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Reconstructive Hand Surgery

Reconstructive Plastic Surgery Hand Procedures in Birmingham, Alabama

If your hand is impaired in any way, Hand Surgery may improve your condition. This type of very specialized surgery can treat diseases that cause pain and impair the strength, function and flexibility of your wrist and fingers. Surgery seeks to restore to near-normal the function of fingers and hands injured by trauma or to correct abnormalities that were present at birth.

Hand surgery is used to treat:

  • Carpal tunnel syndrome — A condition caused by pressure to the median nerve within the wrist, or carpal tunnel. You might feel pain, a tingling sensation, numbness of the fingers, weakness or aching. Carpal tunnel syndrome is associated with multiple conditions, including repetitive motion or overuse, fluid retention during pregnancy, injury to the nerve in the carpal tunnel or rheumatoid arthritis.
  • 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.
  • 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.

Hand Surgery Candidates

Hand surgery is a highly individualized procedure which 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 non-smoker.
  • 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.

Your Hand Surgery Consultation

By choosing a member of the American Society of Plastic Surgeons (ASPS) for your hand surgery procedure, you can be assured that you are choosing a highly-trained, board-certified plastic surgeon. ASPS Member Surgeons must meet rigorous standards for training, ethics, physician practice and research in plastic surgery.

The success and safety of your hand surgery depends very much on your complete candidness during your consultation. You will be asked a number of questions about your health, desires and lifestyle. 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 hand surgeon may also:

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

It is very important to ask questions at your consultation about your hand surgery procedure. It's natural to feel some anxiety, whether preoperative stress or excitement about your anticipated new look. Don't be shy about discussing these feelings with your plastic surgeon.

Hand Surgery Risks and Safety Information

The decision to have hand surgery is extremely personal. You will have to decide if the bene?ts of hand surgery will achieve your goals and if the risks and potential complications are acceptable. Your plastic surgeon and/or staff will explain the risks in detail.


The risks of hand surgery include:

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

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.

Carpal Tunnel Risks

Additional risks associated with carpal tunnel surgery include:

  • Non-improvement.
  • Recurrence of carpal tunnel syndrome.

Extensor Tendon Risks

Additional risks associated with extensor tendon surgery include:

  • Additional incisions necessary because cut tendons may retract.
  • Failure of tendon repair.
  • Inability to restore function.
  • Tendon scarring.

Flexor Tendon Risks

Additional risks associated with flexor tendon surgery include:

  • Additional incisions necessary because cut tendons may retract.
  • Inability to restore function.
  • Tendon scarring.

Tenolysis Risks

Additional risks associated with tenolysis surgery include:

  • Abnormal tendon position.
  • Additional incisions necessary where scarring occurs or to make new incisions to release scar tissue that is limiting tendon motion.
  • Inability to restore function.
  • Recurrent tendon scarring.
  • Rupture of tendon.
  • Seroma (fluid accumulation).
  • Wound breakdown.

Trigger Finger Risks

Additional risks associated with trigger finger surgery include:

  • Non-improvement.
  • Tendon scarring.

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, as they 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 Procedures

Anesthesia choices for hand surgery include intravenous sedation and general anesthesia. Your doctor 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.

Hand showing trauma repair incision
Hand Surgery trauma repair

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.

Hand showing carpal tunnel relief incisions
Hand Surgery carpal tunnel relief

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 showing birth deformity grafts and incisions
Hand Surgery birth deformity repair

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.

Depending on your condition and type of treatment, you may have incisions that need to be closed with removable or non-removable sutures.

Hand Surgery Recovery

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.

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

Be sure to ask your plastic surgeon specific questions about what you can expect during your hand surgery recovery period.

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery, and when will they be removed?
  • Are stitches removed, and when?
  • When can I resume normal activity and exercise?
  • When do I return for follow-up care?

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 the instructions of your therapist and plastic surgeon.

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.

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 bodily part.
  • Flexor tendon: A tendon which serves to bend a body part.
  • 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 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.
  • 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.

Procedure Information © American Society of Plastic Surgeons

Hand Surgery restores the function and appearance of the hands for patients with hand problems.

Birmingham, AL Office & Surgery Suites

Hedden & Gunn Plastic Surgery
140 Village Street
Birmingham, AL 35242
205-980-1744 or 800-HeddenMD
American Society of Plastic Surgeons American Society for Aesthetic Plastic Surgery
Hedden and Gunn Plastic Surgery

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Contact our Alabama plastic surgeons today to find out more about Hand Surgery or other plastic surgery procedures at our Birmingham-area practice.

To schedule your consultation at the earliest possible date, please call 205-980-1744.

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