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The decision of undergoing hand surgery is up to you and you have to make the sole decision whether the surgery will benefit you and help in achieving your goals and if the risks associated with it are acceptable. Your Hand Surgeon will explain in detail the risks and complications.

In most surgeries, the risk is of anesthesia and bleeding. Additional risks depend on the type of surgery performed, and it may include:

Infection

Incomplete healing

Loss of sensation or movement of the hand or fingers

Formation of Blood clots

Unfavorable scarring

Poor healing of incisions

Injury to the blood vessels, nerves, or tendons

Unexpected swelling in the hand

Dr. Prashanth S, is well known for performing Hand Surgery in Pune. He is expertise in performing Microvascular Reconstructive surgery and provides comprehensive care to his patients for any problem related to hand surgery. 

The additional risks associated include:

Carpal tunnel

Non-improvement

Recurrence of carpal tunnel symptoms

Extensor tendon

The need for additional incisions may be necessary     because cut tendons may withdraw

Failure of tendon repair

Inability to restore function

Tendon scarring

Flexor tendon

The need for additional incisions may be necessary     because cut tendons may withdraw

Inability to restore function

Tendon scarring

Tenolysis

Abnormal position of the tendon 

The need for additional incisions may be necessary     where scarring occurs or to make new incisions to release scar tissue that     is limiting the tendon motion

Inability to restore function

Recurrent tendon scarring

Rupture of tendon

Seroma (fluid accumulation)

Wound breakdown

Trigger finger

Non-improvement

Tendon scarring

Fractures are breaks caused in the bones. They can be caused due to any sort of injury, accident, trauma, or a pre-existing bone-weakening condition like osteoporosis. There are different ways to analyze fractures. 

A simple fracture is caused when the bone remains inside the skin and doesn't extend out, also called closed fractures. 

A compound fracture is also called as open fractures. These broken bones enter through the skin. Compound fractures are more severe ones, their healing process may get affected due to the infection, for that antibiotic needs to be used. 

There are many different subtypes of fractures lets have a look at them: 

Comminuted Fracture: This type of fracture causes severe injury where the bones crack into several small pieces. 

Avulsion Fracture: In this type of fracture, the bone is completely cut off from the main bone due to intense tearing off a part of the body.

Other types of fractures can be defined by the angle the bone is been hit or broken. 

Diagnosis

When there is a bone break, the symptoms are like severe pain and swelling that doesn't reduce on its own. Doctors are able to identify the fractures by physical examination or by taking an X-ray. Dr. Prashanth S is an orthopedic surgeon in Pune. He is also well known for all types of Hand Surgery. The X-ray provides the doctor with a clear idea about the type of fracture and the intensity of the displacement of the bone. 

Hand surgery is needed when you face any kind-of hand injury, degenerative structure change in hand, or rheumatic diseases like osteoarthritis and rheumatoid arthritis. They are different types of surgeries that can be performed on hand, depending on the causes and problems related to it.  

These procedures include:

Skin grafts

Skin flaps

Closed reduction and fixation

Tendon repair

Nerve repairs

Fasciotomy

Surgical drainage or debridement

Joint replacement 

Replantation

 Let's have an overview of them in details:

Skin grafts: This involves replacing skin to a part of your hand that has missing skin. Skin grafts are mostly performed for fingertip amputation or injury over it. The procedure of skin grafting is done by taking a piece of healthy skin from other parts of your body and attaching it to the affected area.

Skin flaps: Just like a skin graft, skin flaps for hand surgery involve taking skin from other parts of the body, but the difference is, the procedure uses the skin that has a blood supply. The reason behind it is the portion of the skin being used has its underlying blood vessels, fat, and muscles. Skin Flaps may be used for the area, where the skin is missing good blood supply. This may be because of the damage caused to the vessels, or extensive tissue damage.

Closed reduction and fixation: This procedure is done when a person has a bone fracture, broken bone in a part of the hand, or in the fingers. This surgery realigns the broken bone and holds it, or immobilizes it, while it heals. Immobilization is done when internal fixtures such as wires, rods, splints, and casts are used.

Tendon repair: Tendons are fibers that join the muscles to the bone. It is a difficult part of hand surgery because of the structure of the tendon. Injuries to the tendon can occur due to an infection, hand trauma, or sudden cracks.

Nerve repairs: Hand trauma can also cause nerve injury in the hand.  

This can lead to loss of hand function or hand sensation. Some injuries heal on their own, while some need a surgical approach. In some complicated cases, surgery is done to check the level of damage caused to the nerve soon after the injury.

Fasciotomy: This method is done to treat compartment syndrome. This condition occurs when there is swelling and prolonged pressure in a small compartment of the body. The increased pressure can conflict with blood flow to the body muscles hamper its functionality. Compartment syndrome causes severe muscle pain and weakness. 

Surgical drainage or debridement:  If there is a sore or abscess in the hand, the surgical drainage method can help remove any infection/pus. If the wound is severe, then a debridement procedure is used to clean the dead or infected tissue. This procedure helps in preventing the infection and healing the wound.

Joint replacement: This surgery is also called arthroplasty. It is performed in cases, where there is severe hand arthritis. The procedure includes replacing joints that have damaged or destroyed due to arthritis by using an artificial joint. 

An artificial joint can be made up of metal, plastic, silicone rubber, in some cases from your own tendon i.e body tissue.

Replantation: As the name is, it re-attaches the finger, hand, or toe that has been completely cut or separated from the body. The main goal of performing this surgery is to restore the maximum functionality as possible. Replantation is a complex surgery, it uses small tools and is performed under magnification using a microscope also called microsurgery. In severe cases, the surgery is performed more than once.

Hand Surgery is a term that covers various types of procedures. It includes the wrist, elbow, and the peripheral nerves of the upper limb. It also comprises reconstructive surgery which improves the hand functionality. The Role of a plastic surgeon in hand surgery to restore hand and finger function but hand surgeons make the hand look normal even after any trauma, injury, or deformity. Dr. Prashanth S. is a Hand Surgeon in Pune holding an experience of more than 16 years. 

Why do you need a hand surgery?

Reconstructive Hand Surgery is performed for many reasons. Some of them are: 

1.       Hand Trauma

2.       Osteoarthritis

3.       Rheumatoid Arthritis

4.       Degenerative Changes in hand structures.

5.       Congenital Birth defects

6.       Infections occurred in the hand 

These diseases change and damage the internal structuring of the hand. 

Procedure for Hand Surgery:

Hand surgery is a day-case performed under regional anesthesia, it is injected in the armpit or above the shoulder to numb the arm. In the procedure, the patient is either awake or slightly sedated as per the surgery preference. In some cases, an overnight stay in the hospital is required for some hand operations especially when performed on children or if the hand surgery is prolonged.

Risks associated with hand surgery?

In most cases, there is a risk of anesthesia and bleeding. The risk associated with the surgery depends on the surgery type which may include:

1.       Infection

2.       Rough Healing

3.       Loss of hand sensation or movement of the fingers.

4.       Formation of blood clots.