Hand Surgery

Hand surgery is surgery that changes, adds to, or removes parts of the hand, wrist, or forearm. It is done to treat a condition that causes pain, numbness, or inability to do daily tasks.

There are many different types of hand surgery. A hand surgery specialist can help you determine the best type of surgery for your child’s condition. Some different types of hand surgery include:

• Fracture repair. The surgeon works to realign the fractured bones and support the damaged area so that it doesn’t move while healing. To support the damaged area, The doctor may implant wires or rods or put your child’s hand in a splint or cast.
• Nerve repair. This type of surgery is performed when there has been damage to one of the three main nerves in the hand. Nerve damage can make it difficult to move the hand, or decrease feeling in the hand. Sometimes nerve injuries can heal on their own without treatment, but if the injury is severe enough, your child’s doctor may recommend surgery to repair and help them heal.
• Tendon repair. This type of surgery is done when a tendon has been injured, and may need to be repaired. Usually, tendon repair surgery is performed within a few days of an injury. In some cases, the doctor may wait 2 to 5 weeks before recommending a tendon repair surgery. Tendon repair surgery may be done to directly correct the injury, or it may include transplanting tendons from other parts of the body.
• Joint replacement. This type of surgery may also be called an arthroplasty [AHR-thruh-plas-tee]. It is usually recommended when a joint has been destroyed, usually by arthritis. In this procedure, the old, damaged joint will be removed and replaced with a new, man-made joint.
• Drainage or cleaning. Although draining and cleaning a wound is not always done surgically, the doctor may recommend it depending on your child’s condition. Sometimes thedoctor will recommend surgical drainage if there is a serious abscess [AB-sess] in the hand.

Be sure to ask your child’s doctor any questions you have so you know what to expect.

Although most hand surgeries are typically successful, complications may still occur. Most surgery carries the risks of anesthesia and bleeding. Additional risks associated with surgery depend greatly on the type of surgery being performed and may include:

• Infection
• Incomplete healing
• Loss of feeling or movement of the hand or fingers
• Blood clots

Nerves or blood vessels in the area of surgery may be injured and, although rare, nerves or surrounding tissues may be damaged during the surgery.

The joint pain may not be relieved by the surgery and/or complete function may not return.

For joint replacement surgery, there is a risk that the implant (prosthesis) may become damaged by wear and dear, breakage, or dislocation, or that it may loosen.

There may be other risks depending on your child’s specific medical condition. Be sure to discuss any concerns with the doctor before the procedure.

The benefits of hand surgery generally include pain relief, restoration of function, and improved quality of life.

In addition to a complete medical history, the doctor may perform a complete physical exam to ensure your child is in good health before undergoing the procedure. Your child may need blood tests or other diagnostic tests. During this time, you should tell the doctor:

• If your child is sensitive to or are allergic to any medicines, latex, tape, and anesthesia (local and general).
• About all medicines your child is taking, including prescriptions, over-the-counter medicines, inhalers, patches, vitamins, and herbal supplements.
• If your child has a history of bleeding disorders or if they are taking any blood-thinning medicines, aspirin, or other medicines that affect blood clotting. Your child may need to stop taking these medicines for several days before the procedure.
• If your child is pregnant or may be pregnant, tell the doctor right away.

Depending on the type of procedure, the doctor might ask you and your child to follow certain steps or take specific medicines before the surgery:

Your child will need to go without any food or drink for a period before the procedure. This is to prevent problems with anesthesia.

You may meet with a physical therapist prior to your surgery to discuss rehabilitation for your child after the procedure.

Ask the doctor if your child will need to stay in the hospital or if they will be able to go home right after the procedure. Arrange for someone to help you and/or your child at home for a week or two after surgery.

Although the details will differ based on the type of surgery your child is are having, you can expect the following:

1. You and your child will be asked to arrive early, usually a few hours, on the day of the surgery.
2. Your child may be asked to remove any clothing and will be given a gown to wear.
3. An intravenous (IV) line may be started in the arm or hand to give fluids and medicine during the procedure.
4. Your child will be positioned on the operating table in a manner that provides the best access to the hand being operated on.
5. A urinary catheter may be inserted.
6. Any hair on the area may be shaved off.
7. The anesthesiologist will watch your child’s heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
8. The skin over the surgical site will be cleansed with an antiseptic solution.
9. The surgeon will make an incision in the area of the hand that will be operated on.
10. The surgeon will repair or remove the damaged parts of the hand.
11. The incision will be closed with stitches or surgical staples.
12. A sterile bandage will be placed on the wound to keep it clean and dry.
13. The hand will most likely be placed in a splint to help keep it from moving while it heals. Be sure to talk to the doctor about when the splint can be safely removed.

At home, it will be important to keep the surgical area clean and dry. The doctor will give you specific bathing instructions. The stitches or surgical staples will be removed during a follow-up office visit.

Give any pain medicines exactly as ordered by the doctor.

Call the doctor if your child has any of the following symptoms:

• Fever or chills
• Redness, swelling, bleeding, or draining from the incision site
• Increased pain around the incision site
• Numbness and/or tingling of the arm or hand

Talk to the doctor about any other movement restrictions. If your child is old enough to drive, they may not be allowed to do so for a time after surgery. 

Full recovery from a hand surgery will depend on the type of hand surgery your child had and the extent of the injury.

Your child will likely need to go to several follow-up appointments while healing. The doctor may also recommend physical therapy.

Surgery may be recommended to treat certain hand problems, such as trigger finger or carpal tunnel syndrome. There are many different types of hand surgery. Your child’s doctor can help you determine the best type of surgery for their condition.