HAND SURGERY

What is Hand Surgery?

The hand is the most important organ that provides the reflection of our thoughts, feelings and behaviors. We use our hands while talking, working, and performing our daily tasks. We use various tools with our hands. Of course, this causes our hands to be injured more often than our other limbs. Diagnosis and proper treatment of hand injuries is very important for the continuation of one's work and social life.

📞 Book an appointment for a personalized treatment plan after your examination:

📍 Kocaeli Aesthetic Surgery Clinic

Dr. Nurgül Altuntaş

👉🏻 BOOK NOW

WHAT DOES HAND SURGERY INVOLVE?

Hand, wrist, forearm problems

Hand surgery encompasses a wide range of conditions affecting the hand, wrist, and forearm that cause pain, deformity, and limited movement, impacting daily life. Problems in the bones, joints, subcutaneous tissues, and soft tissues of this region fall under the scope of hand surgery.

Congenital hand and finger anomalies
Nerve compressions: Carpal tunnel syndrome, Cubital tunnel syndrome
Tendon problems: Trigger finger, tenosynovitis, ganglion cyst
Circulatory problems: Raynaud's disease

Post-traumatic injuries

Following accidents, falls, or sharp injuries, the tissues of the hand and wrist can be affected to varying degrees, including fractures, dislocations, tendon injuries, or nerve damage. Hand surgery aims to repair traumatic tissues in a way that is anatomically correct, thereby restoring both function and achieving the best possible aesthetic results.

Bone and joint traumas such as fractures/dislocations
Soft tissue repairs after cuts and injuries.
Repair of tendon/nerve injuries and post-repair rehabilitation plan.
Restoring circulation after vascular lacerations.
Replantation after limb amputations
Surgical treatments for trauma or sequelae (permanent deformity/stiffness)
Burn repair and hand rehabilitation.

💬 If you have any complaints that cause pain or restrict function in your hand and wrist area, you can submit your questions.

👉🏻 BOOK NOW

INITIAL TREATMENT IN HAND SURGERY

The anatomy of the hand is a complex, dynamic system where tissues of different structures coexist. Injuries can range from simple cuts to limb amputations, resulting in varying functional losses. Generally, when evaluating hand injuries:

Assessment of circulation : Circulatory pathologies and vascular injuries.
Sensory examination: To check for nerve compression, trauma, or nerve injuries.
Movement examination: Tendon or nerve pathologies
Imaging (X-ray or MRI): For fractures, dislocations, and soft tissue injuries.
EMG : Performed to diagnose nerve damage.

HAND INJURIES

Hand injuries can result in simple tissue loss, isolated tendon, blood vessel, or nerve lacerations, bone pathologies, or complex injuries involving a combination of all these.

Tissue defect in the hand and fingers

By planning the most appropriate closure method according to the size and depth of the tissue damage (skin, subcutaneous tissue, tendon-bone level) and the location of the wound, it helps to aim for both functional preservation and the best possible aesthetic result. Frequently used methods include:

Graft (skin patch)
Local flaps: VY flap, Cross-finger flap, Moberg flap, Tenar flap, Ada flaps
Regional flaps: Perforator flaps, tissue transfers from the wrist and forearm.
Distant flaps: Pedicled flaps or free flaps from abdominal or chest tissue.

Tendon injuries

The approach to tendon injuries is determined by whether the tendons affected are on the inside (flexor tendon) or the outside (extensor tendon) of the hand. However, the basic principles are:

Early intervention
End-to-end repair
Function-supporting splint
Careful rehabilitation process
The type and severity of the injury, the number of tendons affected, and the rate of treatment adherence will all affect the outcome.
Risks: re-detachment, adhesion, impaired function.

For more detailed information about tendon injuries, see our article "Tendon Repairs".

