Hand surgery

Hand surgery is a broad term that covers a wide variety of procedures.

UCHealth hand surgeons perform leading-edge hand surgery to restore function to the fingers, hand and wrist. They can also make the hand look as normal as possible after hand injuries.

When hand surgery is called for

We perform hand surgery for many reasons: hand injuries, rheumatic diseases that change and damage the structures in the hand (such as osteoarthritis and rheumatoid arthritis), degenerative changes to the structures in the hand and upper extremity, congenital conditions, and infections.

Serious about your hand injury? See a UCHealth specialist.

If you have a hand condition that might require surgery, make an appointment today with a UCHealth orthopedic specialist.

Our hand surgeons are among the most experienced in the United States. They will work with you to determine the best treatment plan for your unique case. We will restore as much function as possible so you can do the activities you love once again.

Many different types of surgeries can be done on the hand, depending on the underlying cause of the problem.

The goal of any surgical procedure is to restore function and stop the progression of the disease or condition. These procedures include:

  • Arthroscopy. Your surgeon inserts an arthroscope, a thin tube with a light, camera and small tools, through small incisions to access your joint for diagnosis and possible repairs.
  • Closed reduction and fixation. May be used when there is a broken bone in part of the hand. Surgery realigns the broken bone and then holds it in place, or immobilizes it, while it heals.
  • Fasciotomy. Done to help treat compartment syndrome, such as carpal tunnel syndrome, where the surgeon relieves pressure on the median nerve.
  • Joint replacement or arthroplasty. Used in cases of severe hand arthritis. We replace a joint that has been destroyed by arthritis with an artificial joint.
  • Nerve repairs or nerve graft. Generally, surgery is done about three to six weeks after the injury.
  • Replantation. This type of surgery reattaches a body part, such as a finger or hand, which has been completely cut or severed from the body.
  • Skin grafts. Done by taking a piece of healthy skin from another area of the body, called the donor site, and attaching it to the injured area.
  • Skin flaps. Similar to a skin graft, a skin flap involves taking skin from another part of the body, but this procedure uses skin that has its own blood supply.
  • Surgical drainage or debridement. Used as treatment for hand infections.
  • Tendon repair. Tendons, the fibers that join muscle to bone, can be injured due to infection, injury or sudden rupture. There are three types of tendon repair:
    • Primary repair of an acute or sudden injury is often done within 24 hours of the injury. This is usually a direct surgery to fix the injury.
    • Delayed primary repair is usually done a few days after the injury, but while there is still an opening in the skin from the wound.
    • Secondary repairs may occur two to five weeks or longer after the injury. They may include tendon grafts.

 

Two people pose in a sledding selfieMost hand surgeries require that the patient goes to sleep under a general anesthesia.

We can now perform many hand surgery procedures using only local anesthesia, an approach called WALANT. We can safely control bleeding and extend the local anesthesia as necessary, while avoiding the use of general anesthesia or a painful tourniquet.

In addition, WALANT is good for patients with medical complications or other factors that would prevent surgery, such as taking blood thinner medications. The advantages of WALANT include:

  • Avoids possible side effects and complications of sedation and general anesthesia.
  • Costs are typically lower, especially for patients.
  • Eliminates intravenous injections and the need for anticoagulant medications such as warfarin.
  • Helps patients recover and return to normal activities more quickly.

Your orthopedic specialist will discuss the possibility of WALANT as part of. your personalized treatment plan.

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