Reconstructive surgery has come along way in terms of development and advancement with hand surgery. Advances have been made in the last decade to treat patients with hand injuries, degenerative disorders, and birth defects of the hand. Due in thank to plastic surgeon-specialists whose interest lies with improving function and appearance of afflicted limbs. During their intensive training in hand surgery they treat patients with a wide medley of issues.

There are many reasons that one must undergo reconstructive surgery of the hand. As with all surgery there are risks of complications, infection, healing, blood clots, loss of sensation and permanent damage. Although infrequent they are to be treated with care and concern.

Many times patients come in with injuries that need to be attended to. They include injuries to the joints, tendons, nerves and at times burns. There are specific procedures for specific injuries and today's surgeons are using many of these methods to alleviate one or several issues during one surgery. We will address the several types of surgery that may be an option for you.

Grafting is used to transfer skin, bones, nerves, or other healthy tissue from one site to a damaged site; this is used specifically when areas or specific sites can be grafted from. In flap surgery the surgeon will move the skin, with fat, blood vessels, and muscle from a healthy part of the body to an injured site. In replantation or transplantation, fingers or hands may be reattached using microsurgery, performed under magnification. This type of surgery is usually a several part process, something patients should be aware of prior to the initial surgery.

Surgery has the ability to restore feeling and ability to function to a certain degree. It may take weeks, months or even years of physical therapy or healing to get to an acceptable level of usage.

Carpal tunnel is the passageway from the wrist that carries the tendons and one of the hand's major nerves through the arm. Excessive pressure may build within the area due to disease, injury, overuse, or repetitive motion. The wreaks havoc on the nerve within the area, causing a tingling sensation, accompanied by aching numbness and limited hand function, also called carpal tunnel syndrome. When splinting and physical therapy are not working the next option is surgery.

During the surgery, the surgeon creates an incision from the middle of the palm toward the wrist. The surgeon will then cut tissue that is causing pressure on the nerve in an effort to release the pressure. After surgery, a large dressing with a splint will be used to restrict motion and promote the healing process. Eventually, the scar will fade to a light scar, even possibly disappearing. Depending upon nerve damage occurred over time, the surgery will have been a success.

Many surgeons deal with Rheumatoid arthritis, known due to an inflammation of the joints, which can be a disabling disease, affecting the appearance and the function of the hands and other parts of the body. It most often is known to deform finger joints, creating hands that have fingers bent into a position, hampering movement.

Surgeons may be able to repair or reconstruct almost any area of the hand or wrist by removing tissue from the inflamed joints, by repositioning tendons and ligaments, or implanting artificial joints. It is possible that full use may not be an option after surgery, but at least partial use may be restored, in addition to a more soothing appearance.

Dupuytren's contracture is another disorder that can be treated by reconstructive hand surgeons. It is a disorder of the skin and underlying tissue on the inside of the hand. Thick, scar-like tissue forms under the skin of the palm, extending into the fingers, pulling them toward the palm and restricting motion. It is a condition that is unclear on origin, but has been seen in most patients that are in the middle of their lives.

Surgery has been the only option for Dupuytren's contracture. The surgeon may cut and separate bands of thickened tissue, allowing the tendons to be free and allowing better range of motion in the fingers. It is a precise operation, due in large part to the nerves being bundled up in the abnormal tissue. There have been cases where some skin grafts have been required to replace skin. Due to the severity of the condition, it is unclear how successful the surgery may be, but it is the only way to alleviate the issue. Most patients see the most results after a significant amount of time in physical therapy.

When surgeons are faced with congenital defects, it is usually syndactyly, where two or more fingers may be fused together. Surgical correction involves cutting the tissue that connects the fingers, then grafting skin from another part of the body. The surgery can usually allow a patient full range of motion and a fairly normal appearance, although there have been cases where the color of the grafted skin may be slightly different from the rest of the hand.

The hand is a very integral part of the body and there may be mild to severe pain following surgery. Your surgeon may prescribe oral medications for your use, to make you more comfortable. It is important to discuss with your surgeon how long your hands will remain immobilized- and if there will be any physical therapy in the future. It is important to remember that surgery is just the beginning for the recovery process. Speak with your surgeon if you have any questions or concerns regarding the surgical process or to see if a procedure is right for you.

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