Hand surgery is a common procedure aimed at restoring function, relieving pain, and improving the appearance of the hands for individuals suffering from injuries or arthritis. These surgeries are typically performed under general anesthesia or local anesthesia with sedation, and they can often be done on an outpatient basis. Many hand surgeries are now performed using minimally invasive techniques like laparoscopy, offering the benefits of smaller incisions, less scarring, reduced bleeding, and shorter recovery times.

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Hand Surgery Procedures

There are various surgical procedures that can be performed on the hand, depending on the extent of the damage and the type of issue. These procedures may involve removing damaged tissue, repositioning tendons or ligaments, fusing joints, repairing nerves or tendons, or replacing a joint with a prosthetic.

Arthrodesis or Fusion

Arthrodesis, also known as joint fusion, is a surgical procedure used to treat severe cases of degenerative osteoarthritis. The procedure involves fusing the bones of the affected joint to manage pain and improve stability. During this procedure, cartilage is removed, and two or more bones are joined together so they no longer move. Fusions may be performed using screws, plates, pins, or a combination of these materials. While joint movement will be limited after the surgery, the fusion provides significant pain relief and greater joint stability.

Arthroscopy

Arthroscopy is a minimally invasive procedure used for diagnosing and treating joint problems. A small incision is made to insert an arthroscope, a thin tube with a miniature camera, into the joint. This allows the surgeon to view the joint and perform minor repairs, such as removing damaged cartilage or bone fragments, without the need for a large incision.

Osteotomy

Osteotomy involves the removal of a section of bone near a damaged joint to correct misalignment and treat osteoarthritis. This procedure aims to restore the proper alignment of the joint by cutting or repositioning the bone.

Synovectomy

Synovectomy is a surgical procedure that removes the synovium, the tissue lining the joints, to reduce pain and swelling. It is primarily used to treat rheumatoid arthritis and can help slow the progression of the disease.

Repairing Flexor Tendons

Flexor tendons attach the bones of the fingers to the muscles that enable them to bend. When a flexor tendon is torn, the affected fingers may still bend, but the movement will be painful and limited. If the tendon is completely cut, the finger will lose its ability to bend altogether. Surgery is required to repair the tendon, though full normal function may not be restored. Physical therapy is often necessary to reduce scar tissue and improve mobility after the surgery.

Nerve Injury Repair

Hand nerves are delicate and may be damaged by cutting, pressure, or stretching. When nerves are injured, the transmission of signals between the hand and the brain is disrupted, leading to loss of sensation and muscle dysfunction. To repair a nerve, the surgeon must carefully sew the torn ends together, often using a nerve graft if part of the nerve is missing. Nerve fibers will eventually regenerate, but this can take time—sometimes years. It’s common to experience sensations like “pins and needles” during recovery, which typically subside as healing progresses.

Risks of Hand Surgery

As with any surgery, there are risks associated with hand surgery, including:

  • Adverse reactions to anesthesia
  • Nerve damage or loss of sensation
  • Blood clots
  • Post-surgical infection
  • Limited range of motion

However, these risks are generally rare, especially when the surgery is performed by an experienced and skilled hand surgeon.

Recovery from Hand Surgery

After hand surgery, patients may experience mild to severe pain, which is usually managed with prescribed pain medication. The hand may need to be immobilized for a few days to a few weeks, depending on the type of surgery performed. Physical therapy is often required to restore function, increase strength, and improve the range of motion in the hand. Recovery times vary depending on the complexity of the procedure, but with appropriate care, most patients can expect significant improvement in hand function and pain relief.

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