Hand and Microsurgery
Last Updated 11-03-2022 09:47:18

What is Hand Surgery?

Hand surgery , also called Hand and Upper Extremity Surgery , is a branch that deals with the diagnosis and treatment of various diseases and injuries of the hand, and the injury of other parts of our body. Repair of hand, wrist, forearm, elbow, shoulder areas, vascular, nerve and tendon incisions, congenital upper extremity disorders and brachial plexus injuries are the most frequently applied conditions to hand surgeons. This is the reason why this branch is known as hand and upper extremity surgery.

In addition, it can be performed by hand surgeons in the treatment of vascular nerve and tendon injuries in the lower extremity, ie thigh, leg and foot region.

Because the surgical treatment of vessels and nerves that concern these regions is performed using fine-tipped micro-instruments under the microscope. Therefore, hand surgery and microsurgery are generally known as intertwined branches.

What is Microsurgery?

Microsurgery, which stands out as the most frequently used technique in hand surgery, is a surgical technique applied by magnifying the operating field using an operating microscope or special glasses. Thanks to this technique, sensitive problems in structures such as nerves and vessels, which are difficult to see with the naked eye under normal conditions, become surgically treatable. The repair of vessels, nerves and fibers, which cannot be seen with the naked eye due to their extremely small size, is possible thanks to microsurgery. With microsurgery methods, the planting of partially or completely severed limbs can also be performed successfully.

In Which Situations Is Microsurgery Applied?

Microsurgery is generally applied in the following situations:

  • Thumb and trigger finger ruptures
  • Injuries or losses in muscles and tissues, 
  • crush,
  • Tendon repair,
  • Amputations occurring in the finger and the end joint of the fingers,
  • Palm injuries and ruptures in this area,
  • hand break,
  • Removal of tumors in the musculoskeletal system,
  • Vascular and nerve cuts
  • Breaks on the elbow,
  • Amputations in children
  • Avulsion fracture, also known as shear fracture,
  • Injuries that require tendon and nerve transplantation,
  • Treatment of ailments caused by nerve compressions in the hand or elbow,
  • Transplantation of muscle, skin and vascular tissue to another part of the body as a composite.

 

What are Hand Surgery Diseases?

We can list the medical conditions in the field of hand surgery more comprehensively under the following headings: 

1.) Hand, Wrist and Forearm Injuries

A.) Finger and Limb Amputations

Hand, finger, forearm, arm, foot and leg amputations are among the areas of interest of hand surgery. Repair of limb ruptures depends on many factors. How and in what way the rupture takes place is perhaps the most important of these factors. 

B.) Artery, Tendon and Nerve Injuries

Vascular cuts are one of the causes of bleeding. In addition, there is a risk of tissue death due to this situation. In addition to vascular incisions, cuts of tendons that enable the formation of movement by transmitting movement commands and transferring the power of nerves and muscles to the bones are also surgically treated with this technique.  

C.) Fractures and Dislocations

All fractures in the upper extremity are covered by hand surgery. These include fractures and dislocations in the hand, wrist, forearm and elbow, ligament ruptures and arm bone fractures. Such problems are also treated with hand surgery and microsurgery. 

2) Nerve and Tendon Compression

With the development of technology and the widespread use of computers, nerve muscle and compression frequently occur due to excessive computer use. Nerve compression usually manifests itself with symptoms such as numbness, pain and weakness in the hand. The most common type of nerve compression is carpal tunnel syndrome. Both early and late treatments of nerve entrapments are of interest to the department of hand surgery. 

A.) Carpal Tunnel Syndrome

Carpal tunnel syndrome manifests itself as a result of compression in the median nerve at the wrist level due to various reasons. In this syndrome, pain occurs in the first three fingers and numbness/feeling defect in a part of the fourth finger. If it progresses, symptoms such as loss of strength in the fingers and dropping objects from the hands occur. Hand surgery is one of the methods used in the treatment of this syndrome.  

B.) Ulnar Groove Syndrome

It occurs as a result of compression of the ulnar nerve at the elbow level. Numbness occurs in the fourth and fifth fingers. Its treatment is similar to the methods used in carpal tunnel syndrome.

C.) De Quervain's Tendinitis

This discomfort is caused by compression in the tendons that lift the thumb at the wrist level. In the treatment of diabetes, rheumatic diseases and this disease, which is frequently seen in the postpartum period, surgical release is applied if drug and splint treatment are insufficient.

D.) Trigger Finger Syndrome

The tendons that allow the fingers to be bent are thickened while connecting to the palm and compression occurs. In trigger finger disease that occurs in this way, finger movements are stuck and there is pain.

3.) Tumors and Tumor-like Formations in the Hand and Upper Extremities

A.) Tumor-like Formations

The most common among these are ganglion cysts formed in the wrist tendon sheaths. These cysts cause pain. Although drug therapy works to relieve pain, surgical removal of ganglion cysts is recommended. Another common occurrence is dupuytren's disease (dupuytren's contracture). This disease, which is seen on the palms and soles of the feet, can cause the fingers to contract in a way that cannot be opened. It is tried to be controlled with local injections and minimal surgical methods, but surgical intervention is essential in further stages. 

