Hand surgery is performed to restore the structure and functionality of the fingers, wrist and hand secondary to a traumatic injury, medical condition, severe infection, or birth defect causing pain and/or deformity of the hand. It is performed by trained and certified plastic surgeons. The surgery is done either as an emergency procedure or as an elective procedure depending on the condition and its severity.
Conditions for which elective hand surgery is done include:
- Burn reconstruction
- Congenital deformities such as fused digits, extra digits and missing digits
- Tendinitis, an inflammation of the tendons, including De Quervain’s tendinitis of the thumb, flexor and extensor tendonitis of the wrist
- Tumours of the skin, soft tissue or bone
- Dupuytren’s contractures
- Ganglion cysts
- Trigger finger
- Compression syndromes e.g. carpal tunnel syndrome, cubital tunnel syndrome, distal ulnar tunnel syndrome and pronator syndrome
Conditions that may require emergency hand surgery include:
- Tendon injuries
- Nerve or artery injuries
- Fingertip injuries
- Other accidental injuries
Some of the most common procedures used for the treatment of these conditions and injuries include:
- Skin grafts: This involves the use of healthy skin from an area of the patient’s body to cover or resurface the injured area. This is most commonly used for burn reconstruction and amputation of fingers.
- Tendon repair: This is used for the management of ruptured tendons caused by trauma or sports injury by special sutures. Preferably the surgery is performed within 24 hours of the injury, as early surgery is associated with better outcomes.
- Nerve repair: This is a complex surgery done immediately after a nerve injury, as damage to any of the three main nerves of the hand may lead to limited use or hampered range of motion of the hand including the fingers and the wrist. It may also result in permanent disability.
- Closed reduction and fixation: It involves the realignment of the bones of the hand with the help of rods, wires, splints and casts. It is used for fractures with completely displaced and/or crushed bones.
- Joint replacement: This involves the replacement of the joints in the fingers and the wrist with a new joint made of silicone rubber, a portion of the patient’s tendon or a plastic or metal implant. This is usually done in patients with osteoarthritis or traumatic arthritis of the hand to relieve pain and restore function in the affected hand.