Reconstructive Surgery

Hand Surgery and Carpal Tunnel Surgery treatment options

The various forms of reconstructive surgery include hand surgery, carpal tunnel surgery and more. There are also procedures provided for the treatment of rheumatoid arthritis, dupuytren’s contracture, and congenital defects.

Hand surgery procedures are performed to repair common hand injuries, including the tendons, nerves, blood vessels, joints, fractured bones, burns, cuts, and other conditions. The modern reconstructive surgery techniques utilized by Dr. Lesavoy at his office in Beverly Hills, California, can improve the chances of a successful restoration of function and appearance. Treatments include grafting, flap surgery, re-plantation, or transplantation.

Carpal tunnel is a passageway that connects the wrist, tendons, and one of the hand’s major nerves. The pressure may be built up within the tunnel due to disease, fluid retention during pregnancy, injury, overuse, or repetition of motions.

This pressure on the nerve within the tunnel causes a tingling sensation in the hand, often accompanied by numbness, aching, and impaired hand function, which is known as carpal tunnel syndrome.

Carpal tunnel syndrome can cause a dull ache, numbness or tingling in the shaded area shown in the illustrations below.

Rheumatoid arthritis affects the joints as well as the appearance and function of the hands and other areas of the body. It can result in deformed finger joints and cause a bent position that affects movement.

Disabilities caused by rheumatoid arthritis can often be managed without surgery, such as wearing special splints or using physical therapy to strengthen the weakened areas. For some patients, however, surgery offers the best solution. Whether or not to have surgery is a decision you should make in consultation with Dr. Lesavoy and your rheumatologist.

Surgeons such as Dr. Lesavoy can repair or reconstruct almost any area of the wrist or hand by removing tissue from inflamed joints, implanting artificial joints, or repositioning tendons. Your hand may not regain its full use, but you can generally expect a significant improvement in the hand’s appearance and function. It is however important to remember that surgical repair doesn’t eliminate the rheumatoid arthritis, which can continue to cause damage to your hand, and may result in requiring further surgery, and you’ll still need to see your rheumatologist for continuing care.

Congenital deformities of the hand – deformities a child is born with – can interfere with proper hand growth and cause significant problems in the use of the hand. Fortunately, modern surgical techniques can correct most defects at a very early age – in some cases during infancy, in others at two or three years – allowing normal development and functioning of the hand.

Syndactyly is one of the most common congenital defects, in which two or more fingers are fused together. Surgical correction involves cutting the tissue that connects the fingers, then grafting skin from another part of the body. (The procedure will be more complicated if bones are also fused.) Surgery can usually provide a full range of motion and a fairly normal appearance, although the color of the grafted skin may be slightly different from the rest of the hand.

Among other common congenital defects are short, missing, or deformed fingers, immobile tendons, and abnormal nerves or blood vessels. Generally, these defects can be treated surgically and significant improvement can be expected.

After any surgical procedure performed on the hand, some minor or severe pain may follow. This is because the hand is a very sensitive component of the body. Dr. Lesavoy can prescribe injections and oral medications to treat any pain and discomfort. The healing process may include a rehabilitation course, which will involve hand exercises, heat and massage therapy, electrical nerve stimulation, splinting, traction, and special wrappings to manage the swelling.

Injuries to the Hand

Most procedures in hand surgery are those done to repair injured hands, including injuries to the tendons, nerves, blood vessels, and joints; fractured bones; and burns, cuts, and other injuries to the skin. Even in severe injuries, modern techniques have greatly improved the surgeon’s ability to restore function and appearance.

Hand surgery techniques now being used by plastic surgeons:

• Grafting: Grafting is the transfer of skin, nerves, bone or other tissue from a healthy part of the body to repair the injured part.
• Flap Surgery: Flap Surgery involves moving the skin, along with its underlying fat, blood vessels, and muscle from a healthy part of the body to the injured site.
• Re-plantation or Transplantation: Re-plantation or Transplantation include restoring accidentally amputated fingers or hands using microsurgery, which is an extremely precise and delicate surgery performed under magnification.

Some injuries may require several operations over an extended period of time.In many cases, surgery can restore a significant degree of feeling and function to injured hands. Recovery may take months, and a period of hand therapy will most often be needed.