Hand surgery is an important part of plastic surgery. It comprises both acute and chronic diseases. The major cause of hand injury is working accidents which can lead to serious complications, long absence from work or even permanent disability.
The most common chronic diseases of the hand are;
Carpal Tunnel Syndrome
This situation is due to pressure of the median nerve at the wrist. The main symptoms are numbness and pain in the middle finger, index finger and thumb that accentuate during night hours. Muscle atrophy of the hand can be noted in some cases. Surgical treatment is performed under local anesthesia and takes about 30 minutes. Manual labor is allowed after 2 weeks.
Palmar fibromatosis or Dupuytren’s disease is a fixed flexion contracture of the hand where the fingers bend towards the palm and cannot be fully extended causing significant physical disability of the hand. Most common to men, affects one or both hands. The disease is sometimes associated with diabetes, alcoholism or epilepsy. There is also a genetic predisposition.
Surgical excision of part or the whole palmar aponeurosis is the treatment of choice and is performed under regional anesthesia. Physiotherapy is also very important before return to manual work.
Trigger finger or thump
The movements of the tendons of the fingers are carried out through a system of small tubes called pulleys. In trigger finger or thump these movements are hindered due to inflammation, resulting in abnormal flexion and extension of the digits. The condition may be localized to the thumb or any other finger.
Conservative treatment leads to frequent relapses. Surgical treatment consists of release of the A1 pulley, performed under local anesthesia and takes 30-60 minutes. Return to manual labor is possible after a few days.