HandSurgery

Hand surgery is the subspecialty in which surgical or medical treatments are performed to resolve problems in upper extremity regions such as the hand, wrist and forearm that develop due to causes such as congenital anomalies, injuries, nerve compressions or rheumatological diseases.

Hand surgery today includes many different techniques and procedures. Among these procedures are many operations such as reattachment of severed limbs (replantation), arthroscopy, tenolysis, tenodesis, bone fusion, neurovascular surgery, myoplasty, tendon transfer and microsurgery.

Replantation is a procedure requiring microsurgery, performed to reattach a severed limb (e.g. finger, hand, arm) to the place from which it was severed by repairing bone, vessels, nerves, tendons and muscles.

Arthroplasty is a surgical procedure performed to remove and reshape joint surfaces. This procedure can be used to relieve pain in the joint, increase mobility and completely replace damaged joints.

Tenolysis is a procedure performed to increase the mobility of joints by cutting the adhesions on tendons that have developed adhesions to the surrounding tissues.

Bone fusion is a surgical procedure performed to join bones. This procedure can be used in the treatment of fractures or other bone damage.

Tendon transfer is a surgical procedure performed to attach a tendon onto another muscle or bone. This procedure can be used in conditions such as muscle weakness or damage.

Microsurgery refers to surgical procedures in which a surgical microscope is used to repair injured vessels and nerves, or to take tissues from one region of the body and transfer them to another region while preserving their blood circulation.

Congenital hand anomalies refer to structural abnormalities resulting from a developmental disorder of the baby in the womb. These anomalies may occur in the bones, muscles, tendons or other tissues of the hand and can seriously affect the function of the hand. Although the treatment of congenital hand anomalies varies according to the type and severity of the anomaly and the patient's age, most patients with a congenital hand anomaly need surgical intervention at some point in their lives.

For the treatment of congenital hand anomalies, one or several of the surgical procedures mentioned above are used together. Besides surgery, depending on the type and severity of the existing deformity, additional treatment options such as physical therapy, hand devices and external prostheses may also be needed. Physical therapy is used, with rehabilitation methods, to increase muscle, joint and tendon development and range of motion and to improve hand function. Hand devices and prostheses, on the other hand, may be devices designed to increase the mobility and functionality of the hand, or they may also be planned to complete the missing part of the limb. For this reason, the treatment plan is individualised for each patient and is managed by a multidisciplinary team to ensure that the treatment is applied in the most appropriate way.

Syndactyly is a congenital hand anomaly. In this condition, the fingers or toes cannot separate normally because they are joined or fused to each other. The joining may affect only the soft tissues between the fingers, forming a web-like structure between them, or it may take the form of fusion of the hand and finger bones, preventing the normal development of the hands and feet and seriously affecting hand and foot function.

Syndactyly should be treated according to the patient's age, the severity of the condition and which fingers are affected. Treatment requires surgical intervention, and in the operation the structures joined between them (bones and/or soft tissues) are cut and separated from each other. After the fingers are separated, although an attempt is made to cover the open wound by sliding finger skin into the space between the fingers to prevent re-fusion, it is usually also necessary to transfer skin taken from different parts of the body into the spaces between the fingers with a skin graft. After the surgical procedure, the patient's hands and feet may be placed in a splint and physiotherapy may be needed after the procedure. Surgical intervention is generally a successful treatment method for syndactyly and good results are obtained in most patients. However, it should not be forgotten that in the period after the surgical procedure the patients' hands and feet may swell and cause pain. In addition, tissue loss due to circulation problems may develop in the fingers that have been separated from each other.

Surgical treatment of syndactyly is very important for children's normal growth and development. For this reason, it is recommended that children be treated at the earliest possible age. The surgical procedure can improve children's hand and foot function and help them lead a normal life.

Polydactyly is a congenital hand anomaly. This condition can briefly be defined as a numerical excess of fingers or toes. Although most often it shows itself as a small protrusion beside the little finger, in some patients it appears as extra fingers in which all the joints of one or more fingers have fully developed. In patients with polydactyly, the extra finger has its own artery, and there is a risk of bleeding when it is removed. For this reason, however small the finger to be removed, the procedure must be performed by a hand surgeon. In addition, in a hand with fully developed extra fingers, when deciding which finger will be removed and which fingers will be left, how the procedure will affect the function of the hand is taken into account. In other words, it is not always the outermost sixth finger; sometimes it may be necessary to remove a finger located in between that does not function.