What is hand surgery?
Hand surgery is that arm of medicine that deals exclusively with the disorders, injuries and treatments of the hand.
Hand surgery requires special training in its technique since reconstruction of the delicate structures of the hand (veins, nerves, tendons and bones) require precision and a sound knowledge of its anatomy and functions.
Unfortunately, by the time most people consult a hand surgeon, the hand has shown advanced loss of function. In these cases, total function cannot always be re-established.
Another frequent problem is that complications that result from surgery performed by a less accomplished surgeon may not easily be rectified later by hand surgeon.
When should you turn to a hand surgeon?
A hand surgeon should be consulted in the following instances.
The Buda Health Center ensures all diagnostic services and surgical requirements of hand surgery.
- When injury to the wrist or fingers is followed by pain, numbness, swelling and/or restricted movement. This might be an indication of possible bone injury, tendon tear, ligament injury or strain. The belief that there is no breakage if you can move a finger is false.
- In the case of tunnel syndrome. This condition results when the nerves of the hand are under pressure causing numbness of the fingers, clumsiness, decreased ability to grip and squeeze and, in later stages, muscle atrophy.
- In the case of tenosynovitis (inflammation of the tendon sheath). This might occur in various locations of the hand, in varying degrees of severity. One typical symptom is when the fingers are stuck in a bent position, resulting in the so-called snapping fingers. Another frequent location is the pressure sensitive area where the wrist and thumb meet and painful when moving the thumb. Similar symptoms may be caused by abrasion of the cartilaginous surface of the saddle joint or arthrosis. Arthrosis often is the cause of deformities of the facet joints of the hand
- When a soft area, a so-called ganglion, appears on the wrist or possibly at the base of the fingers. These are usually benign growths originating in the articular capsule or the tendon sheath and only surgically removable. A specialist must be consulted whenever a growth is found.
- When middle-aged and older men develop compact nodules on the palms of their hands pulling the fingers in towards the palm and impeding the fingers from stretching out resulting in the so-called Dupuytren’s contracture.
- When body builders, tennis players and combat sports athletes suffer hand and wrist injuries due to extreme straining, since following injuries, inflammation, oedema and micro-injuries may develop at the point of tendon insertion, the tendon-muscle junction or at the section where the tendon is surrounded by the tendon sheath. The wrist’s ability to sustain pressure depends largely upon the ligament system’s stability and the anatomical structure of the wrist which needs to be determined by a specialist.
- All lost hand functions cannot be restored through surgery; however, some problems may be eliminated, loss of movement often replaced with various plastic surgery methods and, where the movement function is retained, a pain-free state attained with denervation. Also, tendon grafting, nerve transplant, bone reconstruction, replacement surgery and, in simpler cases, broken bone repair surgery, tendon and nerve sutures will ensure the functional anatomical requirements. The complete functional capacity of snapping fingers, ganglions and tunnel syndrome may be regained through surgery and that of tenosynovitis, tennis and golf elbow through conservative, injection or surgical treatment. Unusual abnormalities such as extra fingers, fingers fused together or missing fingers may also be corrected surgically.
Our current knowledge of anatomy, the treatment of injuries and malformations of the hand, the technical progress in instrumentation and suture materials as well as the microscopic surgical techniques turned hand surgery into a separate, independent arm of medicine.
Extremely delicate surgical techniques and special knowledge are required in the reconstruction of the hand’s structures, the tendons, nerves and veins, the bone and joint systems, that together control and are responsible for the workings of the hand.
The hand plays an important part in our daily activities, our work, hobbies and sports activities as well as in transmitting our feelings towards our children and loved ones, through touch.
To the hand surgeon-traumatologist there is no greater experience and satisfaction than in seeing a patient’s lost hand function restored together with his or her earlier capabilities.