Hand and wrist surgery is a specialized field of orthopedic surgery that focuses on the diagnosis, treatment, and rehabilitation of disorders and injuries affecting the hand, wrist, and forearm. Surgeons in this field use minimally invasive techniques and advanced technologies to treat a range of conditions, including carpal tunnel syndrome, trigger finger, ganglion cysts, Dupuytren's contracture, and fractures. They also perform reconstructive surgery to repair damaged tendons, ligaments, and nerves, as well as microsurgical procedures to reattach severed digits or repair damaged blood vessels. In addition to surgical treatment, hand and wrist surgeons also work closely with physical therapists to develop customized rehabilitation plans to help patients regain strength, flexibility, and mobility in their hands and wrists. The goal of hand and wrist surgery is to restore function, alleviate pain, and improve quality of life.
a. Carpal Tunnel Release
Carpal tunnel release is a common surgical procedure in plastic surgery that relieves compression of the median nerve in the wrist, causing numbness, tingling, and weakness in the hand. The procedure involves making an incision in the wrist to release the compressed nerve, often due to swelling or scar tissue. Plastic surgeons perform carpal tunnel release to alleviate symptoms such as pain, numbness, and weakness in the hand and fingers. The surgery typically takes about 30-60 minutes and can be done under local or general anesthesia. Recovery time is usually short, with patients able to resume normal activities within a few weeks.
b. Tendon repair
Tendon repair is a common procedure in plastic surgery that involves repairing or reconstructing damaged or injured tendons. This can occur due to trauma, surgical complications, or congenital conditions. The goal of tendon repair is to restore the tendon's normal function, mobility, and strength. The procedure typically involves making small incisions to access the damaged tendon, cleaning and preparing the area, and reattaching the tendon using sutures, wires, or other fixation devices. Reconstruction may also involve grafting or using other tissues to reinforce the repaired tendon. Recovery time varies depending on the extent of the injury and the individual's overall health.
c. Tendon transfers for wrist drop and claw hand
Tendon transfers are a reconstructive surgery technique used to treat wrist drop and claw hand deformities in plastic surgery. Wrist drop occurs when the wrist extensor muscles are damaged, causing the wrist to sag, while claw hand is a condition where the fingers are flexed and curled due to nerve damage. In tendon transfers, healthy tendons from other parts of the body are transferred to the affected area to restore function. The procedure involves disconnecting the donor tendon from its original attachment point and reattaching it to the muscles or bones of the wrist or hand. This can help restore normal hand function and alleviate symptoms.
d. Fracture Management
Fracture management in plastic surgery involves the diagnosis, treatment, and rehabilitation of bone fractures that occur in the face, hands, and other areas. Plastic surgeons work closely with orthopedic surgeons to address the physical and emotional impact of fractures on patients. Treatment options may include reduction of the fracture, internal fixation with plates and screws, and external fixation with pins or wires. Reconstruction may also involve repairing damaged soft tissues, such as skin, muscle, and nerve. Rehabilitation focuses on restoring range of motion, strength, and function to achieve optimal outcomes. The goal is to promote healing, minimize scarring, and restore normal appearance and function.
e. Hand tumours
Hand tumors in plastic surgery refer to benign or malignant growths that develop on the hand or fingers. Benign tumors, such as ganglion cysts, lipomas, and neurofibromas, can cause discomfort, pain, and limited mobility. Malignant tumors, like melanoma and sarcoma, can be aggressive and life-threatening. Plastic surgeons often work with hand specialists to treat hand tumors using a range of techniques, including excisional biopsy, reconstruction, and amputation. The goal is to remove the tumor while preserving hand function and appearance. Reconstruction may involve skin grafts, flap reconstruction, or bone reconstruction to restore normal hand anatomy and function.
f. Brachial plexus surgery
Brachial plexus surgery is a complex procedure performed in plastic surgery to repair and reconstruct injuries or damage to the brachial plexus, a network of nerves that control the arm and hand. The procedure involves a range of techniques, including nerve grafting, transfer, and reconstruction, to restore motor and sensory function to the affected area. The goal is to improve arm movement, reduce pain, and increase hand function. Plastic surgeons who perform brachial plexus surgery must have advanced training and expertise in microsurgery, nerve repair, and reconstruction. The outcome depends on the severity of the injury and the individual's overall health.