Hand Surgery Before and After

February 23, 2012

Hand surgery is a broad term incorporating many different types of hand surgeries. People usually get hand surgery because they were born with a disfigurement or disability or if they have a medical condition during their lives like carpal tunnel, gout or arthritis. It took millions of years for human beings’ (homosapiens) hands to evolve to become and form the perfect structure we have today. Our hands are very important functional parts of our human body which have tens of thousands of uses and we use every day of our lives because without them or even without the one we don’t write with can make our lives extremely difficult. If one were disabled with the hands he may find it hard to get a job or perform everyday tasks such as driving, eating, writing and shaking hands. The majority of us take our hands for granted and don’t or couldn’t even imagine our lives without them. The fact is hundreds of thousands of people in the United States have some form of hand disability whether minor or major but after all it is a disability.

Our hands have a vast variety of functions and have the power to touch, feel, be gentle, squeeze and grip strongly. If we were to list all the uses our functional hands are capable of this page would no doubt take you all day to read, even if you were rushing it with no breaks. The human race surely wouldn’t be where it is today if we didn’t have hands and if they weren’t so useful. Most of us go through our lives without losing a hand or getting some sort of injury or condition (not including arthritis). People who experience enlarged knuckles and pain can have hand arthritis surgery to alleviate some of the symptoms.

Before and after photo

 Hand Surgery Before and After

Photo #1


What are the parts (anatomy) of the human hand?

The outer layer of the hand is comprised of skin which stops us from external bleeding. Our fingertips have one of the densest areas of nerve endings in our entire body and they are extremely sensitive to touch, more so than any other part of our bodies. Lucky people have a wrist, palm, five digits (thumb, index finger, middle finger, ring finger and pinky) at the end of each arm. Everyone’s from the palm (hand-print) to the end of our fingertips (fingerprints) has a unique pattern which is sometimes used to solve crimes such as murders and robberies. The skeletal structure of a normal human hand consists of 27 bones. Our hands contain joints (sometimes known as knuckles), fingernails, nerves, muscles, tendons, bones, skin blood and fat.

Types of hand surgery

There are several types of hand surgery and not every hand surgeon is capable or are experienced in all of these but specialize in a few. Below we have listed types of hand surgeries and before and after effects of each type especially how the hand functions after and are disabled/disfigured before.

Carpal tunnel syndrome – Is when there is pressure on the median nerve of the wrist towards the thumb side which gives movement and feeling to the hand. The term carpal tunnel itself refers to the nerve enters the hand. Carpal tunnel causes weakness, a feeling of numbness, pain and sometimes even tingling at any stage during the day whether the hand is performing activity or not. The condition is very common in alcoholics, people who perform repetitive actions with their hands such as when using a jackhammer or lawnmower which is vibrating all the time, assembly line work is a very common cause also. This condition occurs in adults usually between the ages of 30 to 60 but is quite common in young adults who are alcoholics as the alcohol does damage to nerves. There are several medical problems which come along with carpal tunnel and some of these include kidney failure, infection, obesity, arthritis, bone fractures and hypothyroidism. This condition is very uncomfortable and has the capacity to keep you up all night because of the uncomfortable tingling in your hand/s.

Before carpal tunnel hand surgery

You should try quitting alcohol as this is a trigger. Attempt to lose some weight as this adds pressure on your median nerve. See a doctor to determine the severity of your condition and have a list of things which trigger pain before you see him. Your physician may recommend hand surgery as a last resort and will fully explain the procedure to you. You should review your daily routine activities to minimalize stress on your wrist such as adjusting the height of your keyboard so that it is not too high and triggers carpal tunnel syndrome. There are several types of medication which may help relieve pain before considering hand surgery and these are ibuprofen and naproxen. There is also an injection called corticosteroid which is injected into the affected area and may help with further symptoms for a given period of time. Surgery should always be a last option but please try quitting alcohol if you are a binge drinker and the frequency you feel pain triggers should subside. More than 40% of cases of carpal tunnel syndrome which a physician sees end up requiring surgery. Carpal tunnel hand surgery is quite a common procedure and there is very little risk of complications and is worth thinking about in the long run if you are in a great deal of pain on a daily basis.