B.) Benign Tumors

Giant cell tumor of the tendon sheath, cysts found in bone and soft tissue, tumors originating from vascular and nerve sheaths can be counted among these. 

C.) Malignant Tumors

Just like other malignant bone and soft tissue tumors that occur in the skeletal system, they must be treated. A multidisciplinary approach should be followed in the treatment of malignant tumors, and hand surgery and orthopedic oncology should work together.

4) Rheumatic, Inflammatory and Infectious Diseases

Hand and wrist joints are among the joints where rheumatic diseases are most common. Apart from rheumatic causes, chronic fatigue and microorganisms are among the factors that trigger arthritis and tendinitis. In the case of advanced deformities, surgical interventions are used. 

5) Congenital Anomalies and Birth Injuries

Just like in other parts of our body, congenital anomalies frequently occur in the hands and upper extremities. Anomaly frequencies may decrease thanks to strict follow-up during pregnancy, but it is not possible to prevent them completely. Complex anomalies such as extra fingers (polydactyly), attached fingers (syndactyly) and bones sticking together (synostosis) can be counted among these. In such cases, surgical intervention is often required. Apart from these, collarbone fracture is the most common type of injury that occurs during difficult births. Although a collarbone fracture heals uneventfully, fractures can occur in other bones as well. In such cases, it is possible to treat with surgery and physical therapy. 

Hand Surgery and Microsurgery Treatment

In order to obtain positive results after hand surgery, a physical therapy and rehabilitation process that is initiated in the early period and continues regularly also plays a critical role. Many factors such as the location of the operated area, the nature of the tissue, the physical therapy process and the age of the patient affect the healing process. Hospitals with hand surgery are aware of the need for a good physical therapy process in order to carry out this treatment efficiently. For this reason, it is extremely important to apply to the best in hand surgery. In this way, a successful process is possible. However, in some reconstructive surgeries performed within the hand surgery hospital, excellent results may not be obtained despite the successful operation and physical therapy process. In such cases, the target is  

Frequently Asked Questions About Hand Surgery and Microsurgery

Which Department Does Hand Surgery Enter? 

Individuals researching hand surgery and microsurgery often ask questions such as "Which department deals with hand surgery?" For hand surgery, it is necessary to go to the Orthopedics and Traumatology department.

In Which Surgeries Is Microsurgery Used?

Microsurgical surgery; It is used in cases such as the treatment of vital vessels and nerves as a result of accident or injury, the suturing of amputated body parts, and accidents. Apart from these, it is also a method applied for the treatment of tissue loss due to causes such as burns and cancer. 

What Causes Swelling in Fingers?

Swelling of the hands usually refers to the accumulation of water in the body, inflammation of the hand tissue or inflammation of the joints. Apart from these, a common cause such as water retention during menstruation or pregnancy, or more serious health problems such as an inflammatory disease can also cause swelling of the hands. In such a situation, it is useful to apply to a health institution just in case. 

Which Department Goes to for Hand Swelling?

Depending on the factor causing swelling, the section to be visited also varies. Therefore, in order to learn the cause of the swelling complaint, it is useful to have a general examination first. 

Which Department to Go to for Hand Fracture?

Traumatology department is a branch of medicine that includes emergency treatment in cases that occur as a result of trauma in general. This section deals with traumatic lesions such as wounds, burns, fractures, dislocations and bruises. For hand fractures, it is necessary to go to the traumatology department. 

Which Section Takes Care of a Tendon Rupture?

Tendonitis is covered by the Orthopedics and Traumatology department. 

Which Department to Go to for Hand and Arm Pain?

For arm pain, you should apply to the Orthopedics, Physical Therapy or Neurology polyclinics in hospitals. 

How Is Microsurgical Hernia Surgery Performed?

Microsurgical hernia surgery, also known as microdiscectomy, is the most common treatment method used in lumbar hernia surgery. Microsurgical hernia surgery is a surgical method applied to relieve the pressure on the nerve root and relieve pain by removing the herniated disc parts. In this operation, which usually starts under general anesthesia, a smaller skin incision (1.5-2 cm) is made first. Then, with the help of special retractors, the muscle tissue is stripped and a smaller bone window is opened using imaging methods. Since this operation is performed with special microscope and microsurgical instruments and methods, it is extremely unlikely that the nerve and nerve membrane will be damaged. Hand surgeons and those who have microsurgical hernia surgery usually undergo the operation with the awareness that this possibility is very low. With this special operation, the hernia tissue pressing on the nerve root is cleaned. 

Microsurgery Hernia Surgery Recovery Process     

After microsurgical hernia surgery, patients have the opportunity to return to their work or daily life much faster. With this specially developed application, it is possible to return to your daily routine quickly and the healing process will be much less painful.