HandsHand Surgery can treat a broad range of problems that specifically affect the hand, whether they result from cuts, burns, crushing injuries to the hand, or diseases. Savannah Hand Surgery Specialist, Dr. Daniel Most, is highly trained, skilled and experienced to provide the specialized care that these problems require.
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The human hand is one of the most versatile tools in nature. It not only fulfills countless physical functions, it is also a communication and sensory tool. Illness, injury, or congenital deformity (one present at birth), can diminish the ability to manipulate our hands to grasp, pinch, wave, touch, shake hands or perform countless other functions. Treatment or repair of the hand to improve or restore function requires very specialized attention.
If the function of your hands is impaired in any way, hand surgery may improve your condition. What is hand surgery? Hand surgery is plastic surgery performed to improve the function, physical condition or physical appearance of the hand and can treat diseases that cause pain and impair the strength, function and flexibility of the wrist and fingers. It seeks to restore to near normal the function of the fingers and hands injured by trauma. Hand surgery can also correct abnormalities in hand development present at birth.
Endoscopic Carpal Tunnel Release
Carpal Tunnel Syndrome (CTS) is a condition caused by by pressure to the median nerve within the wrist, or carpal tunnel. The condition results in a tingling sensation, numbness of the fingers, weakness or aching and it can impair hand function.
Carpal Tunnel Syndrome may be associated with multiple conditions including repetitive motion or overuse, fluid retention during pregnancy, injury to the nerve in the carpal tunnel, or rheumatoid arthritis.
While the most common surgical procedure for a carpal tunnel release is still the open-incision technique, many surgeons, like Dr. Most, are using a newer procedure called Endoscopic Carpal Tunnel Release.
The procedure is done using an endoscope, which is a small, fiber-optic TV camera, to look into the carpal tunnel through a small incision just below the wrist. Using the camera allows the surgeon to release the ligament without disturbing the overlying tissues.
The surgery releases the carpal ligament, taking pressure off the median nerve. By using the endoscope, surgeons can accomplish this without disrupting the nearby tissues. Patients can heal faster, are able to use their hand faster, and have fewer problems of tenderness in the palmar incision.
Joint Replacement
Joint Replacement surgery involves replacing a destroyed joint with an artificial joint. In knee or hip replacement surgery, the artificial joint is made out of metal and plastic. In the case of joint replacement in the hand, the new joint is most commonly composed of silicone rubber or the patient’s own tissues such as a portion of tendon.
Joint Replacement surgery, also known as arthroplasty, is very common. Each year, surgeons perform thousands of Joint Replacement surgeries. Joint Replacement surgery in the hand is typically used in treating severe arthritis that involves the small joints of the hand.
The hips and knees receive continuous stress from walking, running, sporting activity, or injury and are more commonly affected by the wearing of cartilage (degenerative arthritis) than the hand joints. However, the joints of the hand do experience stress in everyday use, and because the hand joints are smaller, these stresses are concentrated over a smaller surface area.
The high ratio of stress to surface area can cause the smooth joint cartilage to wear over the years. As the cartilage degenerates, the underlying bone becomes exposed. When the deteriorated joint moves, bone rubs upon bone causing pain, swelling, limiting motion, and frequently causing a grinding or popping sensation.
Furthermore, forms of arthritis that are caused by inflammation of the tissues lining the joint frequently affect the small joints of the hands and wrists to cause joint destruction. Examples include rheumatoid arthritis and psoriatic arthritis.
Tendon Transfers
Tendon Transfer surgery is a type of hand surgery that is performed in order to improve lost hand function. A functioning tendon is shifted from its original attachment to a new one to restore the action that has been lost.
Many different conditions can be treated by Tendon Transfer surgery and is necessary when a certain muscle function is lost because of a nerve injury. If a nerve is injured and cannot be repaired, then the nerve no longer sends signals to certain muscles. Those muscles are paralyzed and their muscle function is lost. Tendon Transfer surgery can be used to attempt to replace that function.
Tendon Transfer surgery may also be necessary when a muscle has ruptured or been lacerated and cannot be repaired. Common muscle or tendon injuries that are treated with this surgery are tendon ruptures due to rheumatoid arthritis or fractures. Also, tendon lacerations that cannot be repaired after injury may be treated with Tendon Transfer surgery.
Trigger Fingers
Trigger Finger is a common disorder of late adulthood whereby the finger or thumb bends towards the palm of the hand and the tendon gets stuck and the finger clicks or locks. Tendons are tissues that connect muscles to bone. When muscles contract, tendons pull on bones. The muscles that move the fingers and thumb are located in the forearm, above the wrist.
About 2-3% of the population will develop Trigger Finger and it is more common in females than males. It is more prevalent in people over 40 and has been linked with some medical conditions such as diabetes or rheumatoid arthritis. Although it has not been proven, repetitive gripping occupations such as working with power tools could also contribute to this condition.
