All individuals use their forearms, hands, and wrists daily to conduct a wide range of activities, from getting dressed, to working and of course, engaging in hobbies and recreational pursuits. When muscles, joints, and tendons in such areas work as they should, these activities can be accomplished with ease. However, when injuries or other ailments cause pain, damage, and limits a person’s movement, minor tasks like picking up a spoon, doing up buttons, or opening a jar may become difficult or impossible.
In the event of such issues, it is recommended to consult a hand and wrist surgeon. They can reveal the diagnosis and offer treatment of the issue to prevent it from deteriorating and getting you back to what you love.
Who is a hand surgeon?
Hand surgery is the field of medicine that deals with pathology of the wrist, arm and hand. Hand surgeons care for such issues with or without surgery.
Most hand surgeons are qualified in General Surgery, Plastic surgery, or Orthopaedic surgery. They have additional training in hand, wrist and microsurgery. They take a minimum of one full year of additional training, with 18-24 months additional training required for the PFET (Hand) training run through the Royal Australasian College of Surgeons (RACS). Some hand surgeons treat only children, or only adults or both. Some hand surgeons also treat brachial plexus injuries, peripheral nerve injuries, quadriplegia, and spasticity.
Why visit a hand surgeon?
In case one has pain in the arm, wrist, hand, or fingers, it is recommended to consult a consultant hand surgeon. Since hand surgeons dedicate most of their time examining, researching, studying, and treating the hand and wrist, they become experts in hand care.
It is important to note that every consultation with a hand surgeon does not necessarily result in surgery. It is common for hand surgeons to recommend non-surgical options of management, such as steroid injections and hand therapy (which is a combination of occupational and physiotherapy to restore movement, eliminate or reduce pain, prescribe exercises and fashion splints and casts).
A visit to a hand surgeon can be warranted if you are experiencing any of the following:
- Pain in the arm, wrist, hand, or fingers which lasts for more than a few days.
- Difficulty in using wrists and arms to conduct daily functions like using the keyboard or carrying bags with groceries, or opening a jar.
- Joint pains.
- Bruising and swelling around the wrist or hand.
- Pins and needles or numbness of the hand, for example at night or when driving.
- Limitations in range of motion of the wrist, thumb or fingers.
- Deformity of joints.
- Symptoms of infection like inflammation, redness in hands or wrists, or fever.
Common kinds of hand surgery
- Following issues may be treated with hand surgery:
- Dupuytren’s contracture or bent fingers.
- Trigger finger leading to limited motion of fingers.
- Repair of tendon lacerations.
- Removal of ganglions.
- Replacement of joints of the wrist, thumb or fingers.
- Removal of Trapezium for thumb arthritis.
- Treatment for arthritis.
- Carpal tunnel syndrome.
- Cubital tunnel syndrome / ulnar nerve compression.
- Injuries to arm, wrist, or hand such as breaks, fractures, and cuts.
- Sports injuries to the wrist or hand.
Treatment options
Though hand and wrist surgeons are well trained to conduct surgery when required, they will only undertake this when non-surgical treatments have been tried or are not appropriate. Non-surgical treatment for hand injuries comprises of:
Medication- They may prescribe anti-inflammatory medication or pain relievers.
Physical therapy with hand therapy: Exercises may help some patients recover motion and strength, splinting/casting and other therapies often address hand complaints.
Surgical treatment options comprise of the following:
Surgery for Carpal Tunnel Syndrome: In this, the surgeon will divide the ligament over the carpal tunnel that puts pressure on the median nerve and helps reduce pain and sensations of pins and needles. The gap where the ligament is cut fills with scar tissue with time, without the nerve compression.
Surgery for tendon transfer: A healthy tendon is removed from its original attachment to a new location within the hand. This results in the enhancement of the lost function of the hand.
Wrist arthroscopy: The surgeon uses surgical tools and a miniscule camera (arthroscope) to closely examine and repair tissues in and surrounding one’s wrist. Such a kind of surgery causes less pain and faster recovery time compared to open surgery.
Surgery for Replantation: This surgery reattaches fingers or hands which have been amputated.
