Hand Surgery and Microsurgery

Which Diseases and Conditions Are Treated?

The hand and upper extremity region has a complex structure where many different tissues such as bones, joints, ligaments, tendons, nerves, and blood vessels work together in perfect harmony. The main conditions treated in our department are:

Hand, Wrist, and Forearm Injuries

• Finger and Limb Amputations: Finger, hand, forearm, or arm amputations are urgent and critical situations. Provided the severed part is brought to our hospital under the right conditions, emergency finger amputation treatment and replantation procedures are performed to restore blood supply.
• Artery, Nerve, and Tendon Injuries: Vascular cuts resulting from sharp object injuries or workplace accidents create a risk of tissue death. In the event of severed nerves that transmit movement commands and tendons that transfer muscle power to the bones, emergency tendon laceration surgery and nerve repair are performed to prevent loss of function.
• Fractures and Dislocations: Fractures of the hand, wrist, forearm, elbow, and arm bones are treated with casts, closed reduction, or surgical methods depending on the patient's age and the condition of the fracture.

Nerve and Tendon Compressions

• Carpal Tunnel Syndrome: Caused by the compression of the median nerve at the wrist level. Symptoms include numbness in the first three fingers, pain that wakes the patient up at night, and progressive loss of strength. In advanced cases, carpal tunnel surgery is performed to relieve the pressure on the nerve.
• Cubital Tunnel Syndrome: Compression of the ulnar nerve at the elbow level. It manifests itself especially with numbness in the ring and little fingers.
• De Quervain's Tenosynovitis: Compression of the tendons that lift the thumb at the wrist. It is frequently encountered in diabetes, rheumatism, and the postpartum period.
• Trigger Finger: Thickening and entrapment of the tendons that bend the fingers within their sheaths in the palm. It creates a painful catching or locking sensation during finger movements.

Tumors and Cystic Formations

• Cystic Formations (Ganglion Cysts): These are the most common benign cysts found in the wrist and tendon sheaths.
• Dupuytren's Contracture: A condition where the connective tissue in the palm shrinks, causing the fingers to contract inward and become unable to straighten.
• Benign and Malignant Tumors: Masses originating from bone, soft tissue, blood vessels, or nerve sheaths are evaluated with a multidisciplinary approach involving orthopedic oncology and are surgically removed.

Congenital Anomalies and Rheumatic Diseases

• Congenital Anomalies: Conditions such as extra fingers (polydactyly) and webbed fingers (syndactyly) are corrected with surgeries planned during childhood.
• Rheumatic Deformities: Joint deformities in the hand developing due to advanced-stage rheumatic diseases are repaired through surgical interventions.

Diagnostic Methods

For an accurate and effective treatment plan, the source of the problem must first be clearly identified. In our department, following the patient's medical history and a detailed physical examination, advanced technological diagnostic methods are utilized.

• X-Ray: The primary method used to detect fractures, dislocations, and deteriorations in bone structure.
• Ultrasonography: Used to evaluate tendon injuries, cysts, and soft tissue lesions.
• Magnetic Resonance Imaging (MRI): Provides detailed imaging of intra-articular ligament tears, cartilage damage, occult fractures, and tumor formations.
• EMG (Electromyography): The fundamental diagnostic tool that measures the electrical activity of muscles and nerves to determine the degree of nerve compressions and nerve damage.

Treatment Methods and Applications

The treatment approach in hand surgery is divided into non-surgical (conservative) or surgical methods depending on the type and severity of the problem. For early-stage nerve compressions and mild tendon injuries, the use of splints, specific medications, local injections, and physical therapy are preferred.

In cases where conservative treatments are insufficient or in acute injuries, surgical intervention is inevitable. Hand nerve compression treatment, tendon and ligament repairs, fracture fixations, cyst excisions, and congenital anomaly repairs are performed using minimally invasive (small incision) techniques to maximize patient comfort. In the postoperative period, our patients are directed to physical therapy and rehabilitation programs to rapidly regain hand functions.

Technology and Team

BHT CLINIC İstanbul Tema Hastanesi stands out as a fully equipped microsurgery hospital. Microsurgery is the procedure of suturing vessels and nerves thinner than 1 millimeter, which are impossible to see and repair with the naked eye, using special surgical microscopes and very fine surgical instruments.

The advanced technology microscopes in our operating rooms provide our surgeons with the ability to magnify the surgical field in high resolution and three dimensions. This minimizes tissue damage and maximizes the success rate of the repair. Our experienced hand surgeons work in perfect harmony with the orthopedics, plastic surgery, neurology, radiology, and physical therapy departments, embracing a multidisciplinary team approach.

When Should You See a Doctor?

Problems in the hand and arm region can quickly reduce the quality of daily life. If you experience one or more of the following symptoms, it is recommended to consult a specialist hand surgeon without delay:

• Persistent numbness, tingling, and loss of sensation in the hand, fingers, or arm
• Hand and wrist pain that wakes you up, especially at night
• Difficulty holding objects, decreased grip strength, and dropping items
• Catching, locking, or hearing a clicking sound when opening and closing the fingers
• Swelling, a mass, or deformity in the wrist, palm, or fingers
• Bleeding and restricted movement after sharp or penetrating object injuries or workplace accidents
• Severe pain, bruising, and swelling in the hand after a fall or impact

Appointment and Consultation Process

For the accurate diagnosis and permanent treatment of your hand and upper extremity complaints, you can apply to the BHT CLINIC İstanbul Tema Hastanesi Hand Surgery and Microsurgery department. For emergencies such as workplace accidents, limb amputations, and acute traumas, our hospital provides uninterrupted service 24/7.

To schedule your consultation, get detailed information, and meet with our expert team, you can visit our online appointment page or contact us via our call center at 0850 811 34 00. We are by your side to help you step into healthy and pain-free days.

Frequently Asked Questions

How soon should an amputated finger be reattached?

Time is highly critical in amputation cases. Wrapping the severed limb in a clean, damp cloth, placing it in a waterproof bag, and keeping this bag in another container filled with ice water to reach a well-equipped microsurgery center within 6 hours at the latest greatly increases the success of replantation (reattachment).

Can carpal tunnel syndrome be cured without surgery?

Early-stage carpal tunnel syndrome can be controlled with the use of a night splint, ergonomic adjustments, medication, and physical therapy. However, in advanced cases where night pains intensify, there is a constant feeling of numbness, and muscle wasting begins, surgical intervention is necessary for a permanent solution.

Does trigger finger heal on its own?

Trigger finger usually does not heal on its own. Although relief can be achieved with medication, splints, and rest in the early stages, if the catching and pain continue, the tendon sheath is released with a minor surgical procedure. This procedure takes a very short time, and the patient can return to daily life the same day.

How long do microsurgery operations take?

The duration of the surgery varies depending on the extent of the injury and the number of vessels, nerves, and tendons to be repaired. While a simple nerve compression operation takes 30-45 minutes, multiple finger amputations or complex tissue repairs can last for hours.

Is physical therapy mandatory after tendon laceration surgery?

Yes, the physical therapy process is one of the most important parts of recovery for the hand to regain its former range of motion and strength after tendon repairs. Regular rehabilitation, started at the right time in accordance with the protocol determined by the surgeon, directly affects the success of the surgery.