Hand Surgery / Wrist Surgery

Abstract

Hand surgery encompasses a range of procedures aimed at treating conditions affecting the hand, wrist, and fingers, such as carpal tunnel syndrome, tendon injuries, fractures, arthritis, and congenital deformities. Below is a comprehensive overview of hand surgery, including pre-surgery preparation, the surgical procedure, and post-surgery recovery.

Pre-Surgery Preparation

1. Medical Evaluation:

• Medical History and Physical Exam: Your surgeon will review your medical history and perform a physical examination to assess your hand condition.
• Imaging: X-rays, MRI, or CT scans may be used to evaluate the extent of damage and plan the surgery.

2. Preoperative Tests:

• Blood Tests: To check for anemia, infection, or other conditions.
• EKG (Electrocardiogram): To evaluate heart health, especially if general anesthesia is planned.
• Urinalysis: To detect any urinary tract infections or other issues.

3. Medication Management:

• Adjustments: Certain medications, such as blood thinners, may need to be stopped before surgery.
• Supplements: You may be advised to take or stop certain vitamins or supplements.

4. Pre-Surgical Education:

• Instructions: You’ll receive detailed instructions about pre-surgery preparation, including fasting, bathing, and what to bring to the hospital.
• Rehabilitation Plan: Discussion about postoperative rehabilitation and physical therapy.

5. Preoperative Physical Therapy:

• Strengthening Exercises: Engaging in exercises to strengthen the muscles around the hand and wrist can improve recovery outcomes.

The Surgery

1. Anesthesia:

• Local, Regional, or General Anesthesia: Depending on the procedure and patient condition, local anesthesia (numbing the hand), regional anesthesia (numbing the entire arm), or general anesthesia (to put you to sleep) may be used.

2. Types of Hand Surgery:

• Carpal Tunnel Release: Cutting the ligament pressing on the median nerve to relieve carpal tunnel syndrome.
• Tendon Repair: Repairing torn tendons due to injury or wear and tear.
• Fracture Fixation: Realigning and stabilizing broken bones using pins, screws, or plates.
• Joint Replacement: Replacing damaged joints with artificial implants, often in cases of severe arthritis.
• Dupuytren’s Contracture Release: Removing or breaking the thickened tissue causing fingers to curl inward.
• Congenital Deformity Correction: Correcting deformities present from birth to improve function and appearance.

3. Surgical Steps:

• Incision: Making one or more small incisions to access the affected area.
• Procedure: Performing the specific repair, release, stabilization, or replacement.
• Closure: Closing the incisions with sutures or staples, and applying a bandage or splint.

Post-Surgery Recovery

1. Immediate Postoperative Care:

• Monitoring: You’ll be taken to a recovery room where you’ll be closely monitored.
• Pain Management: Medications will be provided to manage pain and prevent infection.

2. Immobilization:

• Splints or Casts: Your hand may be immobilized in a splint or cast to protect the surgical site and ensure proper healing.

3. Physical Therapy:

• Early Movement: Gradual movement of the hand and fingers to prevent stiffness, typically starting with passive motion exercises.
• Rehabilitation Exercises: Specific exercises will be prescribed to restore mobility, strength, and function.

4. Home Recovery:

• Continued Physical Therapy: Ongoing physical therapy to ensure proper healing and restoration of hand function.
• Pain Management: Continued use of pain medications as needed.
• Wound Care: Keeping the surgical site clean and dry, and watching for signs of infection.

5. Follow-Up Appointments:

• Checkups: Regular follow-up appointments with your surgeon to monitor healing and progress.

6. Long-Term Rehabilitation:

• Gradual Increase in Activity: Gradually increasing activity levels under the guidance of your physical therapist.
• Strength and Mobility: Exercises to strengthen the hand muscles and improve range of motion.

Expected Outcomes

1. Pain Relief:

• Significant Reduction: Most patients experience significant pain relief after recovery.

2. Improved Mobility:

• Enhanced Function: Increased range of motion and improved ability to perform daily activities.

3. Strength Recovery:

• Muscle Strengthening: Regaining strength in the hand muscles through rehabilitation exercises.

4. Quality of Life:

• Enhanced Quality of Life: Overall improvement in quality of life due to reduced pain and improved hand function.

Conclusion

Hand surgery is a highly effective procedure for treating various hand conditions. Proper pre-surgery preparation and diligent post-surgery care are crucial for optimal outcomes. Following your surgeon’s recommendations and engaging in regular physical therapy are key components of a successful recovery.