BHT CLINIC Istanbul Tema Hospital Department of Hand Surgery and Microsurgery; Diagnosis and treatment of patients with problems related to hand, wrist, elbow and arm.
What is Hand Surgery?
Hand surgery is the sub-branch of orthopedics and traumatology. Hand surgery is a branch that covers the treatment and surgery of all diseases in our body from shoulder to fingertip including hand, arm and fingers.
Our hands are the most functional part of the movement system. Unprotected against diseases and injuries, being exposed is one of the most common causes of hand-related diseases. For this reason, it is very important that they are treated by doctors who specialize in this field.
Hand Surgery Diagnosis and Treatment Areas
- Hand and Finger Ruptures
- Tendon and Nerve Injuries
- Finger Fractures
- Hand Tumors
- Congenital Hand and Finger Anomalies
- Nerve Congestion
- Congenital or Injury Caused Hand and Arm Paralysis
What are Hand Surgery Diseases?
1) Hand, Wrist and Forearm Injuries
a. Finger and limb ruptures
Finger, hand, forearm, arm, foot, leg ruptures are among the fields of interest in this science.
Successful insertion of breaks;
- How the rupture occurs: Different types of injuries from clean and smooth incisions to crushing, crushing / pulling ruptures, dirty wounds / burns,
- The time from the moment of rupture to replantation and blood supply,
- It depends on the correct handling of the broken part.
b. Artery, Nerve and Tendon Injuries
Vein incisions; In addition to being the cause of bleeding, the risk of tissue death (necrosis) as a result of the absence of blood to the tissue. The nerves transmit the motion commands and carry the senses. Tendons transfer the strength of the muscles to the bones and provide the formation of movement. Partial and complete incisions of these tissues are repaired surgically.
c. Fractures and Dislocations:
All fractures of the upper extremity are included in the field of hand surgery. These include fractures of the hand, wrist, forearm and elbow, fractures of the ligament, fractures of the arm bone.Depending on the shape of the fracture, the age of the patient and other factors, it is treated with plaster, closed correction or surgical methods.
2) Nerve and Tendon Jams
a. Carpal Tunnel Syndrome
It occurs as a result of compression of the median nerve at the wrist level for various reasons. Pain, numbness / sensation in the first three fingers and part of the fourth finger. In the advanced period; loss of power in the fingers, the signs of dropping objects occur. Treatment of; drugs, splints, local injections, physical therapy and surgical methods are used.
b. Ulnar Gutter Syndrome
This time, the ulnar nerve is stuck at the elbow level. 4 and 5. Fingers are in. Treatment is based on the methods used in carpal tunnel syndrome.
c. De Quervain Disease
It occurs as a result of the compression of the tendons that lift the thumb at the wrist level. It is frequently seen in diabetes, rheumatic diseases and postnatal period. If drug and splint treatment is insufficient, surgical release is performed.
d. Trigger Finger
The bending tendons of the fingers become thicker as they bind to the palm and become stuck. Finger movements are stuck and painful. There are also non-surgical and surgical treatment methods.
In addition, nerves and tendons may become stuck at other levels.
3) Tumor and Tumor-like Formations of Hand and Upper Limb
a. Tumor-like Formations
The most common are cysts in the wrist and tendon sheaths called ganglions. Diagnosis is made by ultrasonography or MRI. Although they benefit from drug treatment when they do pain, they are recommended to be surgically removed.
Palmo-plantar fibromatosis (Dupuytren’s Disease): Palm and soles of the feet. It can spread in the connective tissue and cause shrinkage in the tissue and contraction of the fingers. Local injections and minimal surgical methods are tried to eliminate. In advanced cases, it should be surgically cleaned.
b. Benign Tumors
Bone and soft tissue cysts, giant tumor of tendon sheath, benign tumors of vascular and nerve sheath are among them. Following the clinical and radiological diagnosis, definitive diagnosis should be made by biopsy and pathological examination and then the mass should be removed by final surgical intervention.
c. Malignant Tumors
The skeletal system needs to be treated like other malignant bone and soft tissue tumors. Multidisciplinary approach and hand surgery and orthopedic oncology should work together.
4) Rheumatic, Inflammatory and Infectious Diseases
Rheumatic diseases are the most common joints of the hand and wrist joints. Although rheumatology and physical therapy is the subject of his specialty, surgical interventions are performed in advanced deformities.
In addition to rheumatic causes, chronic fatigue and microorganisms are the causes of arthritis and tendinitis.
5) Congenital Anomalies and Birth Injuries
Congenital anomalies are frequently seen in the hand and upper extremity as in other parts of our body. Although the frequency of pregnancy is reduced due to close monitoring of pregnancy, it is not possible to prevent them completely. Polydacty, polydactyly, syndactyly, bony adhesions (synostosis), complex anomalies. Surgical intervention is often needed.
The most common injuries during difficult births are the collarbone fracture. Heals mostly without problems. Fractures may also occur in other bones. Damage to the armpit nerves is paralyzed in certain parts of the arm and hand. Surgery and physiotherapy methods are tried.