Reconstructive Hand Surgery
What is Reconstructive Hand Surgery?
Reconstructive hand surgery a common procedure needed to relieve pain in the hand or restore function r improve appearance of the hand after injury, disease or birth deformities.
Reconstructive surgery for traumatic cases can involve simple repair of an injured structure to reattachment of the severed limb, to actually transplanting a portion of the limb such as toe-to-thumb transplant which Dr. Knight performed one of the first in the Southern US. Toe-Thumb Transplant Case Study.
Repair of tendon lacerations such as flexor or extensor tendons are common procedures. Ligaments are frequently injured with jamming injuries and if completely disrupted may require a repair or a tendon graft to bridge the gap. Fractures of the hand are also very common and if displaced require the placement of screws, plates, or wires to hold the bones in place during healing.
Boutonniere and swan neck deformities may require placing a tendon graft to restore the missing function to fingers. These procedures will require extensive rehabilitation to restore mobility.
Reconstructive surgery of the hand is performed in disease conditions such as Rheumatoid arthritis through soft tissue releases and joint replacement to restore function and improve appearance. Arthrodesis or joint fusions are needed in some cases depending on the area involved.
Dupuytren’s disease may require extensive reconstruction after removal of the involved tissue with either skin grafts or flaps.
Tumors in the hand are usually benign and are simply removed. In rare cases malignancies may arise. Skin cancers on the back of the hand may require extensive soft tissue resection with a flap needed to cover the tendons and bone. Metastatic malignancies or a primary malignant bone tumor are rare but must be aggressively treated requiring a partial or complete amputation or wide excision of tissue with a restorative flap.
After fingertip injuries, nail deformities may arise that can lead to chronic infections. In some cases simply removing the scar tissue can restore normal nail growth while in others a nail graft from a toe may be necessary. If all else fails the nail bed may be removed permanently.
Fingertip injuries may leave exposed bone or tendons that must be covered with an advancement flap or cross finger flap to prevent further shortening or amputation of the digit.
Reconstructive surgery is also usually necessary to correct congenital malformations such as syndactily,webbing of digits, excision of duplicate digits or transposing the index finger into a thumb when the thumb is absent or not functional.
Why Dr. Knight?
Reconstructive hand surgery should be performed by a fellowship trained hand surgeon with significant expertise in the type of procedure planned. Dr. Knight has performed thousands of hand procedures in his career with great success. The hand and fingers are complex in design and require significant attention to detail to restore function when just one area of the hand is involved which can cause significant disability in one’s daily life.
MCP joint replacement of all finger on the left hand of a patient with rheumatoid arthritis compared to right side prior to replacement.
About Surgery of the Hand
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