Dramatic advances have been made in recent years in treating patients with hand injuries, degenerative disorders, and birth defects of the hand. The skilled team of surgeons at Bragdon Stofman have extensive training and experience in hand surgery, treating patients with a wide range of hand problems.
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. Some of the techniques include:
- Grafting, which is the transfer of skin, bone, nerves, or other tissue from a healthy part of the body to repair the injured part.
- Flap surgery, which involves moving the skin along with its underlying fat, blood vessels, and muscle from a healthy part of the body to the injured site.
- Restoring function to injured fingers or hands using reconstructive techniques such as tendon transfers, flaps, microsurgery (an extremely precise and delicate surgery performed under magnification), can be very rewarding. Some injuries may require several operations over an extended period of time.
In many cases, surgery can restore a significant degree of feeling and function to injured hands. However, recovery can take months in the cases of more extensive procedures, and a period of hand therapy will most often be needed (see Recovery and Rehabilitation).
Carpal Tunnel Syndrome
The carpal tunnel is a passageway through the wrist that carries tendons as well as one of the hand’s major nerves. Pressure may build up within the tunnel due to disease (such as rheumatoid arthritis), injury, fluid retention during pregnancy, overuse, or repetitive motions. The resulting pressure on the nerve within the tunnel causes a tingling sensation in the hand, often accompanied by numbness, aching, and impaired hand function. This is known as carpal tunnel syndrome.
In cases where splinting of the hand and anti-inflammatory medications does not relieve the problem, surgery may be required.
The procedure consists of an incision from the middle of the palm to the wrist. The tissue that’s pressing on the nerve will then be cut in order to release the pressure. A large dressing and splint are used after surgery to restrict motion and promote healing. The resulting scar will gradually fade and become barely visible.
The results of the surgery will depend in part on how long the condition has existed and how much damage has been done to the nerve. For that reason, it is good to schedule a consultation with us as soon as possible if you think you may have Carpal Tunnel Syndrome.
Dupuytren’s contracture is a disorder of the skin and underlying tissue on the palm side of the hand. Thick, scar-like tissue forms under the skin of the palm and may extend into the fingers, pulling them toward the palm and restricting motion. The condition usually develops in mid-life and has no known cause (though it has a tendency to run in families).
Surgery is the only treatment for Dupuytren’s contracture. The procedure consists of cutting and separating the bands of thickened tissue, freeing the tendons and allowing better finger movement. It is important that the procedure be done very precisely, since the nerves that supply the hand and fingers are often tightly bound up in the abnormal tissue. In some cases, skin grafts are also needed to replace tightened and puckered skin.
There is now enzymes that can dissolve cord contractures in the hand that are used by the experts at Bragdon Stofman Plastic Surgery. Inquire if you are a candidate.
The results of the surgery will depend on the severity of the condition. You can usually expect significant improvement in function, particularly after physical therapy (see Recovery and Rehabilitation), and a thin, fairly inconspicuous scar.
Recovery and Rehabilitation
Since the hand is a very sensitive part of the body, you may have mild to severe pain following surgery. Depending on your condition as well as your needs, injections or oral medication can be prescribed to make you more comfortable. How long your hand must remain immobilized and how quickly you resume your normal activities depends on the type and extent of surgery and on how fast you heal.
To enhance your recovery and give you the fullest possible use of your hand, a course of rehabilitation (physical and occupational therapy) may be necessary under the direction of a trained hand therapist. Your therapy may include hand exercises, heat and massage therapy, electrical nerve stimulation, splinting, traction, and special wrappings to control swelling. Keep in mind that surgery is just the foundation for recovery. It’s crucial that you follow the therapist’s instructions and complete the entire course of therapy if you want to regain the maximum use of your hand.
Be sure to ask questions: It’s very important to address any concerns you have with our experienced staff. All successful surgeries begin with open and honest communication between doctor and patient. Are you considering plastic surgery? Contact us to schedule a consultation and let us educate you about your options and the procedures available.