What does hand surgery deal with?

Hand surgeons deal with minor and more serious injuries, deformities, developmental disorders, inflammations, and cancerous lesions of the hand. Because the hand has an elaborate and complex function in our lives, even a minor injury can become severe, creating limited mobility, edema, and adhesions around the tendon. It is important to restore hand function and regain complete freedom of movement through accurate diagnosis and well-copmposed therapy.

What diseases or complaints are most common here?

Hand injuries account for nearly a quarter of injuries, primarily when the hand is used as a gripper, but often suffer from dislocations, fractures, open, or even damaged injuries when involved in a protective mechanism. . Because proper hand function requires the coordinated, intricate cooperation of more than 200 fine parts, it is important to take injuries, hand complaints seriously, and visit a specialist for a consultation.

Tenosynovitis

Description of the disease: Tenosynovitis develops from the inflammation of the flexor or extensor tendons as a result of not forceful, often repetitive movements, or autoimmune disease, or in case of an infective focus in the body (dental, ear, nose and throat, urology).

Symptoms: The patient feels pain, possibly limited mobility in his hands and wrists, and the area may even swell, and heat may develop around the tendon sheath.  Symptoms can develop at any age and gender, as this hand disease may be caused computer use which is common these days or the constant “fiddling” with a cell phone.

Treatment: In Emineo Private Hospital, tenosynovitis can be diagnosed by a simple physical examination. Rarely, but laboratory tests and x-rays may be needed to see if there is inflammation elsewhere in the body and if the bones have not been damaged. First of all, drug therapy based on anti-inflammatory treatment can be a solution, supplemented with wrist fixation and rest. In more severe cases, physiotherapy, steroid injection, or possibly surgery can help.

Finger and hand fracture

Description of the disease: A bone cracks or breaks as a result of a forceful impact.

Symptoms: Fractures may cause serious pain and deformity sometimes, the injured limb becomes swollen and painful to move.

Treatment: Finger and hand fracture treatment depends on its type and severity. In the case of a non-dislocated or stable fracture, closed reduction and plaster fixation are sufficient. In more severe cases, it is necessary to restore the original condition with surgery, during which, if necessary, fixing with internal metalware (plate, screws) is also used.  This surgery is usually performed in the scope of our Trauma Clinic. You can read more about the surgery here.

After the medical procedure, it is necessary to spare the joint and often additional immobilization (plaster or brace) is needed, which prevents the bones from getting dislocated. After the removal of immobilization, it is essential to perform a personalized physiotherapy as only surgery and proper rehabilitation together can restore the injured limb to its full function without complaints.

Carpal tunnel syndrome

Description of the disease: Nerves network our entire body and connect the central nervous system with other important organs. Peripheral nerves play an important role in biological processes, traveling between muscles, tendons, blood vessels and bony structures during their course, which form a tunnel around the nerve. However, if there is pressure on the nerves in these tunnels, tunnel syndrome can develop. This can often occur due to rheumatoid arthritis, diabetes, hypothyroidism, obesity, or as a result of certain occupations or pregnancy.

Symptoms: pain, numbness, muscle weakness, muscle atrophy.

Treatment: In addition to a physical examination, our hand surgeon may order an electrophysiological test and ultrasound scan to find out if the nerves and muscles in the hand are working properly. At the beginning of tunnel syndrome, wrist rest, wearing a wrist restraint, local anti-inflammatory, and physiotherapy may still be sufficient. Surgical release of the compressed nerve is also often warranted. You can read more about the surgery here. After the operation, we create a personalized physiotherapy for the patient at Emineo Private Hospital so that the hand regains its original functional function as soon as possible.

Dupuytren’s contracture

Description of the disease: It is often referred to in the common language as palm shrinking, as Dupuytren’s contracture is a disease of the skin of the palm and the aponeurosis that stretches beneath the thin layer of fat. First, nodules develop in the aponeurosis, then they are arranged radially in strings for approx. half a year after the onset of the first symptoms, and then they eventually begin to shrink. It is an inherited disease which can be caused by an genetic causes and usually appears between the ages of 30 and 40.

Symptoms: After a while, the patient is unable to stretch his/her fingers and straighten his/her palms and may experience severe pain or sensory disturbances.

Treatment: Effective treatment is only possible surgically. You can read more about the surgery here.  It is important to know that after surgeries, wound healing can often be delayed, a few weeks of wound treatment can be expected, and 6-12 weeks of physiotherapy and scar-releasing physical therapy may also be required.

Trigger finger

Description of the disease: Trigger finger is a painful phenomenon caused by chronic inflammation of the flexor tendons. This is one of the most common lesions on the hands, mostly due to tendovaginitis. Although it develops most in women between the ages of 40 and 60, it occurs in younger and younger age groups due to frequent use of mobile phones and tablets and can be a predisposing factor for diabetes and arthritis.

Symptoms: After bending, one of the fingers “gets stuck” and can only be straightened out in a characteristic “snap” way, which can cause pain at the base of the fingers. Pressure sensitivity and narrowing of the movement of the finger may also occur.

Treatment: It can be identified by physical examination. Early, or in mild cases, local anti-inflammatory, physiotherapy can help, but often surgery is the solution. You can read more about the surgery here.

Ganglion

Description of the disease: The cysts of the wrist and fingers originating from the tendon sheath or joint are called ganglia, which usually develop on the back and palm of the wrist, at the base of the fingers in the palm, at the ends of the fingers, but can also occur in other parts of our skeletal system. The size of the ganglion can decrease, grow and even disappear. The cause of its development is not always clear, but often chronic overload, arthritis, or tendonitis hides in the background.

Symptoms: Most of the time, it appears as a bulge in one of the body areas listed above, which can be painful. (may occur less frequently in the foot and ankle areas)

Treatment: At Emineo Private Hospital, our hand surgeon diagnoses the ganglion on the basis of a physical examination and, if deemed necessary, an X-ray or possibly an ultrasound scan. It can be treated by using splints, using an anti-inflammatory therapy, or aspirating the ganglion with a needle, which can be done on an outpatient basis. If the ganglion is causing a complaint, we usually recommend surgical care. During the operation, the cyst is removed, along with a portion of the joint sheath and tendon sheath. You can read more about the surgery here.