Hand Injuries

The most common procedures in hand surgery are those done to repair injured hands, including injuries to the tendons, nerves, blood vessels, and joints; fractured bones; and burns, cuts, and other injuries to the skin. Modern techniques have greatly improved the surgeon's ability to restore function and appearance, even in severe injuries. The main aim of any surgery to manage hand injury is to restore hand function.

Among the techniques now used by plastic surgeons:

  • Grafting - the transfer of skin, bone, nerves, or other tissue from a healthy part of the body to repair the injured part;
  • Flap surgery - moving the skin along with its underlying fat, blood vessels, and muscle from a healthy part of the body to the injured site;
  • Replantation or transplantation - restoring accidentally amputated fingers or hands using microsurgery, an extremely precise and delicate surgery performed under an operating microscope.
  • Some injuries may require several operations over an extended period of time.

In many cases, surgery can restore a significant degree of feeling and function to injured hands. However, recovery may take months depending on the type and severity of injury, and a period of hand therapy will most often be needed.

(Some information is courtesy of the American Society for Surgery of the Hand)

Tendinitis

Tendons are bands of strong connective tissue that attach muscle to bone. Tendinitis is inflammation of a tendon. The symptoms include pain and swelling. Tendinitis is usually a type of overuse injury; the tendon is repeatedly strained until tiny tears form. Sites that are prone to tendinitis include the shoulder, wrist, knee, shin and heel. Wrist and hand tendinitis can be very debilitating conditions limiting the function of the hand.

The symptoms of tendinitis can include:

  • pain
  • Swelling
  • Stiffness and restricted mobility at the affected joint
  • Muscle weakness
  • The skin over the affected area may feel warm to the touch.

Treatment of tendinitis includes splinting, total rest, anti-inflammatory medications, and pain killers. Sometimes, local steroid injections may alleviate the symptoms. Most cases of tendonitis recover completely; however, severe untreated tendonitis can lead to rupture of the tendon. Tendinitis is more common in certain systemic diseases such as diabetes and rheumatoid arthritis.

The symptoms of tendinitis can be similar to those of other conditions, such as arthritis or infection, so it is important to seek medical advice if your symptoms don't improve despite treatment. Generally speaking, if your symptoms haven't improved after one or two weeks of treatment, or if the pain is severe or debilitating, see your doctor. Your symptoms may be caused by conditions other than tendinitis. For example, you may be suffering from arthritis, bursitis, infection or a fracture.

Hand Surgery

Surgery is recommended if all other treatment methods have failed to solve the problem. If that is the case, the area of tight tendon sheath that cause the painful and difficult tendon movements can be released. The inflammatory tissue can also be removed during the surgery in an effort to create more space for the tendon to move freely.

Adequate rest and splinting is also essential after surgery. Splinting is often required for 4-6 weeks, with hand therapy exercises periodically. This is to ensure that the released tendon continues to glide, and does not form adhesive scars to the underlying tissue. Relief of pain and recovery of function can be achieved with surgery and postoperative hand therapy.

(Some information is courtesy of the American Society for Surgery of the Hand)

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