A hand surgeon is trained to diagnose and treat conditions affecting the hand, wrist, and forearm. Their work often involves non-surgical treatments, but they possess the skills to perform intricate operations when injuries or conditions require intervention. Patients usually seek these professionals when facing complex trauma or chronic issues that limit function. Here are some types of complex hand and wrist surgeries:
Realigning Fractures
Bones in the hand and wrist may break into multiple pieces or shift significantly out of place during a traumatic event. Simple casts do not always work for these complicated injuries, necessitating surgical intervention to restore alignment. To hold the bone fragments in the correct position while healing occurs, surgeons use:
- Pins
- Plates
- Screws
- External fixators
This process stabilizes the skeletal structure. Without proper alignment, the bone might heal in a way that restricts movement or causes long-term deformity. The procedure varies based on the fracture’s location and severity. Open reduction and internal fixation allow the surgeon to directly access the fracture site, and sometimes, bone grafts are necessary if bone has been lost or crushed. The goal is to recreate the original anatomy as closely as possible.
Cleaning Wounds
Traumatic injuries frequently introduce debris, dirt, or foreign objects into the hand’s structures. Infection poses a risk in these scenarios, potentially compromising the healing process. A hand surgeon performs debridement to thoroughly clean the wound and remove dead or damaged tissue. This step prepares the area for subsequent repairs or closure. High-pressure irrigation washes away microscopic contaminants that manual cleaning might miss; if a wound is left unclean, bacteria often multiply rapidly, threatening the viability of the surrounding healthy tissue. In severe cases involving machinery or crush injuries, multiple surgical cleanings are performed over several days. Only once the tissue is healthy and free of infection will the surgeon proceed to close the wound or apply skin grafts.
Repairing Tendons and Nerves
The hand relies on a complex network of tendons to bend and straighten fingers, while nerves provide sensation and muscle control. Lacerations or deep cuts often sever these structures, resulting in loss of movement or feeling. Tendon repair involves stitching the two ends of a torn tendon back together. This is a delicate process, because the repair must be strong enough to hold but smooth enough to glide through the surrounding tunnels. Nerve repair is more intricate, requiring a microscope to reconnect tiny nerve fibers. If the gap between nerve ends is too large, a nerve graft from another part of the body might bridge the defect.
Timing plays a role in these surgeries. Tendons typically need repair soon after injury to prevent them from retracting too far. Nerves grow slowly, so recovery of sensation or muscle function typically takes months. Post-operative therapy helps guide tissue healing, as stiffness is common following these procedures. Patients usually wear splints to protect the repair while engaging in controlled motion exercises.
Work With a Hand Surgeon
Navigating the complexities of hand and wrist injuries requires specialized medical attention. A hand surgeon is trained to address fractures, deep wounds, and damage to tendons or nerves. They evaluate the extent of the trauma and determine the appropriate surgical approach for your situation. If you have sustained a hand injury or are experiencing chronic pain, schedule a consultation with a surgeon today.
