Hand Surgery in Birmingham AL

Hand Surgery Candidates

Patients with painful conditions like carpal tunnel syndrome, rheumatoid arthritis and Dupuytren's contracture may be suitable candidates for hand surgery.

These procedures can be performed on people of any age and is a good option for you if:

• You do not have additional medical conditions or other illnesses that may impair healing.
• You are a nonsmoker.
• You have a positive outlook and realistic goals for your hand surgery.
• You are committed to following your plastic surgeon's prescribed course of treatment.

In some conditions, hand surgery is necessary to treat wounds and injuries. Plastic surgeons are often involved in treating patients who come to the emergency room with severe hand trauma.

Your Hand Surgery Consultation

The success and safety of your hand procedure depends very much on your complete candidness during your hand surgery consultation. You'll be asked a number of questions about your health, desires and lifestyle.

During your hand surgery consultation be prepared to discuss:

• Why you want the procedure, your expectations and desired outcome.
• Medical conditions, drug allergies and medical treatments.
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs.
• Previous surgeries.

Your plastic surgeon will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors.
• Examine your hand in detail.
• Discuss your options and recommend a course of treatment to restore hand function.
• Discuss likely outcomes of hand surgery and any risks or potential complications.

Hand Surgery Risks and Safety

Each patient must decide if the benefits of hand surgery will achieve their goals, and if the risks and potential complications are acceptable. Possible hand surgery risks include:

• Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents.
• Anesthesia risks.
• Bleeding (hematoma).
• Blood clots.
• Change in skin sensation.
• Damage to deeper structures — such as nerves, blood vessels, muscles and lungs — can occur and may be temporary or permanent.
• Deep vein thrombosis, cardiac and pulmonary complications.
• Infection.
• Injury to the blood vessels, nerves or tendons.
• Pain, which may persist.
• Poor healing of incisions.
• Possibility of revisional surgery.
• Skin contour irregularities.
• Skin discoloration/swelling.
• Unexpected hand swelling.
• Unfavorable scarring.

Your plastic surgeon and/or staff will explain the risks in detail. You will be asked to sign consent forms to ensure that you fully understand your hand surgery procedure, the alternatives and the most likely risks and potential complications.

Preparing for Hand Surgery

Prior to hand surgery, you may be asked to:

• Get lab testing or a medical evaluation.
• Take certain medications or adjust your current medications.
• Stop smoking well in advance of surgery.
• Avoid taking aspirin and certain anti-inflammatory drugs and herbal supplements, which can increase bleeding.

Special instructions you receive will cover:

• What to do on the day of surgery.
• The use of anesthesia during your procedure.
• Post-operative care and follow-up.

Your plastic surgeon will also discuss where your procedure will be performed. Depending on the type of surgery, your procedure may be performed in your plastic surgeon's accredited office-based surgical facility, an ambulatory surgical facility or a hospital. If your hand surgery is performed as an outpatient procedure, be sure to arrange for someone to drive you to and from surgery and stay with you for at least the first night.

Hand Surgery Procedure

Your plastic surgeon may recommend one or a combination of techniques to achieve your goals. Some of those techniques include microsurgery; grafting of skin, bone, nerves or other tissue from healthy parts of the body; z-plasty; and physical therapy.

Anesthesia choices for Hand surgery is performed using intravenous sedation or general anesthesia. Your surgeon will recommend the best choice for you.

Hand Surgery Incisions

Hand or Finger Trauma Treatment

The most common traumatic hand or finger injury requiring hand surgery is tendon repair. When a tendon is cut, it will retract from the original wound site. Tendon repair retrieves the retracted tendon and reconnects it using surgical techniques to restore function and movement.

Carpal Tunnel Syndrome Relief

Pressure on the median nerve in the carpal tunnel must be relieved to repair this condition. An incision is made from the middle of the palm to the wrist, allowing access to the constricted tissue causing pressure on the nerve. An alternate procedure is referred to as an endoscopic carpal tunnel release, with smaller incisions (see blue dotted lines below) and the use of a surgical microscope or endoscope (a small, flexible tube that contains a light and lens) to release pressure.

Birth Deformity Repair

When fingers are fused together at birth, known as syndactyly, they may be joined only by a web of skin or by skin and a partial fusion of bones. Surgery involves separating the two fingers to provide a full range of motion and a normal appearance, as well as permitting more normal finger growth. Techniques such as skin grafting or a local flap procedure like Z-plasty create flexibility at the incision site for growth and movement of the fingers.

Hand Surgery Recovery

After surgery, bandages or dressings may be applied to keep the surgical site clean and splints may be used when needed.

You will be given specific instructions that may include:

• How to care for your hand(s) following surgery.
• Medications to apply or take orally to aid healing and reduce the risk of infection.
• When to follow-up with your plastic surgeon.

Follow all postoperative instructions including cleansing, taking prescribed medications and hand therapy exercises. Therapy is critical to restoring strength, flexibility and movement. If you attempt to return to normal function too soon, the risk of re-injury is possible. Continue your hand therapy regimen and attend follow-up visits with your plastic surgeon as scheduled. This is essential to a successful outcome.

The end result of your hand surgery is directly related to following your therapist's and plastic surgeon's instructions.

Hand Surgery Results and Outlook

The results of hand surgery will appear gradually as swelling subsides. Your final outcome will develop over time and may not be realized for several months.

While advances in hand surgery can accomplish near miracles in reconstruction and replantation, your outcome cannot be fully predicted. For certain traumatic injuries, it may not be possible to achieve completely normal function.

If you had surgery to correct carpal tunnel syndrome, modifying work habits as recommended is vital to long-term improvement. Your final outcome may not be realized for several months. If your procedure involved microsurgery, a year is considered appropriate to fully reach restored function.

Hand Surgery Words to Know

• Carpal tunnel syndrome: A condition caused by pressure to the median nerve within the wrist or carpal tunnel causing pain, tingling and numbness.
• Dupuytren's contracture: A disabling hand disorder in which thick, scar-like tissue bands form within the palm and may extend into the fingers. It can cause restricted movement, bending the fingers into an abnormal position.
• Extensor tendon: A tendon which serves to extend a finger or hand.
• Flexor tendon: A tendon which serves to bend a finger or hand.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Grafting: Tissue taken from other parts of the body.
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
• Microsurgery: High magnification to repair or reconnect severed nerves and tendons, common in trauma cases and often used to reattach severed fingers or limbs.
• Polydactyly: The presence of extra fingers.
• Rheumatoid arthritis: A disabling disease that can cause severe inflammation in any joint of the body. In the hand, it can deform fingers and impair movement.
• Syndactyly: When fingers are fused together at birth.
• Tendon: A tough cord or band of dense white fibrous connective tissue that unites a muscle with some other part.
• Tenolysis: A surgical procedure to free a tendon from surrounding adhesions.
• Trigger finger: An abnormal condition in which flexion or extension of a finger may be momentarily obstructed by spasm followed by a snapping into place.
• Z-plasty: A surgical incision technique that creates small triangular flaps of tissue that help to close wounds over areas of the hand where bending or flexing is essential to function, such as around knuckles.