Types Of Hand Surgery

Types Of Hand Surgery

What are the different types of hand surgery?

Many different types of surgeries can be performed on the hand. It depends on the underlying cause of the problem. These procedures include:

Skin grafts

Skin grafts involve replacing or attaching skin to a part of the hand that has missing skin. This surgery is most often done for fingertip amputations or injuries. Skin grafts are done by taking a piece of healthy skin from another area of the body, called the donor site, and attaching it to the injured area.

Skin grafting is a type of graft surgery involving the transplantation of skin. The transplanted tissue is called a skin graft

Skin grafting is often used to treat:

  • Extensive wounding or trauma
  • Burns
  • Areas of extensive skin loss due to infection such as necrotizing fasciitis or purpura fulminans
  • Specific surgeries that may require skin grafts for healing to occur - most commonly removal of skin cancers

Skin grafts are often employed after serious injuries when some of the body's skin is damaged. Surgical removal (excision or debridement) of the damaged skin is followed by skin grafting. The grafting serves two purposes: reduce the course of treatment needed (and time in the hospital), and improve the function and appearance of the area of the body which receives the skin graft.

iranian surgery

There are two types of skin grafts, the more common type is where a thin layer is removed from a healthy part of the body (the donor section) like peeling a potato, or a full thickness skin graft, which involves pinching and cutting skin away from the donor section. A full thickness skin graft is more risky, in terms of the body accepting the skin, yet it leaves only a scar line on the donor section, similar to a Cesarean section scar. For full thickness skin grafts, the donor section will often heal much more quickly than the injury and is less painful than a partial thickness skin graft.

Skin flaps

Like a skin graft, a skin flap involves taking skin from another part of the body. But this procedure uses skin that has its own blood supply. That’s because the section of skin that is used includes the underlying blood vessels, fat, and muscles. Flaps may be used when an area that is missing skin does not have a good blood supply. This may be because of the location, damage to the vessels, or extensive tissue damage.

Closed reduction and fixation

Closed reduction is a procedure to set (reduce) a broken bone without cutting the skin open. The broken bone is put back in place, which allows it to grow back together. It works best when it is done as soon as possible after the bone breaks.

A closed reduction can be done by an orthopedic surgeon (bone doctor) or a primary care provider who has experience doing this procedure.

Tendon repair

Tendons are the fibers that join muscle to bone. Tendon repair is a difficult surgery because of the structure of the tendon. Tendon injuries can occur due to infection, trauma, or sudden rupture. There are 3 types of tendon repair: primary, delayed primary, or secondary.

  • Primary repair of an acute or sudden injury is often done within 24 hours of the injury.  This is usually a direct surgery to fix the injury.
  • Delayed primary repair is usually done a few days after the injury, but while there is still an opening in the skin from the wound.
  • Secondary repairs may occur 2 to 5 weeks or longer after the injury. They may include tendon grafts. This is when tendons from other areas of the body are inserted in place of the damaged tendon. Or other more complex procedures may be used.

Nerve repairs

An injury can damage the nerves in the hand. This can cause a loss of hand function and a loss of feeling in the hand. Some nerve injuries may heal on their own. Others may require surgery. Generally, surgery is done about 3 to 6 weeks after the injury. This is the best time for nerve repairs that are linked with other more complicated injuries.

In cases where nerve damage is not linked to more complicated injuries, surgery to check the damaged nerve is usually done soon after the injury. This increases the chance of a full recovery. If the nerve is cut or severed, it may be fixed by reattaching it to the other end of the nerve. Or a nerve graft may be done. This involves replacing the damaged nerve with nerves taken from other areas of the body.

Fasciotomy

Fasciotomy or fasciectomy is a surgical procedure where the fascia is cut to relieve tension or pressure commonly to treat the resulting loss of circulation to an area of tissue or muscle. Fasciotomy is a limb-saving procedure when used to treat acute compartment syndrome.

Surgical drainage or debridement

Hand infections are very common. Treatment for hand infections may include rest, using heat, elevation, antibiotics, and surgery. If there is a sore or abscess in the hand, surgical drainage may help remove any pus. If the infection or wound is severe, debridement may be used to clean dead and contaminated tissue from the wound. This prevents further infection and helps promote healing.

Joint replacement 

This type of surgery, also called arthroplasty, is used in cases of severe hand arthritis. It involves replacing a joint that has been destroyed by arthritis with an artificial joint. This artificial joint may be made of metal, plastic, silicone rubber, or your own body tissue, such as a tendon.

Replantation

This type of surgery reattaches a body part, such as a finger, hand, or toe, which has been completely cut or severed from the body. The goal is to restore as much function as possible. Replantation uses microsurgery. This is a complex type of surgery that uses tiny tools and is done under magnification using a microscope. In some severe cases, more than 1 surgery may be needed.

10 common questions about Types Of Hand Surgery

1How long is recovery from hand surgery?
After the operation It'll take two to three weeks for your skin to heal and up to 12 weeks before you have full use of your hand. You'll be seen by a hand therapist who will start you on exercises and monitor your movement and function. A night extension splint may be made for you, although this won't always be needed.
2Do they put you to sleep for hand surgery?
General anesthesia involves being put to sleep with medications that are given to you through your intravenous line. ... More than 90% of the hand surgeries at HSS are performed under regional anesthesia. When you receive this type of anesthesia for hand surgery, you will feel no pain during the surgery
3What is Dupuytren's contracture surgery?
Fasciectomy (say "fash-ee-EK-tuh-mee") is surgery to cut out a layer of tissue called the fascia (say "FASH-ee-uh") that lies deep under the skin. In Dupuytren's (say "duh-pwee-TRAHNZ") contracture, the fascia of the palm of the hand becomes thick and tight. ... Your hand and fingers may be swollen for the first few days.
4Is Dupuytren's contracture surgery painful?
Surgical incisions will vary based on the extent of your Dupuytren's contracture but may look like a zig-zag on the palmar surface of the finger and hand. Dupuytren's contracture release can be painful.
5Is Dupuytren's contracture a form of arthritis?
Dupuytren's contracture is an inherited disorder, where nodules and cords form in the hand and result in contractures, or stiff bent fingers. ... Patients with arthritis in the hand have trouble with everyday activities like turning a key or a doorknob, or opening a jar.
6What are the first signs of Dupuytren's?
Symptoms of Dupuytren's Contracture The first symptom for many patients is one or more lumps (nodules) under the skin in the palm of the hand. The lump may feel tender and sore at first, but this discomfort eventually goes away. The nodules cause tough bands of tissue to form under the skin in the palm
7Does stretching help Dupuytren's?
Dupuytren's disease may get worse slowly. If you have mild Dupuytren's disease, you may be able to keep your fingers moving with regular stretching. Surgery usually helps in severe cases.
8How does Dupuytren's contracture start?
The condition usually begins as a thickening of the skin on the palm of your hand. ... In later stages of Dupuytren's contracture, cords of tissue form under the skin on your palm and can extend up to your fingers. As these cords tighten, your fingers might be pulled toward your palm, sometimes severely
9Can Dupuytren contracture be cured?
The goal of treatment for Dupuytren's is to reduce the symptoms and disability caused by the disease. At this time, however, there is no treatment to stop Dupuytren's contracture from getting worse.
10What is wrong with Bill Nye's hands?
The couple separated in 2008. He has Dupuytren's contracture, a hereditary condition which can, depending on the condition's severity, cause contractures of the fingers, most commonly the ring and little fingers

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