The symptoms of this condition include catching, snapping or locking of the involved finger on movement. Pain at the base of the affected finger on movement or when pressing the area. A nodule may develop at the base of the finger. The finger may eventually be bent towards the palm of the hand or stiffness and clicking when trying to move the finger will occur.
Treatment of the condition depends on the severity of the symptoms. Non surgical intervention is used if the symptoms are not too severe. Rest is advised of the hand and you may be prescribed non-steroidal anti-inflammatory medication to relieve pain and inflammation.
Splinting may help to relieve symptoms, either by keeping the finger straight or bent, and stopping movement of the finger to decrease inflammation.
In more severe cases, a corticosteroid injection may be recommended for symptom relief. In extreme cases, surgery may be recommended to cut the affected tendon and release the finger from its bent position.
Dupuytren’s Contracture
Like Rheumatoid Arthritis, which is a disabling disease that can cause severe inflammation, commonly in the hands, that can deform fingers and impair movement, Dupuytren’s Contracture is another disabling hand disorder in which thick, scar like, tissue bands form within the palm and my extend into the fingers. It can cause restricted movement, bending the fnigers into an abnormal position.
The condition becomes more common after the age of 40. Men are affected more often than women. Risk factors are alcoholism, diabetes, and smoking. One or both hands may be affected. The ring finger is affected most often, followed by the little, middle, and index fingers. A small, painless nodule or lump develops in the tissue below the skin on the palm side of the hand.
Over time, it thickens into a cord-like band and becomes difficult to extend or straighten the fingers. In severe cases, straightening them is impossible.
Surgery may be performed to release the contracture, depending on the severity of the condition. Normal movement of the fingers is usually restored by surgery followed by physical therapy exercises for the hand.
Finger / Hand Reattachment
Surgical reattachment of a finger, hand, or arm that has been completely cut from a person’s body is referred to as replantation. The goal of replantation surgery is to give the patient back as much use of the injured area as possible.
In some cases, Finger / Hand Reattachment is not possible because the part is too damaged. If the lost part cannot or should not be reattached, you may have the alternative of a completion amputation with or without a prosthesis, a device that substitutes for a missing part of the body. In some cases, this option will give you better and faster recovery than a replantation.
There are a number of steps in the replantation process. First, damaged tissue is carefully removed. Then bone ends are shortened and rejoined with pins or plates. This holds the part in place to allow the rest of the tissues to be restored to a normal position. Muscles, tendons, arteries, nerves and veins are then repaired. Sometimes grafts of bone, skin, tendons, and blood vessels may be needed, too.
Fractures
Because we constantly use our hands, fractures to the bones of the fingers and hands are a common injury that hand fracture surgery doctors often see. Hand fractures can occur in the long bones of the hands or the small bones of the fingers. They can occur from a crushing injury, playing sports, twisting or falling.
Stress fractures can occur in individuals with underlying conditions such as osteoporosis. These types of fractures often occur from doing simple tasks that result from weak and brittle bones.
In most cases, fractured bones in the hands or fingers can be realigned and immobilized with the use of a splint, fracture brace or cast. Although most hand fractures can be managed without surgical treatment sometimes certain bones fractures do require surgical repair. These cases usually transpire if the hand is crushed or if the bone is exposed from the fracture.
Other types of hand fractures that normally require surgery are intra-articular fractures, unstable fractures, angulated fractures or displaced fractures. If these types of fractures are not properly treated, complications can arise causing another type of hand fracture to occur. This can lead to cosmetic disfigurement and loss of function.
Hand fracture surgery requires the surgeon to realign and stabilize the bones. This is often done with the use of screws, plates and wires to reposition the bones and keep them in place.
Syndactyly (Webbed) / Polydactyly (Extra)
Syndactyly refers to joined or “webbed” digits in the hand, and most often this refers to adjacent fingers which are grown together. Syndactyly is one of the most common variations on the basic growth pattern of the hand.
Syndactyly occurs in the womb as the hand is developing one thumb and four separate fingers. In the womb, the new hand starts out in the shape of a paddle, then splits into separate fingers. Sometimes the fingers don’t split apart enough, and webbed fingers result.
Sometimes a extra split forms and extra fingers result which is referred to as polydactyly. Syndactyly and polydactyly are about equally common disorders. Combinations of both can occur as well; webbed and extra fingers.
Why does a child have this? It is not due to anything the mother did during pregnancy, it just happens. Sometimes these problems are in the genes and can be passed down generation to generation, but many times there is simply no known explanation.
Trauma
Everything discussed on this webpage helps to illustrate that trauma to the hand is varied in type and severity. Whether the trauma results from cuts, burns, crushing injuries to the hand, diseases, or birth defects, hand injuries can greatly impair function when it involves the very intricate tendon and nerve system of the hand.
