Hand And Reconstructive Microsurgery

Introduction

The hand is most evolutionary organ of human body apart from brain. It acts as an extension to our mind and many times, we use hand to express our feelings as well. In fact, the existence of thumb differs humans from animals. Thumb can achieve up to 35 to 40% of hand function with help of other fingers.

Most important functions of hand are dexterity, precision, skill and strength. Identity of human or recognition of his or her reaction can be judged by simple touch.

As we all are aware that usually face and hands are the only exposed organs of human body most of the time. So susceptibility to get injured also remains very high. Unlike injury to other organs, hand injuries are managed carelessly or late, as human being gets adapted to the situation very fast & mostly believes on home remedy to solve the problem. For e.g., if someone gets fracture of one digit, the activities of daily living can be managed to maximum extent. The realization of functional deficit is always late and can be proven disappointing as treatment may not get patient back to normal function of the hand.

With all above considerations, now hand injury experts called hand surgeons are available for early diagnosis, prompt & accurate management of hand injuries to get patient normal hand function

MEET THE EXPERTS

Dr. Parag B. Lad

Dr Parag Lad is orthopaedic surgeon trained from Sir H N Hospital & Research Centre and B.Y.L. Nair Hospital & T. N Medical College, Mumbai.

He perceived his super specialization in the field of Hand & Reconstructive Microsurgery from reputed national and international centers in Mumbai, Coimbatore (TN) & Singapore. He is practicing exclusively hand surgery since 2012 & has performed more than 1500 surgeries.

Dr Yogesh Vaidya has attended the Biomet Visiting Surgeons Programme at New Albany Hospital, Ohio, USA under Dr Adolf Lombardi and Dr Keith Barand.He has completed a certified course in Total Hip Replacement at Chula Long Corn Hospital, Thailand.

Dr Parag Lad has huge experiencing in management of complex crush hand injuries or reattachment of totally amputated parts (Microsurgical replantation), acute or neglected complex wrist and hand fractures, brachial plexus & peripheral nerve injury management as well as management of congenital hand differences, deformities caused due to chronic diseases like rheumatoid arthritis or SLE etc.

FAQ's

Are you suffering from diabetes or hypothyroidism? These medical illnesses can cause compression of nerves in the hand & therefore, there is feeling of tingling and numbness in hand. This problem cannot be neglected as in long term; sensation in fingertip or strength in thumb function can be compromised. If we treat well in time, the problem can be permanently solved.

It can be because of overuse of thumb or some time, it is commonly seen in pregnancy or those who have diabetes or other hormonal problems. The tendons, which are responsible for thumb movement can, get stuck at the wrist level (above radial styloid region) and make the movement very painful and unbearable. This is tackled with use of splint or some medications if diagnosed early otherwise local injection or surgery may be necessary to cure the problem.

This could be a condition called ‘Trigger Finger’ in which both the tendons are locked in the palm at particular site due to formation of nodule or lump. This can happen in multiple fingers and may involve both hands. It is seen in person involved in heavy machine handling or it may be observed in those who have diabetes or hypertension etc. Trigger finger problem can be solved with simple surgery performed under local anesthesia and as day care procedure. After surgery, we allow patients to use their hand immediately so that stiffness in the fingers does not occur.

Are you suffering from chronic arthritis like rheumatoid arthritis or SLE or Gout etc? If not please get it checked first. Any cosmetic or functional impairment in hands can be improved with splint or surgery and we can make you independent from dependent. Medical management cannot make position of deformed hand better. Medicines can only get your disease under control. So waiting for longer duration and neglecting the deformity can progress to arthritis of small joints of the hand.

This is called ‘Hypoplastic Thumb’ or ‘Aplasia of thumb’. It can be associated with congenital other systemic anomalies like problem in kidney or intestine function, hematological problems. So they need to be tackled earlier. Human hand may turn to be less useful if thumb is not developed. We can discuss options of creating new thumb for the child to increase efficiency of hand. If we create new thumb at early age then for that child to adapt newly reconstructed thumb becomes easier. Best time to consider surgery is before child starts going to school.

As we know, any abnormal growth on human body, which is progressive in size or painful, or causing functional or cosmetic disfigurement needs careful management. Usually any mass or growth in the hand is benign in nature and does not behave like cancer. But we recommend timely investigation and management for the same to prove it is not malignant.