Some surgeons say that there are as many hand surgeries as there are hands! What hand disorders require surgery? What are the main techniques? Focus on these highly precise interventions.

When hand surgery is necessary

At the crossroads of functional surgery and cosmetic surgery, lies hand surgery. The specialized orthopedic surgeon uses various techniques to treat hand pathology or trauma occurring following an accident.

Hand pathologies

Osteoarthritis of the hand  : particularly common, it can affect several areas of the hand. Pain, stiffness, deformation of the hand and/or fingers are the main symptoms. This form of osteoarthritis is generally linked to age or a history of trauma (for example, a fracture that has healed poorly).

Carpal tunnel syndrome is the most common hand pathology. Its consequences extend from the wrist (or even the forearm) to the fingers, a trajectory which corresponds to carpal tunnel. The main cause of this disease is an increase in volume in this area, usually due to hormonal changes (for example, during pregnancy). Its symptoms are progressive: first (nocturnal) discomfort in the fingers, then pain which can cause difficulty grasping certain objects.

Polyarthritis  : this is an inflammation that affects several joints of the hand (when only one joint is affected, it is arthritis). Rheumatoid arthritis, psoriatic arthritis, gout or chondrocalcinosis are the best known inflammatory diseases (also called rheumatic). Deformation or swelling of the hands are the main consequences if treatment is not provided in time.

Dupuytren’s disease  : of genetic origin, this pathology causes nodules or “strings” in the axis of the fingers, forming a hole in the palm of the hand. Progressive, this disease can lead to permanent flexing of certain fingers or the presence of numerous “strings” making certain movements difficult.

Hand accidents

Whether of domestic or external origin, an accident causing hand trauma most often represents an emergency situation. But, depending on the case, surgery is not systematic.

Fractures :  in the event of displacement of a joint, surgery is necessary. X-ray and CT scan are first necessary to determine the extent and size of the different lesions. Indeed, even small, these can cause particularly disabling discomfort in the long term.

Sprains  : wrist, thumb… Sprains can affect all joints, following an accident such as a fall . From a simple injury to rupture of the ligaments concerned, this injury has different stages of severity. Always painful, only radiological examinations allow it to be assessed precisely and to determine whether surgery will be necessary. Thus, the rupture of a carpal ligament (bone located at the wrist) systematically requires surgical intervention.

Wounds  : their depth and extent require urgent consultation, even if the wound seems “ordinary” to you . Surgery is generally necessary due to the large number of anatomical structures that can be affected, including tendons and nerves.

From its official name orthopedic and traumatic surgery of the upper limb, hand surgery aims to repair, orrect, straighten, but also prevent deformations and trauma of this limb.

Endoscopic hand surgery (arthroscopy)

A minimally invasive technique, it allows certain procedures to be carried out on an outpatient basis and hand functions to be recovered much more quickly. It can be applied in a large number of situations (in cases of pathology affecting the carpal tunnel, for example).

An incision of approximately one centimeter is made to allow the orthopedic surgeon to insert the necessary instruments through a rigid tube. The latter is also equipped with a mini-camera which allows the specialist to control the progress of the intervention and minimize the actions to be carried out.

Micro-surgery

This technique is dedicated to interventions on tiny anatomical parts, such as nerves, arteries or veins. It is particularly suitable when tendons are affected and in emergency situations. Specific surgical equipment (optical magnification, miniaturized suture thread, etc.) is used.

Percutaneous surgery

Using puncture points or tiny sutures, this technique allows a pin, a screw or a micro-blade to be inserted inside a bone to repair it. It is used in particular by the orthopedic surgeon to stabilize a fracture, cut a fibrous area or treat Dupuytren’s disease.