Severed fingers or hands are extreme cases of hand trauma and in some cases can be reattached and made functional through hand and microsurgery. No matter what kind of hand trauma you have experienced, Dr. Most has the experience and skill to help your unique circumstances.
If the function of your hands is impaired in any way, hand surgery may improve your condition. What is hand surgery? Hand surgery is plastic surgery performed to improve the function, physical condition or physical appearance of the hand and can treat diseases that cause pain and impair the strength, function and flexibility of the wrist and fingers. It seeks to restore to near normal the function of the fingers and hands injured by trauma. Hand surgery can also correct abnormalities in hand development present at birth.
Endoscopic Carpal Tunnel Release
Carpal Tunnel Syndrome (CTS) is a condition caused by by pressure to the median nerve within the wrist, or carpal tunnel. The condition results in a tingling sensation, numbness of the fingers, weakness or aching and it can impair hand function.
Carpal Tunnel Syndrome may be associated with multiple conditions including repetitive motion or overuse, fluid retention during pregnancy, injury to the nerve in the carpal tunnel, or rheumatoid arthritis.
While the most common surgical procedure for a carpal tunnel release is still the open-incision technique, many surgeons, like Dr. Most, are using a newer procedure called Endoscopic Carpal Tunnel Release.
The procedure is done using an endoscope, which is a small, fiber-optic TV camera, to look into the carpal tunnel through a small incision just below the wrist. Using the camera allows the surgeon to release the ligament without disturbing the overlying tissues.
The surgery releases the carpal ligament, taking pressure off the median nerve. By using the endoscope, surgeons can accomplish this without disrupting the nearby tissues. Patients can heal faster, are able to use their hand faster, and have fewer problems of tenderness in the palmar incision.
Joint Replacement
Joint Replacement surgery involves replacing a destroyed joint with an artificial joint. In knee or hip replacement surgery, the artificial joint is made out of metal and plastic. In the case of joint replacement in the hand, the new joint is most commonly composed of silicone rubber or the patient’s own tissues such as a portion of tendon.
Joint Replacement surgery, also known as arthroplasty, is very common. Each year, surgeons perform thousands of Joint Replacement surgeries. Joint Replacement surgery in the hand is typically used in treating severe arthritis that involves the small joints of the hand.
The hips and knees receive continuous stress from walking, running, sporting activity, or injury and are more commonly affected by the wearing of cartilage (degenerative arthritis) than the hand joints. However, the joints of the hand do experience stress in everyday use, and because the hand joints are smaller, these stresses are concentrated over a smaller surface area.
The high ratio of stress to surface area can cause the smooth joint cartilage to wear over the years. As the cartilage degenerates, the underlying bone becomes exposed. When the deteriorated joint moves, bone rubs upon bone causing pain, swelling, limiting motion, and frequently causing a grinding or popping sensation.
Furthermore, forms of arthritis that are caused by inflammation of the tissues lining the joint frequently affect the small joints of the hands and wrists to cause joint destruction. Examples include rheumatoid arthritis and psoriatic arthritis.
Tendon Transfers
Tendon Transfer surgery is a type of hand surgery that is performed in order to improve lost hand function. A functioning tendon is shifted from its original attachment to a new one to restore the action that has been lost.
Many different conditions can be treated by Tendon Transfer surgery and is necessary when a certain muscle function is lost because of a nerve injury. If a nerve is injured and cannot be repaired, then the nerve no longer sends signals to certain muscles. Those muscles are paralyzed and their muscle function is lost. Tendon Transfer surgery can be used to attempt to replace that function.
Tendon Transfer surgery may also be necessary when a muscle has ruptured or been lacerated and cannot be repaired. Common muscle or tendon injuries that are treated with this surgery are tendon ruptures due to rheumatoid arthritis or fractures. Also, tendon lacerations that cannot be repaired after injury may be treated with Tendon Transfer surgery.
Trigger Fingers
Trigger Finger is a common disorder of late adulthood whereby the finger or thumb bends towards the palm of the hand and the tendon gets stuck and the finger clicks or locks. Tendons are tissues that connect muscles to bone. When muscles contract, tendons pull on bones. The muscles that move the fingers and thumb are located in the forearm, above the wrist.
About 2-3% of the population will develop Trigger Finger and it is more common in females than males. It is more prevalent in people over 40 and has been linked with some medical conditions such as diabetes or rheumatoid arthritis. Although it has not been proven, repetitive gripping occupations such as working with power tools could also contribute to this condition.
The symptoms of this condition include catching, snapping or locking of the involved finger on movement. Pain at the base of the affected finger on movement or when pressing the area. A nodule may develop at the base of the finger. The finger may eventually be bent towards the palm of the hand or stiffness and clicking when trying to move the finger will occur.
