Wrist Surgery

Wrist surgery encompasses a variety of procedures aimed at restoring function and appearance to the hands and wrists. These surgeries can be necessary due to injuries, rheumatic diseases like osteoarthritis and rheumatoid arthritis, degenerative changes, congenital defects, or infections.

Hand and wrist reconstructive surgery involves various procedures aimed at restoring function, reducing pain, and improving the appearance of the hand and wrist. This type of surgery is offered by several reputable institutions, each bringing a unique approach and expertise to the field.

Penn Medicine, for instance, emphasizes its integrated approach, combining orthopaedic and plastic surgery expertise. Their program addresses a range of conditions, including amputation of the hand or fingers, burns, tumors, carpal tunnel syndrome, congenital abnormalities, hand fractures, tendon conditions, and nerve injuries. They offer advanced microsurgery procedures and have developed a specialty called orthoplastics for limb preservation and restoration​.

Different types of hand surgeries include

• Skin Grafts and Skin Flaps: Used mainly for fingertip injuries or amputations, skin grafts involve transplanting skin from a different body part. Skin flaps are similar but include underlying blood vessels, fat, and muscles, used in areas lacking good blood supply.
• Closed Reduction and Fixation: This method realigns and immobilizes broken bones in the hand or fingers using internal fixtures like wires, rods, splints, and casts.
• Tendon Repair: Essential for joining muscle to bone, this surgery is complex and can be primary, delayed primary, or secondary, based on the timing and method of the repair.
• Nerve Repairs: Necessary for hand function and sensation, these repairs are timed based on the type and complexity of the injury and may involve reattaching or grafting nerves.
• Fasciotomy: Used to treat compartment syndrome, this procedure involves making an incision to reduce pressure, allow muscle tissue swelling, and restore blood flow.
• Surgical Drainage or Debridement: For hand infections, this involves removing pus or contaminated tissue to prevent further infection and promote healing.
• Joint Replacement (Arthroplasty): In severe arthritis cases, damaged joints are replaced with artificial ones made of metal, plastic, silicone rubber, or body tissue like tendons.
• Replantation: This microsurgery reattaches severed body parts like fingers or hands, aiming to restore as much function as possible.

Each type of surgery carries its own risks, such as infection, incomplete healing, loss of sensation or movement, and blood clot formation. The specific procedure chosen depends on the underlying condition and individual patient needs.

Moreover, minimally invasive techniques have also been developed for various hand and wrist surgeries. These include arthroscopic surgery for wrist fractures and other conditions, percutaneous fracture treatment, and percutaneous soft tissue procedures. These methods often involve smaller incisions, less tissue damage, and potentially quicker recovery times.

In terms of specific conditions, surgeries like Dupuytren’s contracture fasciectomy, trigger finger release, tendon repair, ganglion removal, knuckle replacement, and trapeziectomy are also performed based on the patient's specific needs and the severity of their condition. Rehabilitation and therapy, often involving hand therapists, are crucial post-surgery for recovery and regaining function.