Hand Surgery

HAND SURGERY

Hand surgery can be performed by orthopedics and plastic surgery. Making a diagnosis in hand surgery requires expertise because the structures we call tendons in the hand are extensions of the muscles and connect with each other. Even if the tendon ruptures at first, adjacent tendons support these structures and tendon ruptures can be bypassed. If part of the tendon is cut, it may function at first, but over time, due to the tension, the tendon will lengthen and finger movement will be lost. When the tendon ruptures and there is no treatment, the bone and finger may be permanently changed and deformed. Movements are reduced and weakened. These changes over a long period of time cause structural distortions in the bone and other tendons and are very difficult to correct. The skin of the hand is very thin. The incisions on the hand are also thought to be ‘There is nothing in this, what will happen from a 1 cm incision’, but there are vessels, nerves and tendons under the thin skin. A finger with a cut vein can move in the early stages. But the finger will die because it is not fed. After it is too late, the finger becomes immobilized. (The muscle groups that provide the movements of the hand are in the forearm. Muscle groups continue to work while the vessel and nerve are cut. Move your fingers and pay attention to which muscle groups are moving). Each cut must be mutually repaired. It may be associated with bone fractures. Bone and tendon need to be repaired together.

After hand surgery, recovery and physical therapy require a long process. Approximate tendon healing time is 4-6 weeks. So once you have problems with the fingers, it will take 2-3 months at best for the hand to work at full efficiency. The tendons in the fingers are like rubber. There is a certain tension. If you cut a taut tire in the middle, the gap will be too large. What makes hand surgery difficult is to restore this tension and find those broken limbs. If these incisions are not repaired early, the length of the tendons will shorten. When the tension on the tendon is released, the length of the tendons shortens and it becomes difficult for them to come together end to end. More difficult, complicated operations such as tendon transfer are required. The patient feels pain from the incision and does not want to move his/her hand. This makes it difficult to evaluate the finger. Each tendon, each movement of the finger should be looked at separately.

In patients with additional problems such as diabetes or vascular disease, the infection in the finger may not be limited due to finger incisions. So the infection spreads along the entire finger. Older patients may cut the skin around the nail when cutting nails. There is bone just below the nail. An infection here can inflame the bone at the fingertip. Bone inflammation is a very difficult condition to treat. Pay attention to finger cuts, young and old alike. If you think the cut is deep, consult a hand surgeon immediately.