Dramatic advances have been made in recent years in treating patients with hand injuries, degenerative disorders, and birth defects of the hand. At the forefront of these advances have been Plastic Surgeons whose major interest is improving both function and appearance. Plastic Surgeons undergo intensive training in hand surgery, and they (along with orthopedic surgeons and general surgeons) treat patients with a wide range of hand problems.
The most common procedures in hand surgery are those done to repair injured hands, including injuries to the tendons, nerves, blood vessels, and joints; fractured bones; and burns, cuts, and other injuries to the skin. Modern techniques have greatly improved the surgeon’s ability to restore function and appearance, even in severe injuries.
The carpal tunnel is a passageway through the wrist carrying tendons and one of the hand’s major nerves. Pressure may build up within the tunnel because of disease (such as Rheumatoid Arthritis), injury, fluid retention during pregnancy, overuse, or repetitive motions. The resulting pressure on the nerve within the tunnel causes a tingling sensation in the hand, often accompanied by numbness, aching, and impaired hand function. This is known as Carpal Tunnel Syndrome. In some cases, splinting of the hand and anti-inflammatory medications will relieve the problem. If this doesn’t work, however, surgery may be required.
Dupuytren’s contracture is a disorder of the skin and underlying tissue on the palm side of the hand. Thick, scar-like tissue forms under the skin of the palm and may extend into the fingers, pulling them toward the palm and restricting motion. The condition usually develops in mid-life and has no known cause (though it has a tendency to run in families).
Congenital deformities of the hand-that is, deformities a child is born with-can interfere with proper hand growth and cause significant problems in the use of the hand. Fortunately, with modern surgical techniques most defects can be corrected at a very early age-in some cases during infancy, in others at two or three years-allowing normal development and functioning of the hand. Other common congenital defects include short, missing, or deformed fingers, immobile tendons, and abnormal nerves or blood vessels. In most cases, these defects can be treated surgically and significant improvement can be expected.
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In your initial consultation Mr Klein will examine your hands and discuss the possible methods of treatment for your problem and if surgery is warranted. Don’t hesitate to ask Mr Klein any questions you may have, especially those regarding your expectations and concerns about the results. Mr Klein will explain the procedure in detail, including the risks and limitations, the type of anesthesia that will be used, the type of facility where the surgery will be preformed and the costs involved. Be sure to tell Mr Klein if you smoke, and if you’re taking any medications, vitamins, or other drugs.
Thousands of successful hand operations are performed each year. While the procedures are generally safe when performed by a qualified and experienced Plastic Surgeon, complications can arise. During your consultation the procedure will be explained in detail, including the risks and limitations.
|A. Carpel Tunnel Syndrome can cause tingling, numbness, or a dull ache in the shaded area shown in this illustration.|
|B. Mr Klein makes an incision from the palm to the wrist, providing access to the tissue that’s causing pressure on the nerve.|
|C. A section of tissue is cut, relieving pressure on the nerve and restoring feeling and function to the hand.|
|D. In Dupuytren’s Contracture, scar-like tissue in the palm pulls fingers into an abnormal position. The surgeon may make zig-zag incisions across this band of tissue, creating small skin flaps.|
|E. After surgery the repositioned flaps expand like an accordion, allowing freer finger motion.|
|F. In a typical Syndactyly, two fingers are fused together. The surgeon often uses zig-zag incisions to separate the fingers, creating triangular skin flaps.|
|G.Skin flaps cover most of the exposed areas between the fingers. Skin grafts are used to fill the shaded areas at the base of the fingers.|
Since the hand is a very sensitive part of the body, you may have mild to severe pain following surgery. Mr Klein may prescribe injections or oral medication to make you more comfortable. To enhance your recovery and give you the fullest possible use of your hand, your surgeon may recommend a course of rehabilitation (physical and occupational therapy) under the direction of a trained hand therapist. Your therapy may include hand exercises, heat and massage therapy, electrical nerve stimulation, splinting, traction, and special wrappings to control swelling. Keep in mind that surgery is just the foundation for recovery. It’s crucial that you follow the therapist’s instructions and complete the entire course of therapy if you want to regain the maximum use of your hand.