After carpal tunnel hand surgery

It’s extremely important to open and close your hands many times each hour as this helps the nerves heal and be elastic, it also helps prevent stiffness and swelling. Opening and closing your hand will not remove any stitches at all and this motion will help pump blood and fluid in and out of your fingers further helping prevent swelling. You must also try keep your hands elevated to prevent swelling, a few days after hand surgery be careful when walking and do not swing your arms too much as the kinetic energy of this motion will pump fluid into your arms and could make it swell. Feel free to use your hands to perform light daily activities such as eating, you may drive once your hands feel strong enough. Do not remove the bandages your surgeon has applied until your next visit with him; try keeping them as dry as possible to avoid any chance of infection. Shower with something covering your hands like a large plastic shopping bag, getting someone to assist you is only natural. Besides the local anesthesia your surgeon will apply before surgery you will be given pain medication to deal with pain after the surgery. It’s very common to feel tingling in your hand after hand surgery. If you feel the pain medication your surgeon has prescribed you isn’t strong enough make a visit with any doctor and explain to him you’re still in pain and require something of more strength, they will understand. Your stitches should be removed between a week or two following surgery. Use creams and vitamin E oil or cream to rub on the scar left after surgery to assist the healing process. After hand surgery, make sure to keep opening and closing your fist so your scars and nerves heal with a full movement. Avoid putting direct pressure on the scar.

Bone fractures and/or broken bones – Is a break in the bone of the hand. A broken bone usually takes anywhere between a month to two to heal properly. Non-displaced hand fractures is when the bone cracks or a bone ends up breaking but it stays in place. Open fractures is when your bone breaks through the skin and there is a lot of bleeding involved. A displaced hand fracture is when the bone breaks and the bones themselves are separated many times resulting in surgery to bring them together. Comminuted fractures are when your bone ends up breaking in many different places and sometimes this requires hand surgery.

Before broken/fractured hand surgery

The doctor will determine if you have a broken or fractured bone in your hand after he has the results of an x-ray. It’s possible to break or fracture a bone in your hand in many different ways. It usually happens during an accident like a sporting accident, no one breaks the hands in their bones on purpose. You may notice that there is something wrong with the bones in your hand by taking a look at it and seeing it just doesn’t look normal and is out of shape. The first sign of a broken bone in your hand is when you have just had an accident and you have trouble moving or opening and closing your fist and it feels sore and there may even be a sign of bruising. Your doctor should apply a local anesthetic when operating to correct broken bones but may feel the need to apply a regional one if he fears you may move your hand too much during the operation.

After a broken or fractured hand surgery

After broken bone hand surgery your hand may be placed into a brace, cast or splint these are all designed to stop you from moving so much and help the bone heal properly, they also help hold them in place so they also decrease pain. Your physician will prescribe you pain medicine if needed (more than likely) and you are expected to take them as needed until your next follow up visit. You will be given antibiotics to reduce the likelihood of infection from cuts made by the surgeons. You should be given pain medicine, please follow the prescription as directed whether with or after food. Do not add excessive pressure on you cast as there is a possibility that it may break. Avoid using a sharp object to try and scratch the skin under the cast when it becomes itchy. You may bathe with your cast on but avoid getting it wet at all costs, try putting a plastic bag over it and sealing it with a couple rubber bands (tight). You will be directed to avoid driving for half a month after your hand surgery. You may return to normal activity within a month and a half if all is well.

Gout (a form of arthritis) – Is a form of arthritis and is a medical condition characterized by attacks of acute inflammatory arthritis caused by uric acid build up in blood causing joints to inflame by forming crystals from the uric acid. This is a very painful form of arthritis and sometimes there is no other choice than to have surgery. It feels like an attack of pain, stiffness and burning in your joints, this will/can happen over and over until the gout itself is treated. The best way to test for gout is by taking samples of fluid from your joints to check for uric acid crystals.

Before gout hand surgery – You may have had large crystal build ups in the joints of your hand resulting in bumps coming out of your joints making your hand look disfigured. When drinking alcohol the next day your symptoms of a gout attack probably would have been worse as alcohol increases the amount of uric acid in your blood. Getting gout attacks may have become less common but the bumps on the joints of your hands may be bothering you enough to consider having hand surgery.

