Hand Surgery – Treatment, Effect & Risks

Hand surgery

Hand surgery has established itself as a medical specialty in its own right. The anatomy of our hand is very complex and with it various clinical pictures have come into focus. How is the correct diagnosis made and what diseases are there?

What is hand surgery?

Hand surgery is the treatment of disorders and injuries to the hand and forearm . Modern hand surgery was founded by the American Sterling Bunnel after the Second World War. Hand surgery has been an additional specialty since 1993 and can be obtained by orthopedic specialists , surgeons and plastic surgeons .

The main feature of hand surgery is based on the acute and chronic damage or injury to the upper extremity or hand. The upper extremity includes the entire arm : shoulder , upper arm , forearm and hand.

The hand is again divided into individual sub-areas: the wrist , the metacarpal and the fingers . The aim is to provide an indication, i.e. it is determined whether there is a reason for the use of a therapeutic or diagnostic measure. It also includes the prevention, detection and treatment of diseases, malformations and tumors of the hand. The field of hand surgery also includes reconstruction after injuries and illnesses.

Treatments & Therapies

The clinical pictures of our hand are very complex and so is the treatment of the individual diseases. Injuries to the bones of the fingers, the tendons (connective tissue part of the muscle) and the ligaments are treated most frequently . A fracture of the wrist , for example that of the wrist, the ulna-radius joint or the forearm is a common injury. In the event of a fracture, the affected area is splinted or fitted with a cast . 

These injuries can be corrected with conservative therapy, surgical intervention is only necessary for complicated fractures. If blood vessels or nerves are also injured, an operation cannot be ruled out. Caring for the patient with burns of the upper extremities is also part of hand surgery.

The treatment of chronic diseases of the joints has taken on a very important task. Osteoarthritis , the wear and tear of the joints, is damage to the articular cartilage . Primary arthrosis mainly affects women after menopause and the cause of the damage is unknown. It is very obvious that the change in hormone balance plays a major role.

Secondary arthrosis is the result of metabolic disorders and crystal deposits ( gout ) or arthritis (an inflammatory disease of the joints). Osteoporosis (bone loss) can also lead to secondary arthrosis. Overloading the joints or lack of exercise can promote arthrosis. Rheumatoid arthritis begins with pain in the little fingers and wrist. Other joints in the human body can also be affected.

Carpal tunnel syndrome is one of the most well-known compression syndromes. It is a compression syndrome of the median nerve in the carpal area. The pain or discomfort occurs in the hand and can radiate into the entire arm. The symptoms become increasingly acute and can lead to muscle atrophy in the ball of the thumb area. Weakness in gripping and a reduced sense of touch are also side effects. The mild form of carpal tunnel syndrome can be treated without surgical therapy.

Treatment areas of hand surgery also include infections of the soft tissue (tendonitis) and bone , as well as diseases of tumors and cyst formation in the hand and arm and congenital malformations. The treatment also includes children suffering from childhood malformations, rheumatism and the care of patients with prostheses and the rehabilitation of patients with hand injuries.

Diagnosis & examination methods

In order to be able to make a conscientious diagnosis, an X-ray examination is ordered for the initial anamnesis. The anatomy of the hand is shown in detail on an X-ray . 

Projection images are created in two planes and are used for the detection and therapeutic assessment of the course of inflammatory, traumatic, degenerative and tumorous diseases of the bones and joints of the hand. In order to fully clarify a possible disease, a CT scan is ordered after an X-ray . In computed tomography, slice images are created using X-rays. The X-rays and CT scans are evaluated by a radiology specialist.

An MRI is performed to confirm a more accurate diagnosis or to rule out a disease . Magnetic resonance imaging makes it possible to diagnose rheumatic diseases or to assess the course. Joint inflammation and tendonitis are shown directly. Before the MRI, the patient drinks a contrast medium that allows the visualization of inflamed joints and tendons.

Depending on the diagnosis, the form of therapy initiated by the treating physician varies. After an operation on the hand, a complex and consistent follow-up treatment is necessary. The greatest progress is made with occupational therapy. Physiotherapy may be prescribed to help .

Physiotherapy is prescribed for diseases such as arthrosis. To relieve the pain, anti-inflammatory painkillers such as diclofenac or ibuprofen are taken. In order to prevent stomach and liver diseases, the natural medicinal herb devil’s claw can also be administered to relieve pain. Injections into the joints is a treatment option, but it can also lead to side effects. If none of the therapies work, surgery can be a way out.

After every hand injury and operation, it is important to relieve the pain and to train and fully restore movement. A treatment plan is developed individually for each patient. The doctor treating you and the hand therapist are always in close contact in order to better assess the healing process.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.