Hands

Surgery of the Hand and Wrist

The human hand can be elaborate and complex. There are many common injuries to the hand and wrist that may need surgical repairing, including:

  • Carpal Tunnel Syndrome
  • Arthritis Treatment
  • Upper Extremity Joint Replacement
  • Trauma Care
  • Cancer Treatment
  • Pediatric Fracture
  • Birth Defect Correction
  • Workplace Injuries

While this list is only a few of the injuries to the hand or wrist that may need surgery, all of these should be seen by a medical professional. The goal of surgery is to restore function, decrease the chance of re-injury, and minimize pain.


Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is when the nerve in the wrist, located in the carpal tunnel, is pinched causing swelling and pressure on the nerve. Symptoms of carpal tunnel can include pain, numbness, tingling, and a weak grip. The severity of each case depends on what treatment is needed. For mild carpal tunnel syndrome changing patterns of hand use, keeping the wrist splinted in a straight position, or wearing a wrist splint at night may help improve symptoms. For moderate carpal tunnel syndrome steroid injection into the carpal tunnel may be needed to lessen the pain of symptoms. However, this is only a short-term fix to the problem. If the syndrome is severe, surgery may be needed to decrease the amount of pressure being put on the nerve. After surgery it may take up to a week to begin normal activities with the hand, and can take three to four months before being completely healed. It is common for patients to be back to normal activities after a month. However, in some severe cases the nerve may need additional months to heal.


Tendon and Ligament Injuries

Tendon and ligaments are both connective tissue; however tendons connect muscle to bone, while ligaments connect bone to bone. They are both injured when the soft tissue that connects the muscles and joints tear or rupture. This may happen due to a sudden impact to the joint, quickly stopping or starting, or an abrupt movement to the joint. A tendon or ligament injury can happen to any joint in the body, but the knees are the most common area. Symptoms for an injured tendon or ligament include pain, swelling, a popping or clicking sensation, or an inability to straighten the knee. If you injure a tendon or ligament you should seek immediate medical attention. The physician will collect your medical history, perform a physical exam, and ask questions regarding the injury. From there, the physician will diagnose the injury and provide you with the treatment needed. These treatments may include wearing a brace, physical therapy, rest, ice, compression, elevation, and surgery.


Joint Replacement for the Hand and Wrist

Joint replacement of the hand and wrist is very similar to knee or hip replacement. The damaged joints are replaced by a prosthetic joint that can be made of silicone, polyethylene, titanium, or pyrocarbon. It is less common for the joints to be replaced in the hands or wrist, because the bone structure of the hand is small and complex, making the surgery more challenging. Since joint replacement is a major surgery, some things to consider before deciding on the surgery are the recovery time, age, pain, and disability. Surgery may be a good idea if you cannot complete regular daily tasks without assistance, have significant pain everyday, pain does not go away when you rest, non-surgical approaches do not provide relief, or pain keeps you awake at night.


Microvascular / Replantation Surgery

Microvascular surgery is a broad term that refers to surgery for patients who have suffered from a detached body part. During the surgery the severed body part is reattached and with extensive therapy it may be possible to regain functionality of the body part. In the case of an emergency amputation make certain to stabilize the patient, apply steady pressure, and elevate the body part. Then, collect all the severed tissue wrapping it in saline-soaked gauze and placing it in a plastic bag on top of ice. The successfulness of the surgery may depend on the amount of original tissue the surgeon is able to use.

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