Procedures

Hand Trauma Surgery

Hand injuries are among the most common afflictions that can affect your daily routine, causing not only physical discomfort but also potentially impeding your ability to perform simple tasks at work or at home. An injury severe enough to require medical intervention might occur through various means: a fall, a crush injury, a cut, or an accident during sports, to name a few. The hand’s intricate anatomy is composed of various critical components—tendons, which facilitate movement; nerves, which provide sensation and motor function; bones, which provide structure and support; and ligaments, which connect bones to each other and stabilise the joints. An injury to any of these components can severely affect the overall functionality of the hand.

The aim of hand trauma surgery, therefore, is to repair these damaged structures and ensure that your hand regains as much of its normal function as possible. This might include reattaching torn tendons, reconnecting severed nerves, setting fractured bones, or surgically repairing torn ligaments

Chester Consultant Plastic Surgeon Anca Breahna performs hand trauma surgery for her patients in Chester.

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At a glance

The Procedure Who needs Benefits Types The Surgery Recovery Testimonials Pricing Further Reading FAQs

What is Hand Trauma Surgery?

Hand trauma surgery includes different surgical procedures aimed at addressing and repairing injuries within the hand. Each procedure is designed to tackle specific problems—whether they involve the tendons, nerves, bones, or ligaments—depending on the nature and extent of the injury.

In cases where tendons are damaged, the surgery might involve stitching the torn ends together to restore function. For nerves that have been cut, microsurgical techniques are often required to sew the tiny nerve fibres back together. Fractured bones may need to be realigned and secured in place with pins, screws, or plates. Similarly, torn ligaments often require surgical intervention to ensure that they heal in a way that maintains hand function and stability.

The primary goal of these procedures is to not only repair the damage but also to alleviate pain and restore as much functionality as possible. This is important because the hand is involved in so many aspects of daily life—from typing on a computer keyboard to cooking in your kitchen, to performing fine motor skills required in many workplaces.

Moreover, hand trauma surgery can also play a significant role in improving the cosmetic appearance of the hand, particularly in cases of visible deformities resulting from fractures or other injuries. This aspect, while secondary to functional restoration, can also have a profound impact on your overall recovery and the restoration of normalcy in your life.

Who Needs Hand Trauma Surgery?

If you’ve experienced a hand injury, you might be wondering whether hand trauma surgery is necessary for your situation. Candidates for this type of surgery are those who have sustained significant injuries that affect the functionality and structure of their hand. These injuries could include tendon ruptures, nerve damage, serious fractures, or extensive ligament tears.

Identifying the Need for Surgery

Understanding whether you need surgery involves several diagnostic steps. Initially, you might notice severe pain, significant swelling, or an obvious deformity in your hand—these are all signs that something serious may have occurred. It is important to seek medical advice promptly if you experience any of these symptoms following an injury.

Anca will use a variety of methods to assess the extent of your injury. This might include physical examinations to check for tenderness, swelling, range of motion, and overall function of the hand. Imaging tests such as X-rays, CT scans, or MRIs are also commonly employed to visualise the internal structure of your hand and pinpoint the specific areas that have been damaged.

Common Conditions Treated with Surgery

Tendon Injuries: If you have a snapped or severely torn tendon, you may be unable to bend one or more fingers, or you might experience a ‘popping’ sensation during movement.
Nerve Damage: Symptoms of nerve injuries include numbness, a tingling sensation, or even a complete loss of sensation in parts of your hand. You might also find it difficult to move the affected areas.
Fractures: These might present as visible deformities in the hand, severe pain, especially when moving the affected area, or an inability to use the hand.
Ligament Tears: Severe sprains that involve torn ligaments may result in noticeable instability in the joints, considerable pain, and swelling.

When to Consider Surgery

Surgery is generally considered when non-surgical treatments such as immobilisation, medications, and physical therapy do not result in adequate healing or when the injury is so severe that non-surgical treatment is unlikely to be effective. It’s important to have a detailed discussion with Anca about the potential benefits and risks of surgery based on your specific circumstances.

Benefits of the Hand Trauma Surgery Procedure

Choosing to undergo hand trauma surgery can be a significant decision influenced by several potential benefits that aim to improve your quality of life post-injury. Here are some of the primary advantages:

Improved Functionality

One of the most immediate benefits of undergoing hand trauma surgery is the potential restoration of function. This can mean a return to doing everyday tasks without discomfort or hindrance, which might include everything from writing to simply dressing oneself.

Pain Reduction

Hand injuries can be extremely painful, particularly when nerves are involved. Surgery can help alleviate this pain by repairing the damaged structures that are causing discomfort. This relief can be a critical factor in improving your overall quality of life following an injury.

