Hand Surgery

What is Hand Surgery?

Hand and upper extremity surgery is a sub-branch of the orthopedics and traumatology department. The entire area between the shoulder and the fingers is included in the field of hand and upper extremity surgery.

The most functional area in the human movement system is the hands and upper extremities. The reason for the vulnerability to traumas that may cause illness or injury is usually hand and upper extremity diseases. For this reason, in cases where hand and upper extremity surgery is required, specialist and experienced doctors should definitely be consulted.

What are the Treatment Areas in Hand Surgery?

Hand surgery treatment areas can be listed as follows:

Fractures and dislocations that occur in the hand without an open injury
Ruptures in muscles and tendons
Skin lacerations
Very serious injury or rupture of the limb
Open injuries, burns and deformities
All types of congenital disorders, deficiencies and adhesions in the wrist and upper arm
Paralysis, infections, tumors and rheumatic diseases that develop due to trauma during birth
Sequelae that occur in the hand and wrist after trauma
Paralysis caused by accidental nerve cuts or functional losses caused by circulatory disorders
Correction of poorly or incorrectly healed fractures and dislocations
Deformities that develop over time after burns
Various nail disorders other than infection

How hand and upper extremity surgery is performed; It may vary depending on the problem to be treated and the scope of the procedure to be applied.

In cases where wrist compressions continue for a long time, weakness that will cause pain that will wake the patient up at night, and dropping objects held in the hand, surgery may be considered. An injection is given under the armpit to numb the entire arm. A tourniquet is applied to prevent blood flow. An incision is made between the palm and the wrist to access the tunnel through which the nerve passes. The thickened ligament that forms the roof of the tunnel is released. In advanced cases, the thickened nerve sheath of the nerve may also need to be released.

In wrist cyst surgery, the entire arm is numbed with regional anesthesia. The mass is reached with a 2 cm incision made over the cyst. There is a risk that the thin wall of the mass will burst during surgery. For this reason, the mass is carefully separated from its surroundings and followed up to the joint. The success of the application is important in terms of reducing the risk of recurrence of the cyst.

If the problem has lasted for a long time in patients with trigger finger and there is no response to medical treatment, a surgical procedure may be required. The bridges causing the compression are surgically loosened. A small incision is made in the palm and the vascular nerve structures that run close to the tendon sheath are protected. After the tendon is released, the patient’s finger is moved to check whether there is a regression in the complaint.

The most important point in the treatment of finger and hand ruptures is how the rupture is performed. In addition, the length of time from the rupture to the surgery has a direct effect on the success rate of the surgery. Another important issue is how the severed limb is transported to the hospital.

In vascular injuries, there is not only blood loss, but also the risk of tissue death, as the blood flow to the tissues may decrease. It may be possible that movement commands cannot be transferred to the senses due to nerve injuries.

In tendon injuries, some problems may occur while transferring muscle power to the bones. In such injuries, hand and upper extremity surgical procedures may be required.

What Diseases Does Hand Surgery Treat?

Hand and upper extremity surgery deals with the treatment of pathologies such as cutting or blunt traumas, tumors, congenital anomalies, orthopedic problems caused by excessive use, infections and calcifications that negatively affect the functions of the hand, wrist, elbow, arm and forearm.

Traumatic injuries to various parts of the hand and upper extremity are frequently encountered in daily life. Tendon lacerations, skin and muscle tissue losses due to compression and crushing, acute soft tissue traumas such as peripheral vascular and nerve lacerations, fractures or long ruptures are mainly among the subjects of hand and upper extremity surgery. Microsurgical interventions, which are frequently used especially in the repair of damaged vascular and nerve structures and the stitching of amputated limbs, attract attention with their high success rate.

Carpal Tunnel syndrome (nerve compression in the wrist), DeQuervain tendonitis (tendon inflammation), ulnar entrapment neuropathy (nerve compression in the elbow joint), ganglion cysts, trigger finger, tennis elbow, golf elbow and Duputyren’s disease are among the diseases that hand and upper extremity surgery treats non-traumatically.

Wrist and elbow arthroscopy treatment can be applied for cartilage – bone and tendon – ligament problems in the wrist and elbow regions. Calcifications in the wrist and finger joints can be treated with wrist or small joint prosthesis applications. Tendon transfer may be considered for hand and finger deformities that occur due to neuromuscular diseases, congenital diseases or acquired traumatic shapes.