Our hands are crucial to meet our basic needs and to produce things. Many temporary or permanent problems, especially injuries due to occupational accidents, significantly affect our lives and cause many problems. The structure of the upper limb, such as bone, muscle, tendon, vessel, nerve and ligaments, works in harmony in the same environment. Hand surgery deals with all conditions that hinder this harmony secondary to various conditions, traumas and congenital problems.
Early intervention is critical for partial or complete amputations in hands and fingers. Traumas in hands due to conditions such as occupational accidents and traffic accidents cause damage in tendons, nerves and vessels. Initiating the treatment for this damage as soon as possible is crucial for the organ’s health.
Congenital differences that develop secondary to genetic factors such as polydactyly (one or more extra fingers in hand), syndactyly (adherent finger), clinodactyly (curvature of finger) can be seen. A normal looking hand can be achieved by eliminating this kind of problems with surgical interventions or a better appearance can be achieved by partially treating these conditions.
Like many other regions in body, nerve entrapment may develop in hands, elbows and wrists. Carpal tunnel syndrome and cubital tunnel syndrome are important disorders that are caused by nerve entrapment. Movement ability of hands regresses, muscle loss occurs and problems such as sensorial deficits may emerge in patients with these disorders.
Benign or malignant tumors can develop in hands and wrists. Glomus tumors, cysts in hands and wrists and ganglion tumors are the most common conditions among those and they generally cause swelling in hands and wrists. Those mass lesions that develop in hands and wrists generally show tendency to grow; therefore, they should be removed before they grow further.
Trigger finger, which is also known as Stenosing Tenosynovitis, is a type of disease causing catching and sudden locking in the fingers. In this disease, involuntarily and suddenly contracting fingers that stay contracted for a certain time also result in severe pain. Some muscle relaxants and various medication therapies can be primarily tried for management of this disease which makes the daily life and especially handwork difficult. However, the disease should be treated with microsurgery techniques if those methods fail to treat the disease.
Developing with thickening in skin of hand and palm and causing bending and contracting in fingers, Dupuytren’s contracture generally occurs due to thickening of fibrous tissue called aponeurosis under the palm skin. The disease may progress in time and result in difficulty in bending the fingers and even loss of movement in fingers. Therefore, this serious disease should be treated before wasting time immediately after it is diagnosed. Surgery is not required for cases with nodules in palm that do not cause limited movement and a treatment that prevents progression with cortisone injections can be used. However, the contracted tissues should be removed to treat the condition with Dupuytren’s contracture surgery and physiotherapy should be applied for more advanced cases.
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