Aesthetic Improvement

For many patients, there is also a significant aesthetic benefit to undergoing surgery, especially in cases where the injury has caused visible deformities. Correcting these can not only improve hand function but also help mitigate any emotional and psychological impacts associated with the appearance of the injury.

Prevention of Future Problems

Additionally, properly addressing hand injuries through surgery can prevent long-term complications such as chronic pain, recurring dislocations, or permanent disability. This preventive aspect of surgery is often a key consideration for you and Anca alike, aiming to ensure a stable and functional recovery.

By understanding these benefits, you can better weigh the potential positive outcomes of surgery against the inherent risks and recovery time involved. Such an assessment is essential for making an informed decision about whether to proceed with hand trauma surgery.

Types of Procedures in Hand Trauma Surgery

Tendon Repair

Tendons are the tough bands of tissue that connect muscles to bones. When a tendon is injured, it can cause significant loss of movement and function. Tendon repair surgery aims to reattach these tendons and typically involves the following steps:

Suturing: Torn ends of the tendon are sewn together using special surgical threads, which may be absorbable or non-absorbable depending on the injury and surgical preference.
Grafting: In cases where the tendon has been severely damaged, a graft taken from another tendon of your body might be used to replace the damaged part.

Nerve Repair

Nerves carry signals from your brain to muscles to induce movement, as well as signals back to your brain regarding sensation. When nerves in the hand are damaged, they require highly delicate surgery that may involve:

Microsurgery: This is used to reconnect the ends of damaged nerves to restore sensory and motor functions. Anca use a microscope to sew the tiny nerve fibres together.
Nerve Grafting: Similar to tendon grafting, nerve grafting involves replacing damaged nerves with sections of nerves from other parts of the body if the original nerve is too damaged to be directly repaired.

Fracture Repair

Fractures in the bones of the hand can be treated using several methods:

External Fixation: Pins and wires may be inserted into the bone through the skin and are attached to an external frame to hold the bones in the correct position as they heal.
Internal Fixation: Screws, plates, or rods are surgically implanted to stabilise the fractured bones internally.

Ligament Repair

Ligaments are the connective tissues that connect two bones in a joint. An injured ligament can cause instability and pain in the joint:

Surgical Tightening: If the ligament is stretched or torn, it may be shortened and reattached to the bone to tighten the joint.
Reconstruction: Severely damaged ligaments may need to be completely reconstructed using grafts from other ligaments or tendons in the body.

How is the Hand Trauma Surgery Procedure Performed?

The procedure for hand trauma surgery usually follows a structured path from preparation through to completion. Here’s what you can generally expect:

Pre-operative Preparation

Before your surgery, you will undergo a thorough evaluation which includes medical history, physical examination, and imaging studies like X-rays or MRIs. This helps to map out the exact nature of the injury and plan the surgery.

Anaesthesia

Depending on the complexity of the surgery, either general anaesthesia (where you are asleep) or local anaesthesia (where only the hand is numbed) will be administered. This ensures that you experience no pain during the procedure and are comfortable throughout.

The Surgical Procedure

Anca makes an incision in the hand to access the damaged area. Depending on the injury, different techniques are used to repair the injured tissues:

Tendon or Nerve Repair: Anca might use microsurgical techniques to sew the torn ends of tendons or nerves.
Bone Fixation: Fractured bones may be aligned and fixed using plates, screws, or rods.
Ligament Reconstruction: Torn ligaments may be sewn together or reconstructed using grafts.

Closure

Once the repair is complete, the incision is closed with stitches. A bandage or a cast is then applied to immobilise the hand and allow the healing process to begin under optimal conditions.

Hand trauma surgery can involve several different types of procedures, depending on the specific nature of the injury. Each procedure is tailored to address particular damage to tendons, nerves, bones, or ligaments, ensuring that the best possible outcome is achieved for each individual case.

Recovery after Hand Trauma Surgery Procedure

Recovery from hand trauma surgery varies widely depending on the specific procedures performed. Initial recovery generally involves pain management, immobilisation of the hand, and careful monitoring for any signs of infection or complications.

Post-operative Care

Anca will provide specific instructions on how to care for your hand following the surgery. This may include:

Pain Relief: Pain medication is often prescribed to manage discomfort
Immobilisation: You may need to wear a cast or splint for several weeks to ensure that the hand remains stable during the initial healing phase

Rehabilitation

Physical therapy is a critical aspect of recovery, helping to restore strength and flexibility to the hand. Therapy sessions might start with gentle movements and gradually increase in intensity as your hand heals.

