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Injuries and diseases of the hand are a major problem for patients. Quite often they can be treated conservatively – with medication or physiotherapy – but sometimes surgery is unavoidable. The field of hand surgery and microsurgery has advanced significantly over the past decades. The capabilities available to doctors at leading international clinics make it possible to operate safely and effectively on even the most complex pathologies. Learn more about it from our article.
What are the indications for performing hand surgery?
Among the hand conditions that most often require surgical treatment are:
Hand and wrist injuries;
Tendinitis, carpal tunnel syndrome, tenosynovitis and other inflammatory conditions;
“Trigger Finger”;
Benign and malignant tumours of the hand;
Congenital abnormalities of hand development (polydactyly, etc.);
Osteoarthritis, calcifications, etc.;
Dupuytren’s contracture.
Hand surgery is performed by an orthopaedic surgeon or plastic surgeon, depending on the type of problem. There are many techniques and methods that are individually tailored to the patient’s problem. Hand surgery is typically a difficult and delicate procedure, as the doctor deals with a huge number of joints, thin vessels and nerves, each of which plays a key role in preserving the normal functioning of the limb.
Today, modern surgeons prefer a minimally invasive approach to hand surgery. This means that the doctor carries out all manipulations with the smallest incisions possible. This has a positive effect on the postoperative state of the patient due to less blood loss and also allows for a faster recovery.
HAND SURGERY ABROAD
To book an appointment for surgery abroad, click on the button below and fill in the form. Our coordinators will call you back within 30 minutes. They will provide all the information you need and help with travel arrangements.
What types of hand surgery and microsurgery are performed?
Depending on the disease and the extent of the patient’s lesion, the surgeon will individually select the techniques to be used to treat the disease. For more complex pathologies – usually involving trauma and replantation – microsurgery is used. This is a field of medicine that deals with the delicate structures of the body, such as nerves and capillaries. It requires specialised equipment, not available in all hospitals; and special training for the doctor.
Hand surgery may include:
Surgical drainage or debridement | This procedure is often required when treating infections, inflammation, and the effects of injury. Dead tissue must necessarily be removed to prevent pathogenic bacteria from spreading through the body. In some advanced medical centres, debridement may be combined with stem cell therapy to preserve more of the patient’s tissue, but this procedure is more often used in the treatment of chronic wounds. |
Skin grafting | Skin grafting may be necessary for wounds, injuries, and amputations. Typically the graft is taken from another, undamaged area of the body. In more serious injuries, the skin is transplanted along with blood vessels, fat and muscle. An experienced plastic surgeon can hide the cosmetic defect as much as possible. |
Fracture fixation | When the bones of the arm are fractured, the surgeon can fix them using wires, rods, splints and casts. This will stabilise the broken bone and fix it in the correct position while it heals. |
Tendonoplasty | This is a microsurgical procedure to repair tendons after injuries, infections and other conditions. It should preferably be performed within 24 hours of the tendon injury; however, it is possible to recover up to 5 weeks after the injury. In the latter case, a graft transplant may be necessary. |
Arthroplasty (joint replacement) | The main indication for this operation is severe arthritis of the hand. The artificial joint, which is installed to replace the one damaged by the disease, can be made of metal, plastic, silicone rubber or the patient’s tendons. Quality prostheses from proven manufacturers are used abroad for this procedure, which can last 20+ years. |
Fasciotomy | Fasciotomy is used to treat tissue compression caused by inflammation, trauma, tumours, etc. The doctor makes strategically placed incisions to get rid of the pressure, restore normal blood flow, and remove disease-causing foci if necessary. |
Nerve Repair | Usually, injuries that result in nerve damage respond well to conservative treatment. However, if there is no progress in 3-6 weeks, surgery may be needed. If the nerve has been completely severed, it can be fixed by reattaching it to the other end of the nerve. Alternatively, a transplant of the nerve taken from other parts of the body may be performed. |
Hand surgery is necessarily accompanied by a process of supervised rehabilitation and recovery. It is very important to follow the doctor’s recommendations to regain a healthy level of mobility in the hand and fingers.
Surgical treatment of hand injuries
Hand injuries are one of the most common problems that bring patients to orthopaedic surgeons. For example, tunnel syndrome is the #2 referral among patients for surgery, and about a quarter of all sports injuries happen to the hand or wrist.
Hand injuries can have different sources, but two groups that are important to distinguish are acute and chronic. Acute injuries occur as a result of a single incident, such as a sports or work-related injury. Chronic ones often develop as a result of prolonged overuse of the joint, such as using a jackhammer.
On examination, patients may be diagnosed as such:
Fractures;
Nerve damage;
Detachment of a limb;
Soft tissue damage;
Soft tissue tears.
Each of the above problems requires an individualised approach. Surgeons often use minimally invasive, arthroscopic surgical techniques to repair soft tissue injuries or fractures.
One of the most traumatic situations patients may face is the amputation of a finger or hand. The good news is that with prompt medical attention, it is often possible to sew them back on while maintaining the functionality of the hand. Such surgery is very complex, requiring an experienced microsurgical team, and a sufficient amount of healthy tissue. The experience of foreign clinics allows us to predict, for example, an 86% chance of recovering a finger. In case of complex trauma of the hand, the chance of saving it will be lower, but there are many known cases of complete recovery.
