cosmetic procedures aimed at restoring functionality, alleviating pain, and improving the aesthetic appearance of the hand.

Hand surgeons are highly trained specialists who typically undergo additional years of training after completing their orthopedic residency. They are skilled in treating a wide range of hand injuries, diseases, and disorders, using both non-surgical and surgical approaches.

Common Conditions Treated by Hand Surgery

Hand surgery addresses various conditions that can impair the movement and function of the hand. Some of the most common conditions include:

1. Carpal Tunnel Syndrome
   Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed at the wrist. This condition can cause symptoms such as numbness, tingling, and weakness in the hand. Surgical release of the carpal tunnel is often required when conservative treatments such as physical therapy or splinting do not provide relief.

2. Tendon Injuries
   Tendons are tissues that connect muscles to bones. Injuries to the tendons in the hand can result from trauma or repetitive use. For example, “trigger finger” occurs when a tendon becomes inflamed, causing the finger to get stuck in a bent position. Tendon repair or release surgery can restore normal movement and alleviate pain.

3. Fractures and Dislocations
   Hand fractures and dislocations are among the most common reasons for hand surgery. Broken bones in the fingers, wrist, or hand can result from direct trauma or accidents. Surgical intervention may be required to realign bones, insert plates or screws, and ensure proper healing.

4. Arthritis
   Arthritis, particularly osteoarthritis, can cause pain, swelling, and stiffness in the joints of the hands and wrists. Over time, arthritis can severely affect hand function. Surgical treatments such as joint fusion or joint replacement may be necessary to relieve pain and improve mobility.

5. Dupuytren’s Contracture
   Dupuytren’s contracture is a condition where the connective tissue in the palm of the hand thickens, causing the fingers to bend toward the palm. This condition can be disabling if left untreated. Surgery to remove the thickened tissue or release the contracted tendons is often necessary to restore hand function.

6. Nerve Damage
   Nerve injuries to the hand, whether from trauma or conditions like diabetes, can lead to loss of sensation, weakness, or paralysis. Nerve repair surgery or nerve grafting may be necessary to restore proper hand function.

7. Congenital Hand Deformities
   Some people are born with hand deformities such as extra fingers (polydactyly) or missing fingers (syndactyly). Surgical interventions are often used to improve function and appearance, especially for cosmetic purposes or to enhance mobility.

8. Reconstructive Surgery After Severe Trauma
   For severe hand injuries such as crush injuries or amputation, reconstructive hand surgery plays a vital role in restoring function. Reconstructive procedures may include skin grafting, bone repair, and nerve or tendon reattachment.

Types of Hand Surgery Procedures

Hand surgery can be classified into several categories, including:

1. Minimally Invasive Surgery
   Minimally invasive surgery, or arthroscopic surgery, uses small incisions and a camera (arthroscope) to view and treat the affected area. This type of surgery results in less tissue damage, reduced scarring, and quicker recovery times. Common conditions treated with minimally invasive surgery include carpal tunnel syndrome and some joint injuries.

2. Open Surgery
   Open surgery involves making larger incisions to directly access and repair the damaged area. This is typically required for more complex issues, such as fractures, tendon repairs, or joint replacements.

3. Reconstructive Surgery
   Reconstructive hand surgery aims to restore hand function and appearance after significant injury or congenital defects. This may involve bone grafting, tendon transfer, nerve repair, or skin grafting.

4. Joint Replacement Surgery
   In cases of severe arthritis or joint deterioration, joint replacement surgery may be recommended. This procedure involves replacing a damaged joint, such as the thumb or finger joint, with an artificial one to reduce pain and improve mobility.

5. Tendon and Nerve Repair
   Tendon and nerve repair surgery are often required when these structures are injured due to trauma or disease. The goal of surgery is to restore normal movement and sensation in the hand.

6. Fasciotomy
   Fasciotomy is a surgical procedure performed to relieve pressure in the hand when swelling occurs following trauma, such as compartment syndrome. This procedure is crucial for preventing permanent damage to muscles and nerves.

What to Expect Before, During, and After Hand Surgery

Before Surgery: Before undergoing hand surgery, your surgeon will perform a thorough evaluation, including a physical examination, medical history review, and imaging tests (such as X-rays or MRIs). If you have any underlying medical conditions, such as diabetes or heart disease, these may need to be managed before surgery. Your surgeon will discuss the details of the procedure, potential risks, and expected outcomes.

During Surgery: Hand surgery may be performed under local anesthesia (numbing the area), regional anesthesia (numbing the arm), or general anesthesia (full sedation), depending on the complexity of the procedure. The surgeon will make the necessary incisions and perform the required repairs. The duration of the surgery depends on the type of procedure being performed.

After Surgery: Post-surgery care is essential for recovery. After the procedure, you may need to wear a splint or bandage to protect the hand and promote healing. Physical therapy or rehabilitation exercises may be required to restore strength, flexibility, and function in the hand. The recovery period varies depending on the type of surgery, with some patients returning to normal activities within a few weeks, while others may need several months for complete recovery.

Conclusion

Hand surgery is a vital aspect of orthopedic care that helps individuals regain function, alleviate pain, and improve their overall quality of life. From traumatic injuries to chronic conditions like arthritis, hand surgery offers various treatment options tailored to individual needs. Whether through minimally invasive techniques or more complex reconstructive surgeries, the field of hand surgery continues to evolve, offering patients improved outcomes and quicker recovery times.

If you are experiencing hand pain, discomfort, or limitations in movement, consulting with a skilled hand surgeon is crucial to determine the best treatment options for your condition. With advancements in surgical techniques and technology, patients can now enjoy better results and a faster return to their daily activities.