Different Types of Hand Surgery (Part 2)

As the Clarkston area’s leading hand surgeon, Dr. Rehman performs all types of wrist, finger and hand surgeries. This is Part Two part of our article offering a brief overview of some of the more common types of wrist and hand surgery that may be performed.

CLICK HERE for Different Types of Hand Surgery (Part 1)

Grafting Surgery

Hands and wrists can be injured in a wide variety of ways. When the injured are cannot be surgically repaired, grafting may be necessary. During grafting surgery bones, nerves or other tissue from healthy areas of the body are transferred to the damaged area.

Grafting is most commonly performed after severe trauma to the hands, fingers or wrist, where tissue, bone or nerves have been rushed or otherwise destroyed. Thanks to modern grafting techniques, the prognosis for fully recovery after grafting surgery ii usually excellent.

Grafting surgery for the hand involves the transplantation of bones, nerves, or other tissues from healthy areas of the body to the hand to restore function and repair damaged structures. Bone grafts may be used to facilitate healing of fractures or to replace lost bone due to injury or disease. Nerve grafts can be employed to repair damaged nerves, aiding in the restoration of sensation and movement. Tissue grafts, such as skin grafts, are commonly used to cover wounds, promote healing, and improve the cosmetic appearance of the hand.

Closed Reduction and Fixation Hand Surgery

Closed reduction and fixation hand surgery are techniques used to treat fractures and dislocations. In closed reduction, the physician manipulates the fractured or dislocated bones back into their proper alignment without making an incision. Following this, fixation methods, such as splints, casts, or internal fixation with screws and plates, are utilized to maintain the corrected position during the healing process. This surgical approach aims to achieve optimal bone alignment and stability, promoting proper healing and restoring normal function to the hand.

Closed Reduction and Fixation surgery may be used when there is a fracture in part of the hand, including the fingers. Commonly this is referred to as “setting” a broken bone. This surgical procedure realigns the fractured bone and then immobilizes the area during the healing phase.

Immobilization of the affected hand or finger(s) may be done with internal fixtures, such as with wires or rods – or may be done externally with splints, and casts.

Tendon Repair Hand Surgery

Tendons are the fibrous tissue that attach muscles to the bone. Tendon injuries can occur due to infection, trauma, exertion, or even spontaneous rupture. Because of the structure of the tendon, surgical repair of tendons is challenging and requires an experienced surgeon.

Tendon repair hand surgery is performed to address injuries or lacerations that involve the tendons in the hand. Tendons are crucial for movement, allowing muscles to transmit force to the bones. When a tendon is injured, surgical intervention may be necessary to reconnect the torn ends. This typically involves making incisions to access the damaged tendon, stitching the ends together, and ensuring secure fixation. Postoperative rehabilitation is crucial to restore strength and flexibility to the repaired tendon and regain optimal hand function.

There are three types of surgical tendon repair: primary, delayed primary, or secondary. Primary is usually completed within 24 hours of the injury. Delayed primary repair refers to surgery performed a few days after the injury, but while there the skin from the wound is still open. Secondary repairs occur two to five weeks or more after the tendon injury.

Nerve Repair Hand Surgery

Nerve repair hand surgery is employed to address injuries or lacerations that affect the nerves in the hand. Nerves play a vital role in sensation and movement. Nerve repair involves careful suturing of the damaged nerve ends to promote regeneration and restore function. This delicate procedure requires precision and may involve microscopic techniques. Postoperative rehabilitation is often necessary to aid in nerve recovery and maximize functional outcomes.

There are three main nerves that enable the hand to operate: the ulnar nerve, the median nerve, and the radial nerve. When any of these nerves are damaged, it can result in decreased ability to move the hand and experience feeling. While some nerve injuries heal on their own, others may require surgery.

If severed, the nerve may be repaired by reattaching it directly to the other end of the nerve. Nerve grafting – inserting nerves from other areas of the body – is another effective way to surgically repair nerve damage in the hand and fingers.

Surgical Drainage and/or Debridement

Surgical drainage and debridement are procedures performed to address infections or necrotic tissue in the hand. In cases of infection, a surgeon may make an incision to drain pus and remove infected material, helping to control the spread of infection and promote healing. Debridement involves the removal of dead or damaged tissue, fostering a healthier environment for healing. These procedures are vital in preventing the spread of infection and facilitating the recovery of the hand.

Infections of the hand are a common reason people seek medical treatment. While nonsurgical treatment for infections to the hand may include rest, use of heat, elevation and antibiotics, surgery may be required for more severe infections.

If there is an abscess in the hand surgical drainage may be used to help remove the collection of pus. Surgical cleansing (“debridement”) of a wound may also be required to prevent further infection and to help promote healing.

Joint Replacement Surgery

Joint replacement surgery, also called “arthroplasty”, is sometimes used in people with severe arthritis of the hand. During joint replacement surgery, a joint that has been destroyed by the disease process is surgically replaced with an artificial joint. The new, artificial joint may be made out of metal, plastic, silicone rubber, or even the patient’s own body tissue – such as a tendon.

Joint replacement surgery for the fingers, hand, or wrist is a specialized procedure designed to address severe arthritis or joint damage that significantly impairs function and causes persistent pain. Arthritis in these joints can result from conditions like osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis. When conservative treatments such as medications, splints, or physical therapy are insufficient in managing symptoms, joint replacement surgery may be considered.

During the surgery, the damaged joint surfaces are removed and replaced with artificial implants made of metal, plastic, or a combination of both. The goal is to recreate a smooth joint surface, allowing for improved range of motion and alleviation of pain. Finger joint replacement may involve the proximal interphalangeal (PIP) or metacarpophalangeal (MCP) joints, while wrist joint replacement typically targets the radiocarpal or intercarpal joints.

Recovery after joint replacement surgery involves a period of physical therapy to regain strength, flexibility, and functionality. Patients are encouraged to participate in rehabilitation exercises to optimize the outcomes of the procedure. Joint replacement surgery for the fingers, hand, or wrist has demonstrated success in relieving pain, restoring joint function, and enhancing the overall quality of life for individuals suffering from debilitating arthritis or joint disorders. It is essential for individuals considering this surgery to consult with their orthopedic surgeon to determine candidacy and understand the potential benefits and risks associated with the procedure.

Best Hand Surgery – Clarkston, MI

If you are suffering from any pain or limitation in your hand, fingers or wrist, contact Dr. Rehman for a comprehensive evaluation and consultation. As with most medical conditions, early detection, awareness, and a prevention or treatment plan is the most effective way to treat injuries of the hand or wrist.

In many cases we may be able to treat your condition with non-surgical, non-invasive procedures in ouir Clarkston, MI area office. In more severe cases, where wrist or hand surgery is required, board certified hand surgeon Dr. Rheman offers the highest standard of medical care and the latest techniques in hand surgery.

Clarkston Area Hand Surgery Doctor: 248.335.2638