Hand and Wrist

The wrist joint consists of the distal part of the ulna and radius and the wrist bones (scaphoid, pyramidal, etc.).Ligaments provide stability.

Some of the most frequent conditions that a hand and wrist Surgeon attends are:


Treatment of hand and upper limb fractures
Wrist fractures - Metacarpals - Phalanges
Bone reconstruction due to accident sequelae
Treatment of tendon injuries
Vascular and Nerve
Microsurgery Treatment of rheumatic diseases
Osteoarthritis and deformation of the thumb
Correction of arthritis deformities
Joint replacements
Treatment of inflammatory diseases
Tenosynovitis
Congenital malformations of the hand
Tumor lesions of the upper limb
Cysts
Skin lesions, Plastic and reconstructive surgery of skin defects
Surgery of Carpal Tunnel Syndrome and other upper limb nerve entrapments
Treatment of acute and chronic upper limb pain
Sports injuries
Specialized rehabilitation
Splinting/bandaging



Carpal Tunnel Syndrome The carpal tunnel is a canal through the wrist in which tendons run along with one of the major nerves of the hand. Pressure may increase inside the tunnel because of many diseases (such as rheumatoid arthritis), trauma, fluid retention during pregnancy, excessively repeated movements, etc. The resulting pressure on the nerve within the tunnel causes a tingling sensation in the fingers and decreases the opposing function of the thumb. This is known as carpal tunnel syndrome.



Some of the techniques used by hand surgeons are:

Arthroscopy: Provides a non-aggressive way in treating problems within a joint causing less tissue damage and resulting in a faster, more comfortable recovery.
Osteosynthesis: Is the repair of fractured bones by means of implants, such as: Plates and Screws which give fixation and stability helping with the healing of bone.
Grafts: Transfer of skin, bone, nerves, and other tissues from a healthy part of the body to repair the damaged part.
Flap surgery: The mobilization of skin with subcutaneous tissue, blood vessels, and muscle or bone from another part of the body to the place that has suffered the trauma.
Replants or Transplants: Allow the reconnection of amputated fingers or hands using microsurgery. This is an extremely precise and delicate surgery performed under magnification. Some injuries require a number of dilated operations over an extended period of time to achieve functional recovery.

MICROSURGERY

Microsurgery is the surgical field that uses magnification techniques to repair blood vessels and nerves (with magnifying glass or microscope).  Hand reconstructive surgery and its development is linked to microsurgery which requires mastery of various disciplines.  The medical team must establish a treatment strategy from the beginning. It is ideal to carry out all the reconstruction quickly in order to initiate early mobilization. The initial debridement is continued with the reconstruction of all hand tissue. The coverage is another important step, which is ideally performed in emergency care. The hand should initiate rehabilitation immediately otherwise it will lead to the onset of stiffness. At present it is possible to reconstruct or replace damaged, amputated or absent structures of the patient by transplanting other structures.