There is nothing more frustrating than having a physical condition that makes the simplest task difficult. For many people, problems with their hands can make reaching, grabbing and holding items very painful. Fortunately, as medical science has made advances there are now surgeries that can be performed on almost any condition. Some of the most common hand surgeries are those done on such conditions as carpal tunnel syndrome, trigger finger, ganglion cysts, and Dupuytren’s disease. When surgery is needed to correct these conditions, using a skilled plastic surgeon may be your best option.
It should be noted that the first hand surgeons were indeed plastic surgeons. The field developed as a specialty following World War I as many soldiers were injured or maimed in the fighting. It took the special skill of plastic surgeons to repair these injuries to the hand treating the tendons, bone, nerve, skin and other issues with a special set of skills. It is interesting to note that the field of hand surgery as a specialty predated the field of orthopedic surgery. Orthopedics really began in the 1920’s and 30’s as a way to treat children who had developed issues with the bone growth, whether from the effects of malnutrition or other infectious disease. An interesting fact: the word “Orthopedic” literally translates to mean, “straightening out of children.” As orthopedics developed in the last century many studied the work of early plastic surgeons such as James William Littler, and Sterling Bunnel, to help advance the craft. However, Hand Surgery is still a cornerstone aspect of every plastic surgery residency-training program. While every plastic surgeon is required to complete core training in hand surgery, others will pursue additional training after residency. Lets look at some of the areas that plastic surgeons can make a difference in hand disease:
Carpal Tunnel Syndrome
l tunnel syndrome is a condition in which the median nerve of the hand is compressed within the wrist. The symptoms can feel like the hand is constantly falling asleep to severe throbbing pain in the hand that can radiate up the arm. Over time carpal tunnel syndrome can lead to nerve damage and weakness. Surgery is exceptionally effective at treating this condition. Some studies show that endoscopic carpal tunnel release has a 98% success rate. Patients are usually able to return to work within a week of surgery and have little pain with the procedure, which is performed as an outpatient. Plastic surgeons are used to working with delicate tissue and the nerve is one of the most delicate tissues in the body.
Trigger finger, a condition where a finger or thumb catches and gets stuck in a bent and locked position much like it would be when holding a gun, requires surgery only if rest, medications, massage and exercises fail to solve the problem. Surgery involves making a small incision in the palm of the hand to allow the tendons to fully release, allowing the finger to glide back and forth. For patients who fear post-operative scarring, having a plastic surgeon perform the surgery will allow the doctor to use minimally invasive procedures to lessen the chances of significant scarring. Usually the incisions are only a few millimeters in width and they fade with time.
Ganglion cysts, while not serious in and of themselves, can present problems to one’s hands and wrists if left untreated. The cysts are benign lumps below the skin that can cause tremendous inflammation and pain when holding or grabbing items. Many patients have problems holding cups or writing instruments with this condition, often avoiding tasks due to the discomfort. While the cysts can be drained or treated with steroid injections, surgery is often the most viable option because they tend to just fill up again with fluid if simply drained. Plastic surgeons can again not only remove the cysts, but also reduce scarring by using minimal incisions during the procedure and plastic surgery techniques for closure.
Dupuytren’s disease can cause extreme disability for those afflicted depending upon the amount of contracture in the hands. Using a board-certified surgeon with experience in hand surgery is best for this and the above conditions, for it lets the patient know their doctor has had success in the past with other patients.
While there are risks in hand surgery such as scarring and discoloration, using a top rated, board-certified plastic surgeon lessens the chances of complications. Patients should ask the doctor how many procedures they have performed and how previous patients have responded post-surgery. By doing so, the chances of success will greatly improve.