Comprehensive Guide to Types of Hand Surgery Operations

Hand surgery is the second-largest orthopedic specialty in the United States, having seen a 12% increase in fellowship positions between 2012 and 2016. Patients may undergo various hand surgery types, ranging from standard to complex procedures. If you’re struggling with a hand condition such as carpal tunnel syndrome, arthritis, tenosynovitis, or a ganglion cyst, a surgical operation may be the best course of action to relieve discomfort and restore functionality. Here’s a brief look at what you can expect from different treatments.

Types of Hand Surgery Operations

There are many types of hand surgery operations, from common hand surgeries that release painful tendons to complex microsurgeries that reconnect tiny blood vessels and reattach fingers. Here are some of the hand surgery types you may encounter:

• Carpal tunnel release: This surgery involves releasing the band of tissue around the median nerve to alleviate pressure and restore comfort in the wrist.
• Tendon repair: Torn or damaged tendons are sewn back together, sometimes using an artificial tendon or a piece of tendon from another part of the body to restore movement.
• Joint replacement (arthroplasty): An artificial joint made from silicone rubber, plastic, or a piece of the patient’s tendon replaces joints destroyed by arthritis. This surgery often addresses articular finger joints or wrist joints.
• Dupuytren’s contracture surgery: Thickened tissue under the fingers and palm is released, potentially covered by a skin graft.
• Nerve repair: Severed nerve ends are reconnected, sometimes with a nerve graft, and the surrounding tissue is sewn together to protect the repair and restore sensation.
• Trigger finger release: The procedure involves making a small incision in the tendon over the affected finger, allowing it to bend correctly and curing stenosing tenosynovitis.
• Ganglion cyst removal: Fluid-filled lumps, known as ganglion cysts, can be surgically removed by cutting the stalk at the root.
• Fracture repair: Fracture surgeries involve internal fixation, in which broken bones are reconnected and secured with wires, plates, screws, and other devices.
• Skin grafts and flaps: Skin grafts and flaps surgically replace severely damaged skin with healthy skin taken from another body part.
• Replantation and microsurgery: Replantation is the process of surgically reattaching a severed part of the body, such as a finger. This often involves microsurgery, which uses magnification to help the surgeon view the tiny nerves and blood vessels.

Specialized Hand Surgery Procedures

Some hand operations are especially complex and require the skilled touch of a highly experienced specialist. These include:

• Thumb carpometacarpal (CMC), or basal, joint reconstruction: The CMC joint is replaced with the trapezium tendon to restore functionality to the thumb joint.
• Arthroscopy: Arthroscopy is a diagnostic procedure in which the surgeon inserts a tiny fiber-optic camera through a small incision to identify joint problems.
• Tendon transfers: Tendon transfer surgery detaches the tendon from the bone and attaches it to another tendon or a different bone. This can restore muscle function lost due to a nerve injury.

Assessing Need and Suitability: When Is Hand Surgery Necessary?

The hand is an intricate structure composed of 27 bones, 27 joints, 34 muscles, and more than 100 tendons and ligaments. There are many types of hand surgery operations that can address injuries, musculoskeletal problems, and arthritis pain. However, surgery is rarely the first line of treatment. A hand specialist can recommend many conservative treatment options, such as splints, physical therapy, and medication.

Hand surgery may be necessary in certain situations. The best way to determine whether surgery is appropriate for your needs is to consult an expert. In general, you may find an operation is recommended if:

• The injury is severe, such as a severed finger or an open fracture that’s punctured the skin.
• The patient is an athlete who needs to prioritize quick and effective recovery.
• Nonsurgical treatments have failed to provide relief.
• A degenerative condition, such as arthritis, has progressed beyond the point where it will respond to nonsurgical treatments.

Risks vs. Benefits: What You Should Know Beforehand

While you may think hand surgery is dangerous, it’s essential to understand that most procedures are safe and effective. However, like any surgery, there are risks associated with certain hand surgery types. Some of these risks relate to the products and medications used during the procedure. For example, some patients may be allergic to glues, latex, blood products, or anesthesia. Many surgeries present the hazard of damage to other structures in the hand, such as blood vessels, muscles, and nerves.

Some complications after hand surgery may appear hours or even days later. These may include poorly healed incisions, persistent pain, skin discoloration, scarring, swelling, or infection. While these risks are usually very unlikely, many issues are easily managed when your surgeon promptly addresses them. Speak to your health care provider about the risks associated with a particular surgery.

The benefits of hand surgery nearly always include pain relief and improved range of motion. Your surgeon can elaborate on what you can expect after your surgery, as outcomes vary greatly by patient and procedure.

Recovery and Rehabilitation Following Hand Surgery Operations

Immediately after hand surgery, you may need to immobilize and rest the affected finger, wrist, or hand. Restrictions are common in the first few days after a surgical procedure. Your surgeon may recommend ice, elevation, and an anti-inflammatory medication.

As the hand begins to heal, you should carefully follow any prescribed physical therapy and exercises. This may include massage, nerve stimulation, and stretches. A specialized hand therapist can recommend strengthening techniques and range-of-motion exercises to help restore your hand to full functionality after the surgery.

Consult a Specialist for Your Surgical Needs

Our specialists at The Hand and Wrist Institute are equipped to diagnose and treat a wide range of hand conditions. We’ve proudly served the Dallas-Fort Worth area for over 25 years, providing effective treatments for burns, arthritis, fractures, and more. Contact us  to schedule your consultation and determine whether hand surgery is the right choice for you.

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Dr. John Knight

Dr. Knight is a renowned hand, wrist and upper extremity surgeon with over 25 years of experience. Dr. Knight is a Board Certified Orthopedic Surgeon and Fellowship trained. Dr Knight has appeared on CNN, The Doctors TV, Good Morning America, The Wall Street Journal, The Washington Post, Forbes, The Huffington Post, Entrepreneur, Oxygen network and more.