Hand Surgery

The hand is a unique area of the human body that serves many purposes in our day to day life. Anatomically, it is made up of bone, joints, ligaments, tendons, muscles, nerves, blood vessels andskin. The relationship between these structures is delicate and refined. All these elements must be in good working order for the hand to function well.

An injury or disease can affect any or all of these structures and impair the use of the hand.In such a case,attention must be paid to all the different types of tissues that make function of the hand possible. The aim is to restore optimum function and maximize the cosmetic appearance of the hand. Dr Amit Bhalotia has additional specialized training in diagnosis and treatment of all problems related to the hand, wrist and forearm.

Types of Hand Surgery

  • Closed Reduction and Fixation
    This technique may be used when there is a bone fracture in part of the hand, including the fingers. This type of surgery realigns the broken bone and then holds it in place, or immobilizes it, while it heals. Immobilization can be done with internal fixtures such as wires, rods, splints and casts.
  • Tendon Repair
    Tendons are fibres that attach muscle to the bone. Repair of tendons remains a surgical challenge because of the structure of the tendon. Tendon injuries can occur due to infection, trauma or spontaneous rupture like sports injuries. Tendon repair is classified based on the timing of surgery. Primary repair is within 24 hours and usually involves direct surgical correction of the injury. It can be delayed in the setting of an infection and maybe done after a few days.Secondary repair is usually done a few weeks after the injury and generally includes insertion of a tendon graft.
  • Nerve Repair
    Damage to nerves in the hand from an injury may affect hand function namely decreased sensation and/or movement. Some nerve injuries may heal on their own, while others require surgical intervention. In cases where nerve damage is not associated with more complicated injuries, surgery to check the damaged nerve is done as early as possible to increase chances of a full recovery. A severed nerve can be repaired by suturing the two ends together. If there is significant damage a nerve graft may be inserted to attain continuity.

Treatment for Infection

Hands being exposed parts of the body, are constantly at risk for injury and infection. Infections of the hand although common are mostly minor. The treatment may include rest, use of heat, elevation, antibiotics and rarely surgery.If there is a sore or abscess in the hand, surgical drainage may help remove the pus. If the infection or wound is severe, debridement may be done to clean the wound by removing dead and contaminated tissue from the wound. This prevents further infection and helps promote healing.

Replantation

This type of surgery reattaches a body part, such as a finger, hand or toe, which has been completely cut or severed from the body. The goal is to restore as much function as possible.   microsurgery to reattach all the important structures of the body part necessary for form and function. This is a complex type of surgery that uses tiny tools and is done under magnification using a microscope. In some severe cases, more than one surgery may be needed.

Recovery and Result

After surgery, a rehabilitation protocol is recommended to hasten recovery and increase the strength and function of the hand. A trained specialist will be involved in the care to optimize the recovery of the hand. Self-care and maintaining hygiene are important especially keeping the wound clean. Elevation of the arm and hand may be recommended to reduce swelling.

Some other helpful methods are:

  • Exercises for the hand
  • Heat therapy
  • Massage therapy
  • Splinting
  • Traction
  • Bandages to help control swelling
  • Nerve stimulation

Sometimes there may be a tingling or burning sensation which will disappear after a while.