Significant progress has been made in the treatment of hand injuries, degenerative diseases and congenital deficiencies in recent years. Plastic surgeons have played a valuable role in making this progress, whose main concern is to improve both function and image. This article is designed to tell you what common hand problems are, what plastic surgeons do to correct these problems, and the results. It is not possible to answer all your questions, because each problem is unique and dependent on individual differences. If there is anything you do not understand about the procedure, definitely ask your doctor.
If You Are Considering Having Hand Surgery
If you are considering hand surgery, meeting with a plastic surgeon is a good starting point. Your surgeon will evaluate you, explain the treatment methods and decide whether surgery is necessary. If surgery is decided, the surgical procedure, where the surgery will be performed (in the practice, clinic or hospital), type of anesthesia and surgical techniques to be used, possible risks and undesirable results, duration of beautification and rehabilitation, and possible results in function and image are discussed.
Every Surgery Carries a Measure of Uncertainty and Risk
Thousands of successful hand surgeries are performed each year. Although performed by a skilled and experienced plastic surgeon and these surgeries are faithful, undesirable results may occur.
In all types of hand surgery, problems such as infection, macular wound healing, loss of sensation or movement, bleeding may be encountered. But while these are rare, they can often be treated.
The most common processes in hand surgery; It includes repairing damage to tendons, borders, vessels and joints, broken bones and repairing burns and skin injuries. Contemporary techniques have greatly increased the surgeon’s ability to restore function and view, even with major injuries.
In the midst of techniques currently used by plastic surgeons:
Grafting: It is the transplantation of skin, bone, border or other tissues from a healthy part of the body to repair the damaged area.
Flap surgery: It is to move the skin from a healthy part of the body to the damaged area together with the underlying fat tissue, blood vessels and muscle tissue.
Replantation or transplantation: It is the process of replanting severed fingers or hands using microsurgery, which is a very careful and subtle surgery performed under the microscope. These types of injuries may require many repetitive operations over a wide period of time.
In many cases, valuable sense and function can be restored to hands that have been injured as a result of surgery. However, recovery can take months and often requires rehabilitation.
Carpal Tunnel Syndrome:
The carpal tunnel is a tunnel in the wrist through which the tendons and one of the main boundaries of the hand pass. The pressure inside the tunnel may increase after various diseases (rheumatoid arthritis, etc.), injuries, fluid collection during pregnancy, excessive use or repetitive movements. This increase in pressure above the end of the tunnel causes an electrifying sensation, often accompanied by numbness, pain, and impaired hand function. The disease under these complaints is known as carpal tunnel syndrome.
In some cases, splinting the hand and anti-inflammatory drugs will solve the problem. If that doesn’t work, surgery may be needed.
In surgery, the surgeon makes a real incision from the middle of the palm to the wrist. Then, the tissues that put pressure on the end are cut to reduce the pressure. After the operation, the movement is restricted by dressing and using a splint, thus smoothing is accelerated. The surgical scar will gradually disappear and the strength will become visible.
The results of the surgery depend, in part, on how long the condition has existed and how much damage the border has been. Therefore, if you think you may have carpal tunnel syndrome, it would be a good idea to consult a doctor in the early period.
Rheumatoid arthritis is an inflammation of the joints, a disabling disease that can affect the appearance and function of the hands and other parts of the body. It often deforms the knuckles and forces the fingers to stay in a bent position, which hinders movement.
Disabilities caused by rheumatoid arthritis can often be treated without the use of surgery, for example; Physical therapy can be done using special devices or to strengthen weakened areas. However, for some patients, surgery is the best solution. Talk to your surgeon and your rheumatologist and decide whether or not to have surgery.
The wrist and hand can be treated by removing tissues from inflamed joints, replacing tendons, or placing artificial joints. Although you may not be able to use your hand fully after surgery, you can obviously expect an improvement in function and appearance. It should be noted that surgery does not cure your underlying disease. Rheumatoid arthritis can continue to damage your hand, and repeated surgery is sometimes required. You may also need to consult your rheumatologist for the continuation of the treatment.
The disease of the skin and subcutaneous tissue of the palm is called Dupuytren’s contracture. Thick, scar-like tissue forms under the skin on the palm and can travel to the fingers, pulling the finger real into the palm and restricting its movement. This disease usually develops in middle age and has no known cause, but it can be familial.
The surgeon can separate the bands of thickened tissue and tendons and provide a smoother movement to the finger. Surgery must be done very carefully, as the ends of the hand and fingers are often firmly attached to this unusual tissue. In some cases, skin grafts can be used instead of thickened and folded skin.
The outcome of the surgery depends on the severity of the disease. Often there is a clear improvement in hand functions after physical therapy.
Congenital anomalies of the hand are deformities present at birth that affect hand development and obviously cause problems in the use of the hand. Together with the developing surgical techniques, many of the defects are corrected at a very early age, even during pregnancy in some patients and at the age of 2 or 3 years, waiting for the normal development and function of the hand in others.
The most common congenital hand anomaly is syndactyly. Here, two or more fingers are joined. As a surgical treatment, the tissues connecting the fingers are cut, then skin grafts taken from another part of the body are stitched into the spaces there. The procedure becomes more complicated if the bones are also joined. Although surgery provides full movement and a near-normal view at the same time, the color of the grafted skin may be slightly different from the other skin.
Other common congenital defects are short, missing, or deformed fingers, immobile tendons, and unusual borders or veins. In more than one patient, these defects are surgically corrected.
Recovery and Rehabilitation
Since the hand is a very sensitive organ of the body, there may be pain ranging from mild to severe after surgery. Your surgeon can help you relax with injections or medication. How long your hand will be immobilized and how quickly it will regain its normal activities depends on the type and extent of the surgery and how quickly you can recover.
Physical therapy may be required by an experienced hand therapist in order for your hand to heal faster and to use it more properly. Your therapy includes hand exercises, massage therapy, electrical boundary stimulation, splinting, stretching and special wraps. If you want to use your hand to the maximum, you must strictly follow the therapist’s offers.