There has been significant progress in the treatment of hand injuries, degenerative diseases and congenital deficiencies in recent years. Plastic surgeons have played an important role in achieving this progress, their main interest being to restore both function and appearance. This article is designed to tell you what common hand problems are, what plastic surgeons do to correct these problems, and the results. It is not possible to answer all your questions, because each problem is unique and depends on individual differences. If there is anything you do not understand about the procedure, be sure to ask your doctor.
If You Are Considering Having Hand Surgery
If you are considering having hand surgery, it is a good idea to meet with a plastic surgeon. is the starting point. Your surgeon will evaluate you, explain treatment methods and decide whether surgery is necessary. If surgery is decided, the surgical procedure, where the surgery will be performed (office, clinic or hospital), the type of anesthesia and surgical techniques to be used, possible risks and undesirable consequences, recovery and rehabilitation time and possible results in function and appearance are discussed in detail.
Every Surgery Carries Some Uncertainty and Risk
Thousands of successful hand surgeries are performed every year. Even though these surgeries are performed by a skilled and experienced plastic surgeon and are safe, some undesirable consequences may occur.
In all types of hand surgery, such as infection, poor wound healing, loss of sensation or movement, and bleeding. problems may be encountered. However, although these are rare, they can usually be treated.
Hand Injuries
The most common procedures performed in hand surgery are; It includes repairing damage to tendons, nerves, vessels and joints, broken bones and burns, and skin injuries. Modern techniques have greatly increased the surgeon's ability to restore function and appearance even in cases of serious injury.
Techniques currently used by plastic surgeons include:
Grafting: The damaged area skin, bone, etc. from an intact part of the body to repair It is the transplantation of blood vessels or other tissues.
Flap surgery: It is the transfer of skin from a healthy part of the body to the damaged area, together with the underlying fat tissue, blood vessels and muscle tissue.
Replantation or transplantation: It is the process of reattaching severed fingers or hands using microsurgery, an extremely careful and delicate surgery performed under a microscope. Such injuries may require many repeated operations over a long period of time.
In many cases, surgery can restore significant sensation and function to the injured hand. However, recovery may take months and rehabilitation is often needed.
Carpal Tunnel Syndrome:
Carpal tunnel is a tunnel in the wrist through which the tendons and one of the main nerves of the hand pass. The pressure inside the tunnel may increase after various diseases (Rheumatoid arthritis, etc.), injuries, fluid accumulation during pregnancy, overuse or repetitive movements. This increased pressure on the nerve within the tunnel causes an electric sensation that is often accompanied by numbness, pain, and impaired hand function. The disease underlying these complaints is known as carpal tunnel syndrome.
In some cases, splinting the hand and anti-inflammatory medications will solve the problem. If this does not work, surgery may be required.
During the surgery, the surgeon makes an incision from the middle of the palm towards the wrist. Then, the tissues pressing on the nerve are cut to relieve the pressure. After the surgery, movement is restricted by dressing and using a splint, thus accelerating recovery. The surgical scar will gradually disappear and become barely visible.
The results of the surgery depend in part on how long the condition has existed and how damaged the nerve is. Therefore, if you think you may have carpal tunnel syndrome, it would be a good idea to consult a doctor early.
Rheumatoid Arthritis:
Rheumatoid arthritis is inflammation of the joints, hands and It is a disabling disease that can affect the appearance and function of other parts of the body. It often deforms the finger joints and places the fingers in a bent position that hinders movement. a forces it to stop.
Disabilities caused by rheumatoid arthritis can usually be treated without the use of surgery, for example; Physical therapy may be performed using special devices or to strengthen weakened areas. But for some patients, surgery is the best solution. You should decide whether to have surgery by talking to your surgeon and rheumatologist.
The wrist and hand can be treated by removing tissues from inflamed joints, relocating tendons, or placing artificial joints. Even though you may not be able to use your hand fully after surgery, you can expect a significant improvement in function and appearance. It should be noted that surgery does not cure your underlying disease. Rheumatoid arthritis can continue to damage your hand and sometimes require repeated surgery. You may also need to consult your rheumatologist for further treatment.
Dupuytren's Contracture
The disease of the skin and subcutaneous tissue of the palm is called Dupuytren's contracture. Thick, scar-like tissue forms under the skin in the palm and can advance to the fingers, pulling the finger into the palm and restricting movement. This disease mostly develops in middle age and although it has no known cause, it may be inherited in families.
The surgeon can separate the bands of thickened tissue and tendons and provide better movement to the finger. The surgery must be performed very carefully because the nerves of the hand and fingers are often tightly adhered to this abnormal tissue. In some cases, skin grafting can be used to replace thickened and folded skin.
The outcome of the surgery depends on the severity of the disease. Generally, there is a significant improvement in hand functions after physical therapy.
Congenital Defects
Congenital anomalies of the hand are present at birth, affecting hand development and causing significant problems in the use of the hand. are the deformities that cause it. With developing surgical techniques, most of the defects are corrected at a very early age, even during pregnancy in some patients and at the age of 2 or 3 in others, waiting for the normal development and function of the hand.
The most common congenital hand anomaly is syndactyly. Here two or more fingers are joined. As a surgical treatment, the tissues connecting the fingers are cut and then removed from another part of the body. The skin grafts taken are stitched into the gaps here. The procedure becomes more complicated if the bones are also united. Although surgery also provides full movement and near-normal appearance, the color of the grafted skin may differ slightly from other skin.
Other common congenital defects are short, missing or deformed fingers, immobile tendons, and abnormal nerves or vessels. . In most patients, these defects are corrected surgically.
Healing and Rehabilitation
Since the hand is a very sensitive organ of the body, pain may vary from mild to severe after surgery. Your surgeon can provide relief with injections or medication. How long your hand will be immobilized and how quickly it will regain its normal activities depends on the type and extent of surgery and how quickly you can recover.
Physical treatment by an experienced hand therapist may be required for your hand to heal faster and allow you to use it better. . Your therapy may include hand exercises, massage therapy, electrical nerve stimulation, splinting, stretching and special wraps. If you want to use your hands to the maximum, you should strictly follow the therapist's recommendations.
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