Long-term Care

Follow-up visits with Anca are important. These appointments allow Anca to monitor your recovery and ensure that your hand is healing correctly. You might also discuss further rehabilitation strategies and any additional treatments needed to maximise the functionality of your hand.

Costs of Hand Trauma Surgery in the UK

When considering hand trauma surgery in the UK, it’s important to be aware of the potential costs involved. These costs can vary widely depending on several factors including the specific type of surgery required, the complexity of the procedure, whether the surgery is performed in a public NHS hospital or a private medical facility, and the surgeon’s expertise. Here’s a detailed overview to help you navigate the financial aspects of hand trauma surgery in the UK:

NHS vs. Private Costs

If you are eligible for treatment under the National Health Service (NHS), the cost of your hand trauma surgery will typically be covered at no direct cost to you. The NHS provides free healthcare services to residents in the UK, which includes all aspects of hand trauma surgery—from initial consultations and diagnostic tests to the surgery itself and post-operative care. However, it’s important to note that waiting times for elective surgeries under the NHS can be lengthy, which might lead to a delay in receiving treatment.

Opting for private healthcare can mean shorter waiting times and potentially higher standards of care with more personalised service. However, these benefits come at a cost. Here are some typical expenses associated with private hand trauma surgery:

Consultation Fees: Before any surgery, you’ll need a consultation with a specialist. In the private sector, this can cost between £150 and £250.
Surgical Costs: The surgery itself can vary significantly in price, generally ranging from £2,000 to over £10,000, depending on the surgery’s complexity and the specific injury involved.
Hospital Stay: If you need to stay in the hospital overnight, costs can increase considerably. Private room rates can range from £250 to £1,000 per night.
Post-operative Care: Follow-up appointments and physical therapy may not be included in the initial surgical costs and can add additional expenses.

Additional Costs

Beyond the basic fees for surgery, there are other potential costs that you might need to consider:

Medication: Post-surgery medications, pain relief, and possibly antibiotics might incur extra charges.
Rehabilitation: Physical therapy is crucial for recovery but can be expensive, especially if required for an extended period. Private physiotherapy sessions can cost between £40 and £70 per session.
Travel and Accommodation: Depending on your proximity to the private clinic or hospital, you might also need to consider the costs for travel and accommodation, especially if multiple follow-up visits are necessary.

Frequently asked questions

What are the risks associated with hand trauma surgery?

Like all surgical procedures, hand trauma surgery comes with potential risks, though they are generally low. Possible complications include infection, bleeding, and an adverse reaction to anaesthesia. There is also a risk of surgical complications such as damage to nearby nerves or blood vessels, which might lead to additional problems like loss of sensation or impaired blood flow. Sometimes, despite surgery, there may be incomplete recovery of hand function due to the severity of the original injury or the formation of scar tissue.

What should I expect during the rehabilitation process?

Rehabilitation after hand trauma surgery usually involves physical therapy to help regain strength and mobility in the hand. This process can start with simple movements to reduce stiffness and progress to more complex exercises to improve hand function. The duration of physical therapy varies depending on the injury’s severity and the individual’s progress but generally lasts for several weeks to months.

How can I ensure the best outcome from my hand trauma surgery?

To ensure the best possible outcome from your hand trauma surgery, it is important to follow all post-operative instructions provided by Anca. This includes taking prescribed medications, attending follow-up appointments, and participating in rehabilitation programs. Additionally, keeping your hand elevated to reduce swelling, applying ice packs as advised, and protecting the surgical site from injury are all important steps in the healing process.

Is there anything I should avoid doing after my surgery?

After hand trauma surgery, you should avoid activities that could stress or strain your hand during the initial recovery phase. These might include lifting heavy objects, engaging in high-impact sports, or using the affected hand in vigorous activities. Anca will give you a detailed list of activities to avoid, and it’s important to adhere to these guidelines to prevent complications or setbacks in your recovery.

How soon can I return to work after undergoing hand trauma surgery?

The timing for returning to work after hand trauma surgery depends on the nature of your job and the extent of your surgery. If your job involves heavy physical labour, you may need to take more time off than if you work in an office setting. Generally, patients are advised to take at least a few weeks off to ensure adequate healing.

Medical References about Hand Trauma Surgery

Introduction of a hand trauma day surgery operating list – Science Direct
Surgical site infection following surgery for hand trauma – Sage Journals
Hand Trauma Care in the United States: A Literature Review – PubMed
Detailed analysis of surgically treated hand trauma patients in a regional German trauma centre – PubMed
Hand Surgery in the UK – The British Society for Surgery of the Hand