Some injuries may
require several operations to restore function and appearance. Recovery
may take months, depending on the severity of the injury. A period of
hand therapy is needed in most cases.
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Carpal tunnel syndrome
Pressure may build up in a passageway
through the wrist because of disease, injury, fluid retention during
pregnancy, overuse or repetitive motions. The resulting pressure on the
nerve within the carpal tunnel causes a tingling sensation in the hand,
which is often accompanied by numbness, aching and impaired hand
function. This condition is call carpal tunnel syndrome.
Anti-inflammatory medications and splinting the hand will sometimes
relieve the problem. However, surgery may be required. During the
operation, an incision is made from the middle of the palm to the wrist,
providing access to the tissue that’s causing pressure on the nerve. The
surgeon will cut the tissue to release the pressure.
After the surgery, a splint and large dressing are used to promote
healing and restrict motion. The scar will fade over time and will soon
be barely visible. The results of the surgery will depend, in part, on
how long the condition has existed and how much damage has been done to
the nerve. For that reason, carpal tunnel syndrome can be treated best
if it is caught early.
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Rheumatoid arthritis
Rheumatoid
arthritis is an inflammation of the joints that can affect the
appearance and the function of the hands as well as other parts of the
body. The disabling disease often deforms finger joints and forces the
fingers into a bent position that hampers movement.
Wearing special splints or using physical therapy can sometimes lessen
the effects of rheumatoid arthritis. However, surgery offers the best
solution to some patients. Your plastic surgeon and your rheumatologist
can help you decide if surgery is the best option for you.
Surgeons can repair or reconstruct almost any area of the hand or wrist.
This is done by removing tissue from inflamed joints, implanting
artificial tendons or repositioning tendons. Your hand may not regain
its full use. However, a significant improvement in function and
appearance can be expected. After the surgery, rheumatoid arthritis can
continue to cause damage to your hand. Further surgery may be required.
Dupuytren’s contracture
Dupuytren’s
contracture is usually an inherited disorder of the skin and underlying
tissue on the palm side of the hand. Dupuytren’s contracture restricts
the hand’s motion when thick, scar-like tissue forms under the skin of
the palm extending into the fingers, pulling them toward the palm.
The only treatment
for Dupuytren’s contracture is surgery. The surgeon will free the
tendons and allow better finger movement by cutting and separating the
bands of thickened tissue. Zig-zag incisions may be made across the
thickened tissue, creating small skin flaps. The repositioned flaps
expand after the surgery, allowing freer finger motion. Skin grafts are
sometimes needed to replace tightened and puckered skin.
The results of the surgery will be different for every patient. However,
you can usually expect a thin, fairly inconspicuous scar. After physical
therapy, you can expect a significant improvement in function.
Congenital defects
Deformities that a
child is born with can cause significant problems in the use of the hand
and can interfere with proper hand growth. However, most defects can be
corrected at a very early age, allowing normal development and
functioning of the hand.
Syndactyly is one of
the most common congenital defects. In this condition, two or more
fingers are fused together. This condition can be corrected by cutting
the tissue that connects the fingers and grafting skin from another part
of the body. The procedure becomes more complicated if bones are also
fused. Although the color of the grafted skin may be slightly different
from the rest of the hand, surgery can provide a fairly normal
appearance and a full range of motion.
Other common
congenital defects can be treated surgically with the expectation of
significant improvement. Some of those conditions include immobile
tendons, short, missing or deformed fingers and abnormal nerves or blood
vessels.
Recovery and
rehabilitation
Because of the
sensitivity of the human hand, mild to severe pain may follow surgery.
Injections or oral medications can be prescribed to help you feel more
comfortable during your recovery. How quickly you resume your normal
activities and how long your hand must remain immobilized depends on the
type and the extent of your surgery.
Your surgeon may
recommend a course of rehabilitation to enhance your recovery and give
you the fullest possible use of your hand. Physical and occupational
therapy is conducted under the direction of a trained hand therapist.
Therapy may include heat and massage therapy, electrical nerve
stimulation, hand exercises, splinting, traction and special wrappings
to control swelling. Surgery is the foundation for recovery but the
entire course of therapy must be followed to regain the maximum use of
your hand.
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For an appointment
call
Arrowhead
Plastic Surgeons 419.887.7000 or toll free 1.800.783.2111
