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Reconstructive Surgery Procedures

Hand Surgery

Very dramatic advances have been made in recent years in treating patients with hand injuries, degenerative disorders, and birth defects of the hand.

Plastic Surgeons have been at the forefront of these advances with major interest is improving both function and appearance. Plastic surgeons undergo intensive training in hand surgery, and they (along with orthopedic surgeons and general surgeons) continue to treat patients with a wide range of hand problems.

Who’s a Candidate?

The most common procedures in hand surgery are those done to repair injured hands, including injuries to the skin, tendons, nerves, blood vessels, and occasionally joints. Other procedures are done for fractured bones, burns, cuts, and other injuries to the skin. Modern techniques have greatly improved the surgeon's ability to restore function and optimize appearance, even in very severe injuries.

What Are the Risks of Hand Surgery?

As with any surgery, there is always a possibility of complications, including bleeding and bruising, infection, fluid collection, or reaction to anesthesia.  Poor healing and possibly wide scars are possible, and even more likely in smokers. Numbness and sensory changes of the hand, with possible changes to your function and appearance are possible.  Other potential risks include injury or poor healing of the blood vessels, nerves, tendons or bones of the hand as well as earlier onset of arthritis.

Preparing for Surgery

Your surgeon will examine your hand and potentially your wrist and arm as well.  He or she will discuss the findings and several of the variables that may affect the procedure and its final outcome.  These may include the type of injury, the time of the injury to presentation, how much therapy you may have done prior to surgical intervention, your smoking history, etc.  It is important to follow all instructions prior to surgical intervention such as elevation, range of motion exercises, and other interventions such as occupational therapy assistance.

The Surgery

There is great variability to hand surgeries.  A traumatic hand injury may be brought to the operating room emergently or slightly delayed, as an urgent procedure.  Depending on the initial presentation and surgical procedure to be performed, the operation may be done under general anesthesia (you are asleep), local anesthesia (you are awake, but numb), or under regional block (you are awake, but your hand and arm may be numb).  Your surgeon will discuss this with you during your consultation.

After Your Surgery

Since the hand is a very sensitive and intricate part of the body, you may experience some mild to severe pain following surgery. Your surgeon will prescribe injections or oral medication to make you more comfortable. How long your hand must remain immobilized and how quickly you resume your normal activities depends greatly on the type and extent of surgery as well as how fast you heal.

To enhance your recovery and give you the fullest possible functional use of your hand, your surgeon may recommend a course of rehabilitation (physical and / or occupational therapy) under the direction of a trained hand therapist. Your therapy may include a combination of hand exercises, heat and massage therapy, electrical nerve stimulation, splinting, traction, ultrasound, light therapy and special wrappings to control swelling. Keep in mind that the surgery is just the foundation for your recovery. It's crucial that you follow all of the surgeon’s and therapist's instructions, and complete the entire course of therapy to regain the maximum use of your hand.

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