Plastic surgeons treat a variety of hand problems including injuries, degenerative problems and congenital problems. With appearance and function going "hand in hand" so to speak, plastic surgeons are eminently qualified and have extensive training to treat these types of problems. Hand therapists also play a major role to complement the efforts of the hand surgeon in maximizing efforts to rehab the injured or "operated" hand.
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. Techniques used now are:
Grafting - transfer of skin, bone, nerves or other tissue from a healthy part of the body to repair the injured part.
Flap surgery - moving the skin along with its underlying fat, blood vessels and muscle from a healthy part of the body to the injured part.
Replantation or transplantation - restoring accidentally amputated fingers or hands using microsurgery, an extremely precise and delicate surgery performed under magnification.
Endoscopic Carpal Tunnel
The "classic" surgery for carpal tunnel syndrome involves an open technique where a small incision is made over the region of the ligament which compresses the median nerve. This ligament is released to decompress the median nerve. With the introduction of endoscopic surgery in other locations in the body, some hand surgeons are using a similar technique at the wrist. Usually two small incisions would be substituted for one larger incision at the wrist level. The incidence of nerve injury is slightly higher with the endoscopic surgery, but the return to work time may be slightly shorter. Because of the slight increased risk to the median and ulnar nerves associated with endoscopic carpal tunnel surgery, the majority of surgeons prefer an open technique.
Known as an inflammation of the joints is a disabling disease that can affect the appearance and the function of the hands and other parts of the body. It also deforms finger joints and forces the fingers into a bent position that hampers movement. This can be managed without surgery by using splints or physical therapy to strengthen weakened areas.
Any area of the hand or wrist can be repaired or reconstructed by removing tissue from inflamed joints, repositioning tendons or implanting artificial joints.
Congenital deformities of the hand that a child is born with and can interfere with proper hand growth and cause significant problems in the use of the hand. Most defects can be corrected at an early age.
Syndactyly is one of the most common congenital defects. It is described as having two or more fingers fused together. Surgical correction involves cutting the tissue that connects the fingers and then grafting skin from another part of the body.
Other common defects include, missing, short, or deformed fingers, immobile tendons and abnormal nerves or blood vessels.