Microsurgery of the hand and wrist may be used to treat traumatic injuries such as a severed thumb or finger, severe laceration of a blood vessel, or a severe tendon or nerve injury. The surgery involves the use of specialized operation microscope and precision instrumentation. The procedure is commonly performed for nerve repair, reattachment of a severed finger, tendon repair etc. It is performed by an expert surgeon specializing in microsurgery or microvascular surgery. It is also used in the treatment of Carpal Tunnel Syndrome, Rheumatoid arthritis, Dupuytren's contracture.
The patient is given anaesthesia either local anaesthesia, intravenous sedation or general anaesthesia. Next, an incision is made based on the procedure. The most common procedures are described below:
Treating Trauma: The most common traumatic injury is tendon repair. Tendon repair retrieves the retracted tendon and reconnects it using surgical techniques to restore function and movement.
Carpal Tunnel Relief: This procedure is done to relieve the pressure on the median nerve in the carpal tunnel. An incision is made extending from the middle of the palm to the wrist. An alternate procedure is referred to as an endoscopic carpal tunnel release, with smaller incisions and the use of a surgical microscope or endoscope, a small flexible tube that contains a light and lens, to release pressure.
Treating Birth Deformities: This is usually done to treat syndicate a condition where two fingers fused together by a web of the skin or by the skin and a partial fusion of bones. Techniques such as skin grafting or a local flap procedure like Z-Plasty create flexibility at the incision site for growth and movement of the fingers. The incision is usually closed with resorbable sutures.
The recovery time for the procedure is minimal. The patient is advised to keep his/her arm elevated for the next 3-5 days. This ensures minimal swelling and pain. It is also essential to keep the wound dressings dry and clean. Physical movement in areas other than the procedure area is recommended to ensure that there is no stiffness. Physical therapy is usually prescribed to gain full function of the hand. Following all postoperative instructions including cleansing, taking prescribed medications and hand therapy exercises ensures a proper speedy recovery.
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