Hand Surgery is a separate speciality and demands extensive experience on part of the treating doctor, and finesse in tissue handling to minimize the scarring and achieve the best possible functional recovery. Hand surgery demands functional recovery and aesthetic appearance at the same time, as the hand is what makes a man the most skilful and functional animal. So if you have any concerns about the structure, function, appearance, or any discomfort in carrying out activities of daily living, a hand surgery consult with a plastic surgeon dealing with hand will surely be of benefit to you and your work output.
Hand Surgery is a subspecialization in plastic surgery involving restorative and reconstructive surgery for patients with congenital anomalies, injuries due to burning and trauma, cancers, arthritis, nerve disorders, and tendonitis in the hand. Plastic Surgeons are extensively trained in managing hand injuries and congenital anomalies of the hand. The hand is a complex biomechanical structural organ having an interplay of bones, tendons, ligaments, blood vessels, nerves, and soft tissue thereby demanding a specialized approach to its treatment. Reconstructive Plastic Surgeons at DRHC in Dubai Healthcare City provide Hand surgery services.
Any hand surgery facility is incomplete without a Physiotherapy department. We at DRHC have in-house physiotherapy services for hand surgery patients. Physiotherapy makes the joints in the hand supple and prevents contracture formation and helps the tendons glide freely which is most essential for having an optimally functioning hand. Any structure works efficiently only when it is in full usage, prolonged rest or immobilization (which may be due to pain that occurs due to the disease) makes the joints stiff due to the shortening of ligaments, capsule, and musculotendinous structures. Physiotherapy aims at reversing all these with guided active exercise and passive exercise programs along with controlled stretching manoeuvres.
The services we provide in Hand Surgery include :
Hand Infections
Carpal Tunnel Syndrome
Finger Tip Injuries
Nail Bed Injuries
Vascular Malformations
Finger replants ( For Finger amputation)
Tendon Injuries
Nerve Injuries
Nerve Entrapment
Trigger Finger
Finger Deformities ( Swan-neck, Boutonniere, Mallet finger)
Thumb surgery
Syndactyly
Polydactyly
Crush Injury
Glomus Tumour
Tendon Transfer Surgery
Wrist Drop Correction
Claw Hand Correction
Hand Injuries
Dupuytren’s Contracture
Post Burn Hand Deformity.
Post-Trauma Hand Deformity.
HAND INFECTIONS:
Infections in the hand are complex and have a tendency to spread proximally along tendon sheaths and fascial spaces. Almost all hand infections begin as finger infections. Therefore infections in hand should not be neglected and they must be reported to a hand surgeon in the first instance. The treatment is dependent upon diagnosis and stage of infection. Initial cases might respond just to oral antibiotic therapy, but advanced cases might need a surgical intervention to drain out all infectious material from the hand.
FINGERTIP INJURIES:
Fingertips are often injured and are exquisitely painful. It often occurs due to the tip of the finer being cut by a knife/ blade/ machine or crushed in a car door or the cupboard. The structures injured might include skin, nails, nailbed, finger pulp, or the bone at the tip of a finger. Tips of fingers have a rich nerve supply and are hence extremely painful when injured.
Fingertip injuries need to be evaluated thoroughly and treated promptly to achieve optimal wound healing and prevent permanent deformity.
The management of fingertip injury depends upon the extent and severity of the injury. Simple soft tissue lacerations are repaired with timely sutures and give an excellent recovery wherein it is impossible to trace that there was an injury. Deeper wounds involving loss of soft tissue will need a full-thickness skin graft or flap cover to accelerate wound healing.
NAIL BED INJURIES:
Often the nail bed (the root of the nail) gets injured as a component of the fingertip injury. This is an extremely painful injury. Nail bed injury is often overlooked by untrained and is neglected during the management thereby resulting in a permanent deformity of the nail. If you have an injury over your nail do consult a specialist hand surgeon who will evaluate and do the repair of the nailbed thereby allowing you to recover naturally and completely from a nail injury.
