Hand Reconstruction

Hand reconstruction surgery is a highly intensive surgical procedure performed to improve the function and appearance of hands impaired by traumatic injury, birth defects or repetitive and strenuous daily activities. Performed by surgeons with extensive, specialized training, this procedure may involve reconstruction, repair or replacement of limbs, skin, joints and other affected tissue.

Reconstructive surgery of the hand may be necessary to correct deformities brought on by traumatic crush injuries, the detachment of limbs or fingers and burns resulting in blood vessel or nerve damage. Reparation procedures may involve nerve and tendon repair, reattachment (microsurgical replantation) of detached limbs and the resetting of fractured bones. Reconstructive surgery is made complete through several procedures. Initially, surgery is performed to correct an injury and is coupled with the replacement or reconstruction of skin, muscle or other tissue that will help restore a degree of feeling and movement to the hands. There are three main techniques used for this case:

	Grafting: the transfer of bone, nerves, skin or tissue from a healthy area of the body to the injured area
	Flap surgery: the movement of fat, blood vessels, muscle and overlying skin from a healthy donor site to the injured hand
	Transplantation or replantation: the reattachment of hands or fingers through a delicate, precise microsurgical procedure performed under magnification

Carpal tunnel syndrome is a strain injury brought on by repetitive motion, overuse or fluid retention. The carpal tunnel is the passageway through the wrist where tendons and major nerves reside. Pressure can build up and strain the nerves in this passageway, causing uncomfortable tingling, aching, numbness and impaired hand function. Although some cases of carpal tunnel syndrome may be alleviated with splinting and anti-inflammatory medication, severe cases may require surgery. During this procedure the surgeon will cut tissue pressing on the nerve to relieve aggravating tension. The goal of this surgery is to recover and restore hand function and feeling. Recovery of normal use will depend on the severity of nerve damage.

Rheumatoid arthritis is an inflammation of the joints which disables movement and disfigures the appearance of the hands and other parts of the body. Deformities can force joints and fingers into abnormally bent positions, restricting significant movement. In the severest cases of rheumatoid arthritis, hand surgery is necessary to restore the movement of joints. Surgeons reconstruct areas of the hand or wrist by removing tissue from the inflamed joints, repositioning tendons or implanting artificial joints. Although hand surgery can greatly improve the form and function of the affected joints, restoration may be an ongoing process involving several surgeries.

Congenital deformities (birth defects) of the hand can hamper proper growth, causing difficulty in the use of the hand. Reconstructive surgery can be performed as early as infancy to correct deformities and allow the hand to develop normally. A common congenital deformity characterized by the fusing of two or more fingers can be corrected by separating the fused tissue and grafting new skin to the site. Deformed, short or missing fingers, abnormal nerves or blood vessels and immobile tendons can also be improved surgically.

Frequently Asked Questions

Will I have feeling in my hand after the surgery?
In many cases, surgery is only the first step in restoring significant feeling to the hand with a comprehensive recovery time and rehabilitation therapy.

Will I be able to perform normal activities with my hand?
In order to restore and improve the function of your hand after surgery, it is important to follow your doctor's specific instructions on therapy and rehabilitation. It is important to keep in mind that surgery is the first step to regaining maximum use of your hand.

Is more than one surgery necessary to correct the damage?
Depending upon individual circumstances, multiple procedures may or may not be necessary. Only a consultation with an experienced, board-certified surgeon can determine this decision.

What is the discomfort associated with this procedure?
Since the hand is a very sensitive part of the body, mild to severe pain should be expected.

What is the recovery period from this procedure?
Recovery time is specifically related to the extent of the surgery, how fast you heal and is usually aided by a recommended course of rehabilitation.