Nerve injuries

Nerves directly affect sensation (reduced feeling) and muscle strength/movement in the fingers. Therefore, nerve injuries can manifest as numbness, tingling, loss of sensation, weakness, and sometimes restricted finger movement. Nerve repair can be detected during examination or seen in an open wound. EMG can be performed in advanced cases. Surgical approach and recovery;

Early intervention (important for stress-free repair)
End-to-end, tension-free nerve repair (microsurgery techniques)
If there is loss or tension between nerve endings, repair can be done with a nerve graft.
Appropriate hand rehabilitation after surgery.
Sensory/feeling return usually occurs gradually over weeks to months.
The type of injury, the time it takes for the nerve to be damaged (delay), and the level of damage all affect the outcome.
Risks: Insufficient functional recovery, sensory changes (numbness, hypersensitivity)

Vascular injuries

Blood vessels are the structures that provide nourishment to the tissues of the fingers and hand. Therefore, prompt evaluation is important in cases of suspected vascular damage; because if circulation is impaired, the risk of tissue loss increases, so vascular injuries should be treated quickly.

End-to-end repair of blood vessels using microsurgical techniques (restoring circulation)
If stress-free repair is not possible, repair with vascular grafting.
Planning splinting and rehabilitation to support recovery.
Re-evaluation and revision if circulation is not achieved.

Complex hand injuries

High-energy traumas generally lead to complex hand injuries affecting bone, blood vessels, nerves, and tendons simultaneously. In such cases, the tissues are treated sequentially.

If there are fractures or dislocations in the bone tissues, these are treated and the skeleton is stabilized.
Tendon repairs
Circulation will be restored (vascular repairs should be done as quickly as possible).
Nerve repairs are performed.
Reconstruction if there is soft tissue loss.
Splint that supports repairs

VY advancement flap application for tissue defect in the fingertip.

Rehabilitation with an appropriate splint is crucial after tendon repairs.

Nerve repair using microsurgical techniques.

In replantation surgery, after the skeleton is stabilized, the other tissues are repaired accordingly.

FIRST AID FOR HAND INJURIES

First, the cause of the injury must be removed :
- Machinery must be stopped, especially in cases of injuries resulting from workplace accidents.
- In injuries such as crushing or pinching, the hand should be freed from the impact in a way that does not damage healthy tissues.
If there is contact with foreign objects, water should be used to clean them.
If there is bleeding, a clean cloth should be wrapped around the wound and pressure applied.
- If bleeding cannot be controlled with pressure, a tourniquet can be applied to the upper arm.
- In this case, the tourniquet needs to be loosened at 15-minute intervals.
If limb loss is involved
- The severed part should be cleaned with water, wrapped in a clean, damp cloth, and placed in a bag.
- The prepared package should be placed inside another bag filled with ice before transport.
- One of the biggest mistakes during the transport of injured organs is applying ice directly to the tissue.
Hand injuries require prompt medical attention.
Early surgery is more successful, especially in cases of arterial injuries that cause circulatory problems.

HAND SURGERY PROCEDURES

(Non-traumatic conditions)

Dupuytren's contracture

Dupuytren's contracture is a condition in which the connective tissue in the palm thickens and shrinks, making it difficult for the fingers, especially the ring and little fingers, to straighten properly by pulling them inward. Over time, it can reduce grip strength, make daily activities difficult, and lead to permanent restriction of function in the finger joints. Early assessment and appropriate treatment planning help preserve hand function; in advanced cases, surgical intervention is necessary. For more details, see our article on "Dupuytren's Contracture".

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition caused by compression of the median nerve within the carpal tunnel in the wrist. It typically presents with numbness, tingling, and sometimes pain in the thumb, index, middle, and half of the ring finger; symptoms may worsen at night and can affect grip strength. Early assessment and appropriate treatment planning help reduce pressure on the nerve; in more advanced cases, surgical options may be considered. For comprehensive information, please see our article on "Carpal Tunnel Syndrome" .

What is trigger finger?

