HAND SURGERY

Hand surgery is a subspecialty of Plastic Surgery which has seen immense developments in the recent years. It is a specialty based on the robust principles laid down by the masters.

We at Sparsh Clinics, Nagpur follow these principles in our practice.

Achieving function and cosmesis is our ultimate goal.

A wide spectrum of hand surgery is being performed on regular basis at Sparsh Clinics with consistent results. This spectrum range from fingernail/tip reconstruction to the most complicated procedure of replantation (Reattaching of the amputated hand or finger). Following text provides a glimpse at the various hand surgery procedures we perform.

Fingernail/Tip injury

After repair of nail bed injury
Pincer Nail Deformity
After surgical correction of Pincer Nail deformtiy

Fingernail or tip injuries are the most common injuries of hand by virtue of its prominent location. Other causes of finger nail and tip deformities are tumour or infection. Nail bed repair is done after trauma to the nail bed (normal nail bed gives rise to a normal looking nail). In cases where there is loss of nail bed, reconstruction is required. Other common deformities of nail are hook nail deformity and pincer nail deformity. Ganglion and Glomus tumors are also taken care of.

 

Tendon Injuries

Tendons are long slender structures that are necessary for the movements of all joints of finger and wrist. Tendon injuries lead to a dysfunctional hand with inability to flex and extend fingers/wrist. There is an equal role of surgery and post-operative rehabilitation in achieving normal function in cases of tendon injuries.

 

Fractures of the hand

Metacarpal and phalyngeal fractures are most common fractures of the upper extremity. The unstable and dislocated fractures require surgical intervention. The goals in treating these injuries are achieving stable fixation, angular correction, maintaining soft tissue balance and full range of motion.

 

Arthrodesis/Arthroplasty

 

A patient with severe rheumatoid arthritis with hand deformities

These are the procedures done for a destroyed joint, either due to trauma or arthritis. These procedures helps achieve pain free and functional joints leading to a good quality of life for a person.

 

Nerve Reconstruction

Nerve reconstruction is one of the most researched topics in hand surgery today. Hand cannot function without nerves as there is loss of motor and sensory function of the hand.

The treatment has to be individualised for each patient depending on the severity of injury and the presence of associated injuries.

Various procedures performed at Sparsh Clinics for nerve reconstruction are primary or secondary nerve repair, nerve grafting, nerve transfers, nerve decompression and rehabilitation.

 

Tendon Transfers

Patient after opponensplasty procedure after median nerve injury achieved full opposition of thumb

Tendon transfer refers to the transfer of normally functioning tendons to the non-functioning ones without further decreasing the function of the hand. Tendon transfers are done for old nerve injuries where repair or reconstruction of nerves is not possible. Commonest indications for tendon transfers are wrist drop and claw hand.

 

Congenital Hand

Congenital hand deformities are fairly common in our region that requires special attention. Appropriate and timely correction is required for lifelong normal hand function. Commonly seen deformities are joint fingers (Syndactyly), extra fingers (polydactyly), thumb duplication and hypoplasia and cleft hand.

 

Burned Hand

Severe hand deformities after Burn Injury

Burn injuries of the hand leads to specific hand deformities. Different types of contractures leads to different joint deformities. Long standing burn hand can cause joint stiffness that is difficult to correct. These deformities severely affect the functioning of the hand. Burn hand deformities are both preventable and correctable with appropriate care.

 

Miscellaneous

Dupuytren’s Contracture

Other conditions treated at Sparsh clinics are Dupuytren’s disease, flexor tenosynovitis, hand infection, thumb reconstruction and brachial plexus injuries. Thumb reconstruction is performed using autologous bone grafts and flaps and transferring of patients toes to the hand. Brachial plexus injuries are treated with nerve repair, nerve grafting, nerve transfers, muscle transfer and free functioning muscle transfers.

 

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