In addition to the professionalism of the doctor, the key factor in the outcome of the surgery is its timing. As a general rule, the sooner an intervention is performed after an injury occurs, the better the outcome is predicted for the patient. However, life circumstances do not always make rapid intervention possible – for example, not all people live close to hospitals with a microsurgery department, which is a common problem in emerging economies. In such situations, an air medevac can come to the rescue. This service can quickly transport patients from anywhere in the world to a hospital for emergency treatment, including international patients.
Surgical treatment of hand tumours
Hand tumours are a common condition. According to various data, approximately 95% of them are benign and have a good treatment prognosis. The remaining cases are cancers: primarily, soft tissue sarcomas and, somewhat less frequently, bone sarcomas.
Distinguishing a benign tumour from a malignant one is not always easy even for an experienced doctor, which is why a certain percentage of patients do not receive adequate treatment in time. For an accurate diagnosis, various imaging examinations are needed – X-ray, Doppler ultrasound, CT, MRI, and biopsy.
It is not always possible to determine with 100% accuracy whether the swelling is malignant, but the following signs are more likely to suggest a cancerous malformation:
rapid growth of the tumour;
size more than 3 cm;
pain during sleep or rest;
general weakness, weight loss, fever.
The mainstay of treatment for soft tissue sarcomas is surgery. Older treatment protocols recommended amputation for this diagnosis, but modern research has shown that it does not significantly improve the prognosis of the disease. Therefore, advanced foreign oncology centres prefer to perform organ-preserving surgery when possible. However, in soft tissue tumours that have penetrated deep into the arm, as well as bone sarcomas, it is often impossible to avoid amputation.
Often, surgical treatment for a tumour on the hand will be accompanied by chemotherapy and/or radiotherapy – depending on the stage of the disease and the amount of tissue involved.
SURGERY APPOINTMENT
To book an appointment for surgery abroad, click on the button below and fill in the form. Our coordinators will call you back within 30 minutes. They will provide all the information you need and help with travel arrangements.
Surgical treatment for arthritis of the hands
Arthritis is the most common hand condition with which patients visit a surgeon. It is a chronic inflammatory process affecting the joints of mainly elderly people, which leads to pain syndrome and loss of functionality of the limb.
In most cases, patients are recommended conservative treatment – anti-inflammatory drugs, corticosteroid injections, physiotherapy and nutritional supplements. However, severe cases may require surgical treatment. There are several types of surgery used in such cases:
Tendon repair | The surgeon can arthroscopically restore balance to the joint by moving the tendon to a different attachment point. If the tendon has ruptured, the surgeon may stitch it back together, reattaching it in its original position or a different location. |
Synovectomy | A synovectomy is the removal of the sheath covering the arthritis-affected joint. |
Joint replacement | A surgeon can replace a joint severely affected by arthritis – in the knuckles, wrist, or finger joints – with an artificial joint. |
Arthrodesis | During arthrodesis, the surgeon fuses two bones. This surgery most often helps with arthritis of the finger joints. |
According to a study published in Orthopedic Reviews, 95% of patients manage to get rid of arthritis pain with the help of surgery.
Surgery for congenital hand abnormalities
The most common congenital hand abnormalities are syndactyly, constriction ring syndrome, duplicated thumb, hypoplastic thumb and trigger thumb. These conditions are successfully corrected through plastic surgery. During the consultation, it is important to discuss with your doctor the best age to have the intervention. In most cases, surgeons recommend correcting the defect before the child is 2, but some surgeries can be performed on 6-month-old children as well.
Babies born with limb defects have an increased risk of other developmental abnormalities; therefore, careful diagnosis of the whole body and monitoring of the child’s development is imperative.
Read: Where to go for treatment and how much does the surgery cost?
MediGlobus recommends seeking hand surgery at certified foreign medical centres with strong orthopaedic/plastic surgery and microsurgery departments. We base our recommendations on the results of our audits, internal hospital statistics and our patients’ feedback on treatment.
Pricing policies can vary significantly from country to country. When it comes to hand surgery, hospitals in Turkey and Central Europe are more economical options. At the same time, it is also possible to find good value for money in Western European countries such as Spain and Germany.
First of all, we can recommend the following clinics:
The prices for hand surgery will vary greatly depending on what type of surgery the patient needs. You can send us your scans and doctor’s reports and we will give you more specific information about the cost of hand surgery abroad. To leave a request, click on the button below, fill in the form and wait for a call from our coordinating doctor.
Resume
Traumatic, oncological, infectious, inflammatory, congenital and chronic hand diseases are successfully treated surgically. Such operations, depending on the diagnosis, can be quite complex and require a high degree of professionalism on the part of the doctor, especially when it comes to microsurgery.
Hand surgery includes a large number of customised techniques – arthroscopy, skin and nerve grafting, fasciotomy, arthroplasty, etc. The approach to treatment is tailored individually to each patient, so prices for hand surgery can vary significantly.
The advantages of hand surgery abroad are experienced microsurgery departments and a high percentage of successfully performed organ-preserving operations. In addition, for emergencies, there is the possibility of air evacuation even for patients from other countries.
For the treatment of tumours, injuries and other hand diseases, the international medical tourism platform MediGlobus recommends clinics in Turkey, Spain, Israel, Poland and Germany. For personalised recommendations and free consultation, please contact our coordinating doctors.
Sources:
- 1. Current Reviews in Muskosceletal Medicine
- 2. Orthopaedics & traumatology, surgery & research
- 3. American Society for Surgery of the Hand
- 4. Medical Hypotheses
- 5. The Journal of Hand Surgery, European Volume
- 6. Orthopedic Reviews
- 7. Plastic and Reconstructive Surgery