After gout hand surgery – The bumps of crystals in your joints at the top of your hands would have been removed making your hand look normal again but maybe leaving a few scars. The majority of patients who undergo this surgery after say they are very satisfied that their hands don’t look as deformed. After hand surgery your physician would have advised you on how to take care of yourself so that the uric acid build up would be at a minimal rate. He will give you a diet and a list of foods to avoid. He will advise you not to take aspirin as this can make it worse by raising the uric acid in your blood which could lead to more crystals being formed.

Transplantation – A hand transplantation surgery may involve reattaching a finger which may have been cut off from an accident such as a lawnmower rotary blade or it may involve a transplantation of an entire or both hands.

Before hand transplant surgery – If you have lost a part of your hand from an accident then it is advised you bandage up your hand tightly as soon as possible and go to the hospital ASAP and be sure to bring the piece of your hand that’s missing if you can so that surgeons may attempts to try and reattach it if possible. If you are having a finger transplanted onto your hand, then be sure to follow all the doctor’s orders before the operation as these are very important because otherwise complications may arise during the actual surgery.

After hand transplant surgery – Patients who have had a finder or part of a hand transplanted on to theirs generally say they can wiggle their new fingers within a week and you should have complete feeling and movement after six months if the operation is a success.

Dupuytren’s contracture – A painless thickening of tissues below the skin of the palm and fingers. Either one or both of your hands may be affected. The ring finger is most often affected. It may become difficult for a patient to straighten or extend his fingers in severe cases of the requiring hand surgery. If you believe you have this medical condition you should see a doctor to examine your hand so that you may be sure. Surgery is often performed to release the contracture. Scientists have developed a new treatment for this medical condition and it involves having three injections into your hand and some of the side effects may or may not include itching, pain and swelling.

After Dupuytren’s contracture hand surgery – You should now be able to have full flexibility of your hand again. Be sure to exercise your hand as prescribed by a physician or physiologist. Take warm baths regularly to warm your hands up to get the blood flowing. Following surgery this disease is likely to happen again to 50% of people within a decade.

Burn hand surgery – Burns to the hand often occur as a result of accidents and when surgery is performed it is usually to make the skin look normal again or to restore function to the hand again. Burn hand surgery is considered to be plastic or re-constructive surgery.

Types of anesthesia

There are a few types of anesthesia patients can have when undergoing hand surgery. The few include general, local and regional anesthesia. The type your doctor administers to you naturally depends on the duration and nature of which surgery procedure you will have done. Your overall health, medical conditions, prescriptions and other medical conditions will also determine which one you will receive from your surgeon/s.

What is local anesthesia?

Usually you tend to get a local anesthesia shot for small areas where the surgeon will perform hand surgery. This shot is a type of numbing injection. Your surgeon may also give you another injection to help you relax and stay calm during the surgery. He will generally ask you to turn away while they perform the operation.

How long before local anesthesia takes effect?

It usually takes effect within 10 minutes of being administered.

How long after I get the shot will the effects wear off of local anesthesia?

Generally between four to five hours and then the nerves within the injected area should start to get their feelings back. You should be careful not to damage or injure your hand while you can’t feel it. Just because you are unable to feel anything doesn’t mean your hand is in pain.

What is regional anesthesia?

This type of injection is aimed at being injected into the path of nerves so that a whole part of your body in way falls asleep like your whole hand or arm. This anesthesia is usually chosen after the hand surgeon has determined some of your nerves near the operating site could potentially feel pain and he has chosen to put the whole part of the body to sleep. Below we’ve written a few frequently asked questions on regional anesthesia.

Does regional anesthesia hurt when placing the block?

It can be slightly uncomfortable and painful but you will have other medications which will help you relax and get through the process. Just know that it is necessary and the pain won’t last forever and you should get through it fine. Many times this type of anesthesia will be combined with a local shot so that when the surgeon places the block it’s not as painful for you. Your hand or arm may twitch, this may feel strange to you but it is only natural and all part of the process and won’t have any long lasting effects.

How long does regional anesthesia take and last?

It takes anywhere from ten to fifteen minutes to administer, that’s as long as the pain will last. The effects can last anywhere from a single hour to a whole day. If you end up walking out of the hospital after the surgery take special care of your hand because you may not feel anything for a long time and just because it doesn’t feel pain doesn’t mean it’s invincible.

Am I going to be awake when the regional anesthesia is going to be administered?

Most likely yes unless you opt to be out when it is done, you have a choice. Many times general anesthesia is recommended by the doctor because you may move during the course of the procedure and may cause complications. A sterile drape is put between you and the surgeons operating before they begin to stop any chance of contamination after hand surgery.

