The human hand is a marvel of anatomy—an intricate structure of bones, tendons, muscles, nerves, and skin that allows us to perform both powerful and delicate tasks. But because of this complexity, it is also highly vulnerable to injury, disease, and functional disorders. When non-surgical treatments fail to resolve hand-related issues, hand surgery becomes a vital intervention, encompassing various types of hand surgery.
Why Is Hand Surgery Needed?
Hand surgery may be necessary in the following cases:
Understanding the different types of hand surgery can help patients make informed decisions about their treatment options.
Surgeons may perform open or minimally invasive procedures depending on the diagnosis. Now let’s dive into the specific types of hand surgeries available today.
Types of Hand Surgery
Tendon Repair Surgery
Tendons are the fibrous tissues that connect muscles to bones and help in hand movement. Tendon injuries can occur due to lacerations, sports injuries, or inflammatory conditions like rheumatoid arthritis.
Why It’s Done :- To repair torn or ruptured tendons (especially flexor or extensor tendons) that limit finger or wrist movement.
How It’s Done :- The torn ends of the tendon are sutured back together using microsurgical techniques. In cases where the tendon is severely damaged, a tendon graft may be needed.
Recovery :- Patients usually wear a splint post-surgery and begin hand therapy within a few weeks. Recovery may take several months depending on the tendon repaired.
Nerve Repair or Nerve Grafting
Injuries or pressure on hand nerves—such as the median, ulnar, or radial nerves—can result in numbness, tingling, or even muscle paralysis.
Why It’s Done :- To restore sensation and muscle function lost due to nerve injury or compression.
How It’s Done :- Microsurgery is used to suture the nerve ends or, if there’s a gap, a nerve graft is used. In some cases, decompression surgery may be performed (such as carpal tunnel release).
Common Conditions Treated:
- Carpal Tunnel Syndrome
- Cubital Tunnel Syndrome
- Traumatic nerve injuries
Carpal Tunnel Release Surgery
One of the most common hand surgeries, this procedure treats Carpal Tunnel Syndrome, where the median nerve is compressed at the wrist.
Symptoms Indicating Surgery :-
- Persistent numbness or tingling in the thumb and fingers
- Hand weakness
- Night-time pain that disrupts sleep
How It’s Done :- A small incision is made at the base of the palm to cut the transverse carpal ligament and relieve pressure on the nerve. It may also be done endoscopically.
Trigger Finger Release
Trigger finger occurs when the finger gets stuck in a bent position due to narrowing of the sheath around the tendon.
Why It’s Done :- To restore smooth tendon gliding and normal finger movement.
Procedure :- The surgeon makes a small incision in the palm and cuts the tendon sheath to release the pressure.
Outcomes :- Most patients regain full finger mobility within a few weeks.
Joint Replacement (Arthroplasty)
Joint replacement surgery in the hand is commonly performed for severe arthritis when joint surfaces are worn out and causing pain and stiffness.
Common Areas Treated:
- Finger joints
- Base of the thumb (CMC joint)
- Wrist joint
How It’s Done :- The damaged joint is removed and replaced with a prosthetic implant made of metal, silicone, or pyrocarbon.
Recovery :- Physical therapy is crucial after surgery to regain motion and prevent stiffness.
Joint Fusion (Arthrodesis)
Unlike joint replacement, joint fusion eliminates movement in a painful joint to provide pain relief and stability.
When It’s Used:
- Severe deformity
- Chronic instability
- End-stage arthritis
Procedure :- Bones at the joint are fused together using plates, screws, or wires. This permanently eliminates joint motion but provides strength and reduces pain.
Ganglion Cyst Excision
Ganglion cysts are fluid-filled swellings that often appear near wrist joints or tendons.
Symptoms Indicating Surgery :-
- Pain or pressure when using the hand
- Cosmetic concerns
- Limited movement due to cyst size
Procedure :- The cyst and its root are surgically removed to prevent recurrence.
Dupuytren’s Contracture Surgery
Dupuytren’s disease causes thickening of the tissue in the palm, leading to curled fingers that can’t be straightened.
Treatment Options:
- Fasciectomy (removal of affected fascia)
- Needle aponeurotomy (minimally invasive)
Why It’s Done :- To restore hand extension and prevent worsening contracture.
Fracture Fixation Surgery
Fractures of the hand bones, such as metacarpals or phalanges, may require surgical fixation if the bones are displaced or unstable.
Procedure :- The bones are realigned and fixed with plates, screws, or pins to allow proper healing and maintain hand function.
Recovery :- Immobilization for a few weeks followed by hand therapy is essential for full recovery.
Congenital Hand Reconstruction
This involves surgical correction of birth defects such as:
- Polydactyly (extra fingers)
- Syndactyly (fused fingers)
- Hypoplasia (underdeveloped fingers)
Goals :- To improve hand function, appearance, and development, especially in children during early growth years.
Replantation and Microsurgery
This highly specialized form of hand surgery is used in emergency cases of amputation, such as finger or hand severing due to accidents.
Procedure :- The severed part is reattached using microsurgical techniques to reconnect bones, blood vessels, nerves, and tendons.
Success Rate :- Depends on time since injury, severity, and surgical expertise. Postoperative therapy is crucial for function recovery.
Skin Grafting and Flap Surgery
Severe injuries, burns, or infections may result in significant skin loss that cannot heal naturally.
Skin Grafting :- Involves transplanting skin from one part of the body to the injured area.
Flap Surgery :- Involves moving tissue along with its blood supply from one part of the body to the hand.
Conclusion
Hand surgery encompasses a wide range of procedures aimed at restoring the intricate balance between movement, sensation, and strength. From tendon and nerve repairs to advanced joint replacements and trauma reconstructions, these surgeries are vital for improving hand function and quality of life.
If you’re experiencing hand pain, stiffness, numbness, deformity, or limited motion that interferes with daily activities, a consultation with a hand surgeon may be the first step toward recovery. Early diagnosis and tailored surgical intervention can significantly reduce complications and help restore normal hand function.
