Dramatic advances have been made in recent years in
hand surgery to correct imperfections caused by injury or birth defects.
At the forefront of these advances have been plastic surgeon-specialists
improving both function and appearance. Hand surgery is often covered
Hand surgery techniques vary, depending upon the reason
for the procedure. The most common reasons are:
Carpal tunnel syndrome,
in which pressure builds up in the passageway through the wrist carrying
tendons and one of the hand's major nerves. This can happen as a result
of arthritis, injury, fluid retention during pregnancy, overuse, or repetitive
motions. Surgery involves cutting the tissue that presses on the nerve
to release the pressure.
Endoscopic Surgery is done
by Dr. Edstrom for carpal tunnel syndrome when quick return to work and
activities is desired. The ligament is released by introducing a scope
through tiny incisions in the wrist and hand. Recovery is quick –
usually back to full activities in 10 days to 2 weeks.
Congenital Defects that
interfere with proper hand growth in children, such as the fusing together
of two fingers (known as syndactyly). Surgery involves cutting the tissue
that connects the fingers, then grafting skin from another part of the
body. Other common defects include short, missing or deformed fingers,
immobile tendons and abnormal nerves or blood vessels.
a disorder of the tissue just under the skin in which thick, scar-like
bands form under the skin of the palm and fingers, restricting motion.
Surgery is a precise procedure that involves carefully removing the bands
of thickened tissue, freeing the joints and allowing the fingers to move
more normally. Recovery can take several weeks, and often requires some
time in hand therapy.
Injury to the tendons,
nerves, blood vessels, and joints; fractured bones; and burns, cuts and
other injuries to the skin. In cases of injury, a variety of innovative
techniques can be used, including grafting, flap surgery, and replantation.
Rhode Island Hospital is a major trauma center, and a large amount of
trauma is treated each year.
Rheumatoid Arthritis, an
inflammation of the joints that can deform finger joints and force them
into a bent position that impedes movement. Surgeons can repair or reconstruct
almost any area of the hand or wrist by removing tissue from inflamed
joints, repositioning tendons, or implanting artificial joints.
Hand surgery is usually performed in our Dudley Street
Operatory, using local anesthesia with sedation. Patients return home
with dressings that must be kept elevated above the heart, and often have
to spend some time working with our hand therapist.