What are the risks associated with regional anesthesia?

There are a few. The anesthesia may not work entirely on the area which it is meant to. There could be a little bruising coupled with soreness where the needle entered your skin. Where the needle was inserted you may feel some tingling after several days. It is  very rare for serious complications to occur at any rate but these are nerve damage, infections and significant bleeding. Make sure to tell your surgeon if you aren’t comfortable during and after the procedure so they may make some modifications.

What is general anesthesia?

General anesthesia is where you are made unconscious during the procedure usually by way of breathing in a gas. The reason why the surgeon may want to administer this would be to remove your reflexes so that they have an easier time performing the surgery. The good thing about this type is that you are out during the operation and don’t have to sit through it knowing your surgeon is making incisions and cutting your hand which can be quite an uncomfortable feeling, you shouldn’t remember anything from the entire operation and just wake up in your bed and know that it’s all over and your hands are bandaged up which is an easy thing to do. This anesthesia has a few purposes and these include analgesia (don’t feel a thing), immobility (no motor reflexes), muscle relaxation, amnesia (don’t remember a thing) and hypnosis (no consciousness).

How long after I wake up from general anesthesia?

When the operation is finished and you’ve been bandages up and prepped for recovery.

Does general anesthesia hurt after it has been administered?

Not at all, you will just breathe in some gas and you should be out before you have the chance to count from one to ten.

What is a hand surgeon called and when should I see one?

Hand surgeons are plastic, general or orthopedic surgeons who have undergone a year or two of additional advanced training of the hands and wrist. If you have pain in your fingers or fingertips, hand, wrist or arm you should see a hand specialist who will tell you which medical condition you have if you have one. Sometimes the only treatment you will require is an injection into a certain part of the hand to relieve pain and tension so you may close your fingers or rotate your hand but sometimes It’s much more sever and this is why you should see a specialist as soon as you have prolonged pain.

Tips to keep your hands safe

Hundreds of thousands of people every year have injuries to the hand which required immediate medical attention and sometimes even hospitalization. An example of a common injury is working with a lawn mower and putting your hand/s near the rotor and having a major cut or loss of a digit (finger/s), it is even possible to lose a hand due to a lawnmower accident. The best thing to do is to read the operators manual when using power tools such as angle grinders or bench saws so that you don’t accidentally injure your hand. Make sure you are always using gloves when working with any power tools as you can easily slip when gripping and the device may come in contact with your wrist, hand or fingers resulting in a major injury and possibly death due to excessive bleeding if urgent medical attention isn’t sought. Be sure to always wear glove when doing routine gardening as there are spiders which when they bite your whole hand could be amputated if you don’t get help as soon as possible. Keep your hands warm at all times. Don’t allow anything to crush your hands as you could lose feeling due to nerve damage. The best thing to do is not be too active and try getting your hands dirty but to step back and be careful what and how you do it. When lifting heavy things such as cabinets try not lifting it right from the bottom as when you go to sit it down it could crush your fingers leaving instant blood blisters or broken fingers. Watch your balance in wet areas and if you slip try to land on the floor with a closed fist as the weight of your body could break your fingers if you leave your hand open

Cost

Reconstructive surgery to improve form and/or function to the hand can be expensive. Expect to pay upwards of $2,000 and even a bill close to $20,000, depending on the complexity of your case. Hand rejuvenation (beautifying the skin) can cost around $200 to $500.

Opinions

I had a several fingers chopped off while I was working on a boat at work. I was rushed to hospital where the surgeon operated on my hand. It was excruciating up until I got the happy gas. Luckily someone grabbed my fingers for me and took them with me in the ambulance. I thought I was going to lose them for sure, but the surgeon stitched them back on. After a while I could move them again. I’ve got scarring and I can’t feel in one of the fingers but I’m very happy that I have my full hand. Work paid for the medical expenses and the time off so I can’t really complain.

Submitted by Rob on March 22, 2012

YouTube video

In this YouTube video is shows a patients hand after it was crushed by an automatic gate and then it shows how the hand looks three months following surgery. The hand seems to have fully healed with full motion and functionality. The only thing wrong with the hand now is there is a few scars. If you are sensitive to blood and raw flesh avoid looking at this video as it shows some blood and raw flesh.

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