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What is hand surgery?

 

If your hand is impaired in any way, surgery may improve your condition. This type of very specialized surgery can treat diseases that cause pain and impair the strength, function and flexibility of your wrist and fingers. Surgery seeks to restore to near normal the function of fingers and hands injured by trauma or to correct abnormalities that were present at birth.

 

What hand surgery can treat

 

Carpal tunnel syndrome: A condition caused by pressure to the median nerve within the wrist, or carpal tunnel. You might feel pain, a tingling sensation, numbness of the fingers, weakness or aching. Carpal tunnel syndrome is associated with multiple conditions including: repetitive motion or overuse, fluid retention during pregnancy, injury to the nerve in the carpal tunnel or rheumatoid arthritis.

Dupuytren’s contracture: A disabling hand disorder in which thick, scar-like tissue bands form within the palm and may extend into the fingers. It can cause restricted movement, bending the fingers into an abnormal position.

 

Hand surgery and health insurance

 

Your health insurance plans will likely cover hand surgery, related complications or another surgery to reconstruct your appearance. Pre-certification is generally required for reimbursement or coverage. Be sure to consult with your insurance company in advance of any surgery.

Your satisfaction involves more than a fee. When choosing a plastic surgeon for hand surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

 

Hand surgery candidates

 

Hand surgery can be performed on people of any age and is a good option for you if:

• You do not have additional medical conditions or other illnesses that may impair healing
• You are a non-smoker
• You have a positive outlook and realistic goals for your hand surgery
• You are committed to following your plastic surgeon’s prescribed course of treatment
• In some conditions, hand surgery is necessary to treat wounds and to help painful conditions

 

Hand surgery procedure steps

 

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedures. The choices include local anesthesia, intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

 

Step 2 – The incision

 

Treating trauma

The most common traumatic hand or finger injury requiring hand surgery is tendon repair. When a tendon is cut, it will detract from the original wound site. Tendon repair retrieves the retracted tendon and reconnects it using surgical techniques to restore function and movement.

Carpal tunnel syndrome relief

Pressure on the median nerve in the carpal tunnel must be relieved to repair this condition. An incision is made from the middle of the palm to the wrist, allowing access to the constricted tissue causing pressure on the nerve. An alternate procedure is referred to as an endoscopic carpal tunnel release, with smaller incisions (see blue dotted lines) and the use of a surgical microscope or endoscope, a small flexible tube that contains a light and lens, to release pressure.

Birth deformities can be repaired

When fingers are fused together at birth, called syndactyly, they may be joined only by a web of skin or by skin and a partial fusion of bones. Surgery involves separating the two fingers to provide a full range of motion and a normal appearance, as well as permitting more normal finger growth. Techniques such as skin grafting or a local flap procedure like Z-plasty create flexibility at the incision site for growth and movement of the fingers.

Your plastic surgeon may recommend one or a combination of techniques to achieve your goals. Some of those techniques include: microsurgery, grafting of skin, bone, nerves or other tissue from healthy parts of the body, z-plasty and physical therapy.

 

Step 3 – Closing the incisions

 

Depending on your condition and type of treatment you may have incisions that need to be closed with removable sutures or your plastic surgeon may use non-removable sutures.

Carpal tunnel

Extensor tendon

Flexor tendon

Tenolysis

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