Treatment of the condition depends on the severity of the symptoms. Non surgical intervention is used if the symptoms are not too severe. Rest is advised of the hand and you may be prescribed non-steroidal anti-inflammatory medication to relieve pain and inflammation.
Splinting may help to relieve symptoms, either by keeping the finger straight or bent, and stopping movement of the finger to decrease inflammation.
In more severe cases, a corticosteroid injection may be recommended for symptom relief. In extreme cases, surgery may be recommended to cut the affected tendon and release the finger from its bent position.
Dupuytren’s Contracture
Like Rheumatoid Arthritis, which is a disabling disease that can cause severe inflammation, commonly in the hands, that can deform fingers and impair movement, Dupuytren’s Contracture is another disabling hand disorder in which thick, scar like, tissue bands form within the palm and my extend into the fingers. It can cause restricted movement, bending the fnigers into an abnormal position.
The condition becomes more common after the age of 40. Men are affected more often than women. Risk factors are alcoholism, diabetes, and smoking. One or both hands may be affected. The ring finger is affected most often, followed by the little, middle, and index fingers. A small, painless nodule or lump develops in the tissue below the skin on the palm side of the hand.
Over time, it thickens into a cord-like band and becomes difficult to extend or straighten the fingers. In severe cases, straightening them is impossible.
Surgery may be performed to release the contracture, depending on the severity of the condition. Normal movement of the fingers is usually restored by surgery followed by physical therapy exercises for the hand.
Finger / Hand Reattachment
Surgical reattachment of a finger, hand, or arm that has been completely cut from a person’s body is referred to as replantation. The goal of replantation surgery is to give the patient back as much use of the injured area as possible.
In some cases, Finger / Hand Reattachment is not possible because the part is too damaged. If the lost part cannot or should not be reattached, you may have the alternative of a completion amputation with or without a prosthesis, a device that substitutes for a missing part of the body. In some cases, this option will give you better and faster recovery than a replantation.
There are a number of steps in the replantation process. First, damaged tissue is carefully removed. Then bone ends are shortened and rejoined with pins or plates. This holds the part in place to allow the rest of the tissues to be restored to a normal position. Muscles, tendons, arteries, nerves and veins are then repaired. Sometimes grafts of bone, skin, tendons, and blood vessels may be needed, too.
Fractures
Because we constantly use our hands, fractures to the bones of the fingers and hands are a common injury that hand fracture surgery doctors often see. Hand fractures can occur in the long bones of the hands or the small bones of the fingers. They can occur from a crushing injury, playing sports, twisting or falling.
Stress fractures can occur in individuals with underlying conditions such as osteoporosis. These types of fractures often occur from doing simple tasks that result from weak and brittle bones.
In most cases, fractured bones in the hands or fingers can be realigned and immobilized with the use of a splint, fracture brace or cast. Although most hand fractures can be managed without surgical treatment sometimes certain bones fractures do require surgical repair. These cases usually transpire if the hand is crushed or if the bone is exposed from the fracture.
Other types of hand fractures that normally require surgery are intra-articular fractures, unstable fractures, angulated fractures or displaced fractures. If these types of fractures are not properly treated, complications can arise causing another type of hand fracture to occur. This can lead to cosmetic disfigurement and loss of function.
Hand fracture surgery requires the surgeon to realign and stabilize the bones. This is often done with the use of screws, plates and wires to reposition the bones and keep them in place.
Syndactyly (Webbed) / Polydactyly (Extra)
Syndactyly refers to joined or “webbed” digits in the hand, and most often this refers to adjacent fingers which are grown together. Syndactyly is one of the most common variations on the basic growth pattern of the hand.
Syndactyly occurs in the womb as the hand is developing one thumb and four separate fingers. In the womb, the new hand starts out in the shape of a paddle, then splits into separate fingers. Sometimes the fingers don’t split apart enough, and webbed fingers result.
Sometimes a extra split forms and extra fingers result which is referred to as polydactyly. Syndactyly and polydactyly are about equally common disorders. Combinations of both can occur as well; webbed and extra fingers.
Why does a child have this? It is not due to anything the mother did during pregnancy, it just happens. Sometimes these problems are in the genes and can be passed down generation to generation, but many times there is simply no known explanation.
Trauma
Everything discussed on this webpage helps to illustrate that trauma to the hand is varied in type and severity. Whether the trauma results from cuts, burns, crushing injuries to the hand, diseases, or birth defects, hand injuries can greatly impair function when it involves the very intricate tendon and nerve system of the hand.
Severed fingers or hands are extreme cases of hand trauma and in some cases can be reattached and made functional through hand and microsurgery. No matter what kind of hand trauma you have experienced, Dr. Most has the experience and skill to help your unique circumstances.