The Best Guide to Hand Surgery, Reconstruction & Finger Regeneration

This is the most common type of traumatic injury to the hands and fingers. The ends of a tendon usually retract from the original wound after the injury. A hand surgeon finds out these cut ends and restores the shape and strength of the tendon by suturing it in multiple layers. After road traffic accidents, big gaps between the tendon ends may occur, which cannot be sutured together. Tendon reconstruction is performed in such cases, where tendons from other parts of the body are taken and utilized to restore the connection between the cut tendons. Alternatively, other tendons in the hand and forearm are redirected to take over the function of the injured or diseased tendons.

Patients may present to a hand surgeon with continuous pain or tingling sensation in the hand. It occurs due to pressure on the median nerve when it passes through a tight tunnel present between the wrist and the hand. The only long-term solution for these patients is to relieve the pressure by surgical means. A hand surgeon makes a small incision in the middle of the palm to find the fibrous tissues that cause pressure on the nerve. These fibrous tissues are divided fully in order to relieve the pressure on the nerve. The results take a few days to appear and are usually long-lasting.

Post-Burns Contractures occur when burns are allowed to heal on their own, forming deep scars and bands. Dupuytren’s Contracture is a disease of the hand in which fibrous tissues in the upper parts of the hand become thick. The formation of nodules and bands causes the fingers, hand, and wrist to bend into an abnormal position. It restricts the movement of the hand and fingers, which can be severe in the late stages. A hand surgeon lays open the skin overlying these thickened fibers and removes all nodules, bands, and other thick fibers. Usually, the fingers can be lengthened fully immediately after the operation and be maintained by continuing physiotherapy.

Different types of defects can occur at birth. Joining of the fingers by skin, bones, or both is a common condition, called Syndactyly. A hand surgeon separates the two fingers. Some plastic surgery techniques like skin grafting or local flap procedures may be performed. This makes both the separated fingers have a full range of motion and a near-normal appearance. The growth of fingers is also possible after that. Another common defect is the duplication of fingers, known as Polydactyly. Many types of hand surgery have been described to treat this properly. Macrodactyly is a condition where an overgrowth of soft tissues of the finger occurs. A hand surgeon can reduce the size by operating on the bone and soft tissues.

When there is a big gap in the hand and fingers, it needs to be covered by flaps,skin grafts, or both. A hand surgeon may use different local and distant flaps for reconstructing these defects. These enable near normal recovery in the function of the hand. Groin flaps; radial forearm flaps with or without a segment of bone; islanded local flaps; local transposition flaps are typical examples amongst others. Shown here is the principle behind a neurovascular islanded flap for coverage of difficult finger defects.