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Hand surgery is a branch related to the diseases and treatment of the part of our body that starts from the shoulder and extends to the tip of the finger and is called the upper extremity. Our hands are of great importance in meeting our basic needs and being a productive individual. Many temporary or permanent problems, especially injuries that impair hand functions, affect our lives significantly. Different structures such as bones, muscles, tendons, vessels, nerves and ligaments in the upper extremity work in harmony in the same environment. Hand surgery is concerned with situations where this harmony is disrupted due to various diseases, traumas and congenital problems. Main topics of interest are:
It is a condition that has an important role in providing the movement and sensation of the fingers and occurs due to the compression of the median nerve at the wrist level. It is the most common ailment among nerve compressions.
The first signs are usually weakness in the hand, fatigue, and a tingling sensation, especially in the first three fingers (thumb, index and middle fingers). In the following periods, the pain intensifies and numbness begins in the fingers. Pain and numbness can often be severe enough to wake the patient at night, and the symptoms subside when the patient shakes their hand and moves their wrist. In the treatment, non-surgical methods are tried first, and if no response is received, surgery should be performed without losing time.
Dupuytren's contracture; It is a disease that occurs with the thickening of the layer called fascia under the skin, often in the palms. It can also be seen on the feet and penis. Due to the thickening of the fascia as a result of the disease, wrinkling of the skin and adhesions in the tendons occur.
The onset is insidious, starting with painless swellings in the palm, especially at the level of the 4 (ring finger) and 5 (little finger) fingers. The swelling increases over time and begins to thicken in the form of a band. As the swelling and hardening of the skin increase, the flexibility of the fingers decreases. When the patient puts his palm on the flat surface, the palm of the hand does not touch the ground and takes the shape of a dome. As the disease progresses, it also affects tendons, adjacent vessels and nerves. It becomes increasingly difficult for the patient to open his finger. For this reason, washing his hands, wearing gloves, clapping and grasping objects are impaired. It becomes difficult for the patient to meet his own needs, and his quality of life decreases. The treatment is surgery before the disease progresses.
The ulnar nerve has a very important place in hand movements and function. Cubital tunnel syndrome is when the ulnar nerve is compressed at the elbow level and causes problems such as pain, swelling, numbness and loss of strength. The nerve passes between two bony prominences in our elbow. Since the nerve is very superficial in this region, it is open to pressure and trauma.
Its symptoms are pain, weakness, numbness, especially in the 4th and 5th fingers, and a feeling of electric shock in the hand, even after small impacts on the nerve at the elbow level. In the advanced stages, it is seen that it is difficult to bring the fingers closer together, and the 4th and 5th fingers are bent backwards while trying to keep the hand straight. If there is no response from conservative treatment in treatment, surgery should be performed without losing time.
They are benign tumors of cystic structure, filled with a gel-like fluid, arising from the joint capsule, tendon or tendon sheath. It is the most common benign tumor of the hand.
There is no definite reason. They can cause pain. It should be completely removed by going to the point of origin surgically.
Our tendons, which we perform the movements that lift the thumb up and away from the other fingers, pass under a tunnel in the wrist, near the base of the thumb. The thickening and stiffness in this tunnel and swellings in the tendon sheaths make it difficult for the tendons to slide under the tunnel during thumb movements. As a result, it presents with complaints of pain and tenderness in the wrist.
In the initial period, it is important to rest the hand by using splints that disable painful movements of the thumb. Again in this period, the swelling of the tunnel and tendon sheaths is tried to be reduced with drugs. If the symptoms do not go away or get worse, surgery is performed, which includes opening the tunnel that compresses the tendons.
It covers all kinds of injuries that can occur due to various reasons such as work accident, home accident, traffic accident, sports injury. While this injury can be a simple skin cut, it can be a tendon cut, nerve cut, vascular cut, bone fracture, partial or complete rupture of the finger. After the injury, the patient should be examined by a specialist doctor and a treatment plan should be drawn up.
The extensor tendons are located on the upper surface of the hand. They play a role in raising the hand and fingers. Extensor tendons are tendon extensions of the muscles of the forearm that extend to the fingertips. In the fingers, the tendons become thinner and flattened. In cases where its integrity is impaired, its treatment is surgery.
The muscles that allow the fingers to bend inward are called flexor muscles. They are connected to the finger bones by structures called tendons, which look like cords coming out of the existing muscles in the forearm. The flexor muscles start from the elbow or forearm and turn into tendons in the middle of the arm and extend to the fingertips. In cases where its integrity is impaired, its treatment is surgery.
Partial or complete motor loss occurs depending on the function performed by the nerve whose integrity is impaired. Its treatment is microsurgical repair.
Depending on the importance of the disintegrated vessel, it may need to be treated. If it needs to be treated, microsurgical repair is required.
Depending on the shape of the fracture, it should be intervened with a splint, plaster or surgery.
Microsurgery is a surgical technique applied by magnifying the operating field using an operating microscope or special glasses. In this way, it is possible to surgically treat problems in structures such as nerves and vessels, which are normally difficult to see with the naked eye. It can be used in microsurgical vascular and nerve repairs, in vascular tissue transplants from one part of the body to another. Repair of limbs injured as a result of work accidents, traffic accidents, glass cuts, falls or similar accidents, which increase rapidly in our daily lives, and suturing broken parts are possible with microsurgical methods.
Every Plastic and Reconstructive Surgery Specialist receives microsurgery training and has the authority to successfully perform surgeries that require microsurgery.
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