What is Hand Surgery?
Hand surgery deals with the problems of hands, arms, shoulders, artery and vein cuts, congenital diseases, muscle paralyses and also benign and malignant tumors.
Most common diseases:
Mallet Finger.
Mallet finger is an injury to the uppermost joint of a finger. When the tendon that straightens your finger is damaged after a fall or hit, you are not able straighten the tip of your finger.
Treatment
A mallet finger is treated with a splint worn for two weeks. Surgical treatment is considered if the finger does not get better after a splint or a big peace of bone is pulled away with the tendon.
Dupuytern’s Contracture
Dupuytren’s Contracture occurs when the tissue beneath the skin of the palm and fingers thickens.
This thickening starts in the palm and can extend into the fingers and makes the fingers bend into the palm.
Risk Factors include genetics, ageing, chronic diseases (diabetes mellitus, seizure disorders and epilepsy) and alcoholism. Men are more likely to develop this disease.
When is the surgery performed?
The surgery is required if you are not able to stretch your arm straight on the table or the disease lingers your daily activities.
Treatment
- Injections: some medications are injected into thickened areas. The needle will be inserted several times to divide the thickened tissue. However, this method might hurt the nerves and joints.
- Surgery: it is the most efficient treatment method. By means of surgery thickened tissue and knots under the skin will be removed.
Tendon Injuries
Extensor tendons lie next to the bone on the back of the hand and fingers which straighten the wrist, fingers and upper arm. The cuts on this area mostly hurt extensor tendons.
The flexor tendons are the tissues that bend the fingers and wrist. They are located in the hand and forearm. These tendons are injured as a result of cuts in your hands and arms. Because the nerves to the fingers are also very close to the tendons, the cut may injure them, too.
Treatment
When there is a cut the torn tendon is repaired in 2-3 weeks and the patient wears a splint on the hand. A physical therapy is advised after the surgery.
Hand Fractures
You may have hand fractures as a result of falling, crush or blow. These fractions can be open or closed. If you have closed hand fracture you may experience severe pain, bruising, swelling and stiffness in your hand. You may also have inability to move your fingers. In open fracture a bone breaks through the skin.
Treatment changes due to the shape and location of the fracture. A splint is worn after the bone is set and held in place with wires or plates. After wearing the splint for 6 weeks, you al should start physical therapy.
Hand Cancer
Cancer refers to a tumor. The majority of tumors in the hand are benign and the treatment is considered complete when the tumor is removed. The most common tumor is ganglion which often occurs in the wrist. It looks like a cyst which contains sticky, colorless, jellylike material. Because of its density it is a giant cell tumor that occurs in the joint and develops slowly. Its treatment is surgical.
Nerve Palsies
Radial nerve palsy: it is responsible for extending the wrist and fingers. Injuries to the arm, forearm or wrist area can lead to Radial nerve palsy.
It should kept in mind that Radial nerve recovers 1 mm a day. If the nerve is not repaired or does not heal after the treatment you will not be able to open your hand and fingers.
Median Nerve Palsy: the nerve starts in the elbow and forearm, continuous to the wrist and provides sensibility of middle and baby fingers. When the Median nerve is damaged middle and baby finger lose their sensibility and makes it difficult to bend the hand.
Treatment; in the shortest time the nerve must be repaired. Otherwise, you will not be able to fold your fingers.
Ulnar nerve palsy
The nerve starts in the inner part of the elbow and arm and continuous through the wrist and provides sensibility of outer part of index finger and baby finger. When the nerve is damaged sensibility in index and baby finger reduces and as a result the patient cannot fold his fingers.
Treatment
A tendon is transferred.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a medical condition which happens due to compression of the median nerve in the wrist.
Symptoms: It causes pain, numbness and tingling in the thumb, index finger and middle finger and some part of the ring finger. It also causes muscle weakness in the hand and dries the skin.
The pain tends to develop and get worse at night and sleep is severely disturbed.
Treatment: A small incision (2-3 cm) is made in the wrist and the tissue that causes pressure is released. After the surgery a splint is worn.
Cubital Tunnel Syndrome
Cubital tunnel syndrome is a condition that involves pressure of the ulnar nerve.
Symptoms: It causes numbness, tingling or weakness in the ring and small finger. Even you cannot bring your fingers close to each other and have pain when you keep the elbow straight.
Treatment: In this surgery a small incision (2-3 cm) is made along the inside of the elbow which releases the pressure.
Finger disconnections
At first the patient’s condition is evaluated and then the torn parts are stitched under a microscope.
First the torn peace is wrapped with wet cloth and put into a package, and placed in another packet filled with ice. It must not be kept directly in water or ice.
Trigger Finger
Trigger finger is a disease of the tissues that bend fingers and cover the tendon. Trigger finger occurs when tendons in fingers are become inflamed. Pullet results in difficulty flexing and extending the finger.
Treatment: An incision (1 cm) is made in the base of the finger and the pullet is released.
Syndactyly (webbed finger)
It means adjacency of two or more fingers. The disease happens when there is a disorder during the separation of fingers in the womb. Webbed finger syndrome is one of the most common genetic diseases. There are some types of syndactyly:
- Complete: when the fingers are completely joined together.
- Incomplete: when the join involves only part of the sides of the fingers.
- Complex: when the bones, nerves and vessels are joined together.
- Complete Complex: when all fingers, bones, nerves and vessels are joined together.
Treatment: A surgery is performed to separate the joined fingers. There are many types of the surgery.
Polydactyly
Polydactyly is a condition in which a person has extra hands or fingers.
Treatment: the extra finger is removed by surgery.