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What You Need to Know about Chicago Orthopedic Hand Surgery

Hand surgery is a broad term that refers to all procedures that deal with problems of the hand, wrist, and forearm. Our hands have numerous purposes and functionalities, but just like other parts of the body, they are also prone to damage. The damage in one’s hands can occur due to degenerative reasons, age-related wear and tear, and injuries sustained in accidents and other unfortunate situations. The primary purpose of hand surgery is to restore the functionality and tackle the source of pain. We are the very best when it comes to Chicago hand surgery and have put together this guide to help you educate yourself further on the procedure. 

Do I need a hand surgery?

Surgery is always considered as the solution that doctor recommends in cases when all other treatments prove to be ineffective. The decision whether to undergo hand surgery or not depends on a variety of factors such as:

  • Your response to other treatment
  • Your needs
  • Severity of symptoms

Types of hand surgery

There is a wide array of surgeries that can be performed on the hand. Here are some examples:

Joint replacement

Joint replacement or arthroplasty is performed in cases of severe hand arthritis. The procedure involves replacing an affected joint with the artificial one. The new joint consists of silicone rubber, metal, or the tissues of a patient like a portion of a tendon. Your Chicago hand surgeon will evaluate your symptoms, perform a physical exam, and order the x-ray. In case there is a significant joint destruction or deformity, he or she will recommend surgery. Joint replacement surgery is usually performed in older, low-activity individuals as well as patients with rheumatoid arthritis. The primary purpose of this surgery is to relieve pain, improve hand function, and increase the range of motion in fingers.

Tendon repair

Tendon is a tough cord of tissue which connects bones and muscles. In case one or more tendons in the hand are damaged, the surgery is required to repair the problem. During the procedure, the surgeon makes an incision in the wrist, hand, or finger to locate the ends of the divided tendon and stitch them back together. Although extensor tendons are quite easy to reach and repair, the flexor tendons are quite tricky because the entire flexor tendon system is complex. When it comes to tendon repairs, there are three types of this procedure:

  • Primary repair – performed on sudden or acute injuries, usually within 24 hours after the injury occurred
  • Delayed primary repair – conducted a few days after the injury when there’s still an opening in the skin from the wound
  • Secondary repair – done 2 to 5 weeks (or even longer) after the injury has been sustained

Both types of tendons require a lengthy recovery time to restore full functionality in the hand. Repaired tendons are still going to continue to be weak until they make a full recovery.

Nerve repair

Injured or damaged nerves can cause a tremendous pain and limit the functionality of the affected hand. Although some nerve injuries can heal on their own, others require surgical treatment. In this case, the surgery occurs between 3 or 6 weeks after the injury. There are several types of nerve repair, such as:

  • End-to-end closure – the simplest procedure that also carries the best prognosis. It’s usually performed in patients in whom the nerve gap is shorter than 2cm and in cases where the nerve can be repaired without tension
  • Nerve grafting – usually conducted to bridge the gap between two ends that can’t be easily approximated
  • Nerve transfer – transfers damaged or minor motor pathways and utilizes them to re-innervate major pathway

Fasciotomy

Fasciotomy is a procedure that aims to treat compartment syndrome. Compartment syndrome is a painful condition which occurs when excessive pressure builds up inside an enclosed space in the arm. In a vast majority of cases, the compartment syndrome is caused by an injury.

During the procedure, a doctor makes an incision in the hand or your arm. This maneuver reduces the pressure, lets the muscle tissue swell, and restores the blood flow. At this point, your doctor will remove any tissue inside the damaged area.

Other types of hand surgeries include:

  • Carpal tunnel release
  • Trigger finger release
  • Trapeziectomy

Anesthesia for hand surgery

There are different types of anesthesia used for hand surgeries. Naturally, the type of anesthesia depends on the procedure your doctor is about to conduct. Here are the anesthetic techniques for surgical procedures on your hands:

  • Local anesthesia – used for simple and small procedures which are performed quickly
  • Hematoma block – for manipulation of some fractures
  • Regional anesthesia – uses medications to block sensory functions of specific nerves
  • General anesthesia – used for more complicated procedures to put the patient to sleep

Recovery

In most cases, the patient can leave the hospital the same day. Depending on the severity of injury or condition and duration of surgery, the patient is required to spend the night in the hospital, but these instances are rare.

The overall recovery time depends on the type of hand surgery, the healing process, and whether the patient follows doctor’s instructions religiously. For example, tendon and nerve repairs or more complicated procedures can take up to a year to reach full functional recovery. The wounds take up to a few weeks to heal. When it comes to joints, it takes several weeks or even longer for the joint to maximally recover.

The patient is recovered to follow specific rehabilitation and activity program suggested by a physician to protect joints from further damage and accelerate the recovery.

After the surgery, your doctor will recommend antibiotics or painkillers to ease the pain. Most physicians recommend using splints to protect the bone and healing tissue.

Conclusion

Hands are prone to different types of damage and injuries that have a tremendous potential to affect the person’s quality of life. The surgery is always the last option, and it’s considered only when all other treatments don’t work to improve functionality and ease the pain. There are different types of hand surgeries, the choice of anesthesia and recovery time depend on the type of surgery as well as patient’s overall condition, your orthopedic hand surgeon should go over all options. If you’re about to undergo a hand surgery, make sure you follow doctor’s orders entirely in order to speed up your recovery.

References

http://www.arthritisresearchuk.org/arthritis-information/surgery/hand-and-wrist-surgery/do-i-need-surgery.aspx
http://www.medicinenet.com/joint_replacement_surgery_of_the_hand/page4.htm
http://www.nhs.uk/conditions/tendonhand/pages/introduction.aspx
http://emedicine.medscape.com/article/1287077-treatment#d10
http://www.handwristcenter.com/anesthesia.cfm
http://oactdocs.com/hand-injuries-and-problems