Hand Surgery

In recent years, significant progress has been observed in the treatment of hand injuries, degenerative diseases, and congenital defects. Plastic surgeons have played a crucial role in achieving this progress, focusing on correcting both function and appearance. This article is designed to explain common hand problems, what plastic surgeons do to address these issues, and the outcomes. It’s not possible to address all questions, as each problem is unique and dependent on individual differences. If there are any aspects of the procedure that you don’t understand, be sure to ask your doctor.

If You’re Considering Hand Surgery:

If you’re considering hand surgery, consulting a plastic surgeon is a good starting point. Your surgeon will evaluate you, explain treatment methods, and determine if surgery is necessary. If surgery is decided upon, discussions will cover details of the surgical procedure, where the surgery will take place (office, clinic, or hospital), the type of anesthesia, surgical techniques to be used, potential risks and unwanted outcomes, recovery and rehabilitation duration, and potential outcomes for function and appearance.

Every Surgery Involves Some Level of Uncertainty and Risk:

Each year, thousands of successful hand surgeries are performed. Despite being performed by skilled and experienced plastic surgeons and being safe, some undesired outcomes may occur.

In all types of hand surgery, issues such as infection, poor wound healing, loss of sensation or movement, and bleeding may arise. However, while rare, these problems are generally treatable.

Hand Injuries:

Common procedures in hand surgery include repairing damage to tendons, nerves, blood vessels, broken bones, burns, and skin injuries. Modern techniques have significantly enhanced a surgeon’s ability to restore function and appearance even in severe injuries.

Techniques Used by Plastic Surgeons:

  • Grafting: Transplanting skin, bone, nerve, or other tissues from a healthy part of the body to repair a damaged area.
  • Flap surgery: Transporting skin from a healthy body part to the damaged area along with underlying fat tissue, blood vessels, and muscle tissue.
  • Replantation or Transplantation: Microsurgery, an extremely precise and delicate surgical procedure performed under a microscope, used to reattach severed fingers or hands. Such injuries might require multiple surgeries over an extended period.


In many cases, significant sensory and functional improvements can be achieved in injured hands through surgery. However, healing may take months, often requiring rehabilitation.


Carpal tunnel, located at the wrist, is a tunnel through which tendons and the main nerve of the hand pass. Pressure inside this tunnel can increase due to various conditions (such as rheumatoid arthritis, etc.), injuries, accumulation of fluid during pregnancy, overuse, or repetitive motions. Increased pressure on the nerve within the tunnel often results in numbness, pain, and a tingling sensation accompanied by impaired hand function. This condition underlies carpal tunnel syndrome.


In some cases, resting the hand and using anti-inflammatory drugs may resolve the issue. If this doesn’t work, surgery may be necessary. During surgery, the surgeon makes an incision from the palm to the wrist. Tissues causing pressure on the nerve are then released. Following surgery, bandaging and splinting limit movement to accelerate healing. The surgical scar gradually fades and becomes less noticeable.


The outcomes of surgery partially depend on the severity of the condition and the extent of nerve damage. Therefore, if you suspect you may have carpal tunnel syndrome, seeking early medical attention is advisable.

Rheumatoid Arthritis:

Rheumatoid arthritis is an inflammatory condition affecting the joints and can significantly impact the appearance and function of the hands and other parts of the body. It often deforms finger joints and forces fingers to remain bent, hindering movement.


Deformities caused by rheumatoid arthritis can often be treated without surgery, for instance, using specialized devices or physical therapy to strengthen weakened areas. But for some patients, surgery may be the best solution. Discussing surgery with your surgeon and rheumatologist is essential to decide if it’s the right approach.


Tissues from inflamed joints can be removed, tendons repositioned, or artificial joints placed in the wrist and hand. While complete restoration of hand function might not be immediate after surgery, significant improvements in function and appearance are expected. It’s important to note that surgery does not cure the underlying disease. Rheumatoid arthritis may continue to affect your hand, sometimes requiring repeated surgeries. Additionally, you may need to consult your rheumatologist for ongoing treatment.

Rheumatoid Arthritis:


Dupuytren’s Contracture:


Dupuytren’s contracture affects the skin and underlying tissue of the palm, forming thick, scar-like tissue beneath the palm’s skin and progressing into the fingers, pulling them toward the palm and restricting movement. This condition often develops in middle age without a known cause, though it may have a familial tendency. Surgery involves separating the thickened tissue bands and tendons to restore better movement to the finger. Surgery must be performed with extreme care as nerves of the hands and fingers are often tightly adhered to this abnormal tissue. In some cases, skin grafts may replace thickened and curled skin.


The outcome of the surgery depends on the severity of the condition. Typically, significant improvement in hand functions is observed after physical therapy.

Congenital Defects:

Congenital hand anomalies are deformities present at birth, impacting hand development and causing significant problems in hand usage. With evolving surgical techniques, most defects can be corrected at a very young age, some even during pregnancy, while others wait until the child is 2 or 3 years old to allow normal development and function.


The most common congenital hand anomaly is syndactyly, where two or more fingers are fused. Surgical treatment involves separating the tissues joining the fingers, followed by skin grafts from another part of the body to fill the gaps. The procedure becomes more complex if bones are fused as well. Surgery generally achieves complete movement and near-normal appearance, but the color of grafted skin may differ slightly from the surrounding skin. Other common congenital defects include short, missing, or deformed fingers, immobile tendons, and abnormal nerves or blood vessels. Most of these defects can be corrected surgically in patients.

Recovery and Rehabilitation:

Due to the hand’s high sensitivity, there may be varying levels of pain post-surgery, ranging from mild to severe. Your surgeon may help alleviate discomfort through injections or medication. The duration of immobilizing your hand and how quickly you return to regular activities depends on the type and extent of the surgery and how fast you recover.


Experienced hand therapists may be required for physical therapy to expedite your hand’s recovery and improve functionality. Your therapy may include hand exercises, massage therapy, electrical nerve stimulation, splinting, stretching, and specialized bandaging. Strict adherence to your therapist’s recommendations is crucial if you want to maximize hand use.”