VASCULAR MALFORMATIONS:
Vascular malformations as the name suggests are tumors arising from the blood vessels. These are benign tumors and may be present on the hand. The hand is a complex structure and the presence of a vascular malformation in the hand might lead to restriction in the movement due to mass effect or may lead to overgrowth of one particular portion of the hand thereby again leading to functional impairment apart from cosmetic disfigurement. Treatment of vascular malformations ranges from simple pressure garments, interventional radiologic approaches, to surgical debulking.
TENDON INJURIES:
Tendons are rope-like structures that connect the muscles to the bones across the joints. They help in accommodating numerous muscle controls over joints thru a compact space. Many times a tendon is cut in glass cut injury or any cut injury of the hand and might be overlooked or missed if it is not examined and treated by a hand surgeon. So, it is important to consult a hand surgeon in each and every hand injury. Primary tendon repair gives the best possible functional recovery. After a tendon repair surgery, your hand will be kept in a plaster splint with graduated physiotherapy till the tendon heals.
NERVE INJURY:
Hand injury may involve a nerve injury as a part of a deep cut injury, or it might accompany a fracture-dislocation. Nerve injury results in numbness in the area supplied by the nerve and the inability to move the muscles which are supplied by the nerve. If not treated in time it might result in deformity and loss of function and sensations. So timely examination by a hand surgeon to recognize and treat the injury is of utmost importance. Treatment of a nerve injury might involve a direct primary repair of the nerve, or a nerve graft or tendon transfer surgery.
NERVE ENTRAPMENT:
Nerves often get entrapped in certain spaces within the hand leading to pain, numbness, or in severe cases loss of function. The common nerves which get entrapped are Median Nerve, (Carpal Tunnel Syndrome), Posterior Interosseous Nerve (PIN entrapment), and Ulnar Nerve (Cubital Tunnel Syndrome). Symptoms include numbness, tingling, pain, weakness in the hands and fingers. Dr. Ateesh Borole will evaluate you clinically and investigate you to formulate a treatment plan.
TRIGGER FINGER:
A trigger finger or a trigger thumb is a condition in which there is a nodule-like formation over the tendons responsible for closing (flexing) the finger. Hence while opening up the fist (finger/thumb extension) the finger opens up with a snap or like a trigger. Dr. Ateesh will evaluate the severity of the condition and recommend appropriate treatment for the condition
THUMB SURGERY:
The most important part of the human hand which makes it functional is the thumb. Thumb is responsible for 70% of the functionality of the hand. Injuries and congenital deformities of the hand should be promptly reported. Common conditions affecting the thumb include de Quervain's tenosynovitis, trigger thumb, Gamekeeper’s Thumb, or Skier’s Thumb. Reaching a correct diagnosis is fundamental to successful treatment.
SYNDACTYLY:
Syndactyly as the name suggests means fingers attached or joined to each other. Syndactyly is a fairly common congenital anomaly of the hand. It is actually non-separation of fingers during development. Treatment involves surgical separation by a plastic surgeon specializing in hand surgery. The ideal age for doing syndactyly surgery is when the child reaches one year of age.
POLYDACTYLY:
Polydactyly means the presence of extra fingers. Most commonly it involves either an extra thumb or an extra little finger. Treatment is surgery by a plastic surgeon specializing in hand surgery wherein utmost care is taken to examine and diagnose the presence or absence of vital structures in all fingers and they are then shared amongst themselves to maintain optimal hand function.
CRUSH INJURY:
Crush injury to the hand is very common in industrial hand injuries where the hand might get trapped in machinery. It is a devastating surgical emergency and the patient needs to be shifted to a healthcare facility with the availability of a plastic surgeon specializing in hand surgery. After a thorough evaluation and patient stabilization repair of damaged structures (Bones, muscles, tendons, nerves, blood vessels, skin) is carried out. Post-surgery physiotherapy Is critical to success.
GLOMUS TUMOUR:
Glomus tumor is a common cause if extreme pain in the region of a fingertip or in the nail. An appropriate diagnosis by thorough clinical examination and imaging is achieved and treatment involves surgical excision by a plastic surgeon trained in hand surgery.
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