Trigger finger is a condition characterized by the fingers catching and "locking" when bending and straightening. It is usually due to thickening/irritation of the tendon sheath at the base of the finger, resulting in fluid movement; stiffness, pain, and difficulty straightening the finger may occur over time. In the early stages, conservative methods such as rest, splinting/orthosis, and corticosteroid injections if deemed appropriate by the physician may be preferred. In persistent or advanced cases, surgical release of the structure causing the tendon to become trapped within the sheath may be performed.

Congenital hand anomalies

Congenital hand anomalies affecting the hands and fingers are treated with surgery within the scope of hand surgery. Syndactyly, polydactyly, camplodactyly, and thumb duplication are the most common hand anomalies. The timing and plan of treatment are determined based on the child's general condition, the level and extent of the anomaly, and the degree to which the deformity affects hand function.

For detailed information, please visit our "SYNDACTYLI TREATMENT" and " POLYDACTYLI TREATMENT" pages.

Tumoral formations in the hand

What is a ganglion cyst?

Tumors found in the hand are mostly benign. The most common is a ganglion cyst.

A ganglion cyst is a generally benign, fluid-filled cyst that can form on the wrist or hand. It may be noticeable as a swelling; it can sometimes be painful, affect movement, or put pressure on nerves and blood vessels depending on its location. Its size can change over time. Treatment may include steroid injections, needle aspiration, or surgery. The risk of recurrence is high.

Other tumors of the hand

Epidermal inclusion cysts, lipomas, giant cell tumors of the tendon sheath, neuromas, fibromas, and nail bed tumors are other benign tumors. Skin cancers such as basal cell carcinoma, squamous cell carcinoma, and malignant melanoma can also occur in the hand area. Treatment is planned according to the location and size of the mass and the functions affected.

FREQUENTLY ASKED QUESTIONS

When should I seek emergency hand surgery?

If there is deformity in the fingers after trauma, limited range of motion, numbness/loss of sensation, severe pain, suspected circulatory problems, or a non-healing wound, a hand surgery evaluation is necessary.

How long does nerve damage repair take and when does healing begin?

Recovery varies from person to person. Because nerve fibers recover slowly, improvement in sensation and function may be seen gradually over weeks or months.

Do vascular injuries require emergency intervention?

Yes, if circulatory problems are suspected, evaluation should be done without delay. Surgical planning may be necessary at the appropriate time to prevent tissue loss.

Is hand rehabilitation necessary after surgery?

Many hand surgery recovery programs include hand therapy/exercise programs that are important for accelerating healing and maintaining range of motion.

📞 Book an appointment for a personalized treatment plan after your examination:

📍 Kocaeli Aesthetic Surgery Clinic - Dr. Nurgül Altuntaş

👉🏻 BOOK NOW

Daily Routines After Breast Reduction Surgery

The recovery process after breast reduction (mammoplasty) is focused on protecting the suture line, managing pain, and reducing the risk of infection. For this reason, planning your daily routines correctly is just as important as the surgical technique itself.

Rhinoplasty Prices

Who is a candidate for rhinoplasty? How is rhinoplasty performed? How are rhinoplasty costs determined? rhinoplasty Rhinoplasty is a surgical procedure performed on individuals with breathing problems and/or nasal deformities. Before rhinoplasty, the individual must not have any contraindications. It is important for the patient to prepare themselves for the change in nasal shape, have realistic expectations about the surgery, and be aware of their unique anatomical character

Treatment of epidermoid cyst

What is an epidermoid cyst? What are the symptoms of an epidermoid cyst? How is an epidermoid cyst treated? What is an epidermoid cyst? An epidermoid cyst is a slowly growing, usually well-circumscribed, round-shaped lesion under the skin. Unless infected, it is painless and does not negatively affect general health. If signs of infection develop, it can cause pain and discomfort, or cause cosmetic problems. Where does an epidermoid cyst occur? It occurs when the keratin in o

How long after breast augmentation can I swim?

One of the most frequently asked questions after breast augmentation surgery is when it's safe to swim in the sea or pool. This question...

+90 505 799 2998

Nurgul Altuntas,M.D.
Aesthetic and Plastic Surgeon

HAND SURGERY