Description

Hand and shoulder surgery is a specialized field within orthopedic surgery that addresses various conditions, injuries, and diseases affecting the hand, wrist, elbow, and shoulder. These surgeries aim to restore function, alleviate pain, and improve quality of life for patients dealing with issues in these regions of the body. Here’s an overview of hand and shoulder surgery, including common conditions, types of procedures, and recovery processes. Common Hand and Shoulder Conditions Requiring Surgery Hand Conditions: Carpal Tunnel Syndrome: A condition where the median nerve becomes compressed at the wrist, leading to pain, numbness, and tingling in the hand. Surgery: Carpal tunnel release involves cutting the ligament to relieve pressure on the nerve. Tendon and Ligament Injuries: Tendon tears (e.g., flexor tendons or extensor tendons) or ligament sprains/tears can impair hand function. Surgery: Tendon repair or ligament reconstruction restores movement and strength. Fractures and Dislocations: Broken bones in the hand, wrist, or fingers can require surgical intervention to realign bones. Surgery: Internal fixation with pins, screws, or plates may be used to stabilize fractures and aid healing. Arthritis: Osteoarthritis or rheumatoid arthritis can cause pain and deformities in the joints of the hand or wrist. Surgery: Joint replacement, fusion, or synovectomy (removal of inflamed tissue) may be needed. Dupuytren’s Contracture: A condition where tissue beneath the skin of the palm thickens, causing fingers to bend. Surgery: Fasciotomy or needle aponeurotomy can be used to release the contracted tissue. De Quervain’s Tenosynovitis: Inflammation of the tendons around the base of the thumb, causing pain and difficulty moving the thumb. Surgery: Tendon release can relieve pressure and improve movement. Trigger Finger: A condition where the fingers or thumb get stuck in a bent position due to tendon inflammation. Surgery: Trigger finger release involves cutting the tendon sheath to restore normal motion. Ganglion Cysts: Fluid-filled sacs that form near joints or tendons, often causing pain or restricting movement. Surgery: Cyst removal or draining may be required if the cyst causes discomfort or interference with function. Shoulder Conditions: Rotator Cuff Injuries: The rotator cuff is a group of muscles and tendons that stabilize the shoulder. Tears or damage can lead to pain and weakness. Surgery: Rotator cuff repair involves reattaching torn tendons to the bone using sutures or anchors. Shoulder Dislocations: A shoulder dislocation occurs when the ball of the shoulder joint comes out of the socket, potentially damaging ligaments and cartilage. Surgery: Labral repair or capsular shift may be necessary to stabilize the shoulder and prevent recurrent dislocations. Frozen Shoulder (Adhesive Capsulitis): A condition where the shoulder joint becomes stiff, causing pain and limited range of motion. Surgery: Arthroscopic release involves cutting through tight joint capsules to restore movement. Shoulder Arthritis: Osteoarthritis or rheumatoid arthritis in the shoulder can lead to pain, stiffness, and loss of function. Surgery: Shoulder replacement or joint fusion may be needed for severe cases of arthritis. Fractures: Fractures of the shoulder, including the clavicle (collarbone), humerus (upper arm), or scapula (shoulder blade), require surgical intervention for proper healing. Surgery: Internal fixation with pins, plates, or screws is often used to stabilize the fracture. Labral Tears: The glenoid labrum is a piece of cartilage in the shoulder that can tear due to injury or overuse. Surgery: Labral repair is performed arthroscopically to reattach the torn cartilage to the bone. Impingement Syndrome: The tendons of the rotator cuff can become compressed under the acromion (part of the shoulder blade), causing pain and weakness. Surgery: Subacromial decompression involves removing part of the acromion to create more space for the tendons. Biceps Tendon Rupture: Rupture of the biceps tendon at the shoulder can lead to a "Popeye" deformity and functional weakness. Surgery: Biceps tendon repair involves reattaching the tendon to its anchor point on the shoulder. Types of Hand and Shoulder Surgeries 1. Open Surgery vs. Minimally Invasive Surgery: Open Surgery: Involves making large incisions to access the area of concern directly. Minimally Invasive Surgery (Arthroscopy): Small incisions are made, and a camera and specialized instruments are used to perform the procedure. This reduces recovery time, pain, and scarring. 2. Arthroscopy: For both the hand and shoulder, arthroscopy is a common procedure where small incisions are made, and a tiny camera is inserted to visualize and treat the joint or tendon. Shoulder arthroscopy is commonly used for rotator cuff repairs, labral tears, and shoulder impingement. Hand arthroscopy can be used for joint debridement or diagnosing issues with tendons and ligaments. 3. Tendon and Ligament Repair: For hand and shoulder injuries, surgery may involve suturing tendons or ligaments back together. This is often performed in cases of torn rotator cuffs, ligament tears in the fingers, or tendon ruptures. 4. Joint Replacement: Shoulder replacement (total or partial) involves replacing the damaged joint with an artificial prosthesis. Joint fusion may be performed when the joint cannot be saved, typically in cases of severe arthritis or deformity. 5. Bone Fixation: Internal fixation is used for fractures, involving the use of plates, screws, pins, or rods to stabilize broken bones during healing. Recovery After Hand and Shoulder Surgery Recovery after surgery varies depending on the procedure and the individual patient, but common aspects of recovery include: Pain Management: Pain medications (e.g., acetaminophen, NSAIDs, or opioids for severe pain) are used to manage post-operative discomfort. Ice and elevation may be recommended for swelling and bruising. Physical Therapy: After both hand and shoulder surgeries, physical therapy is often required to restore strength, flexibility, and function. Shoulder rehab focuses on range of motion, strengthening the rotator cuff, and joint mobility. Hand rehab focuses on regaining fine motor skills, strength, and flexibility. Splints or Braces: After surgery, you may need to wear a splint or brace to protect the joint and support healing. Follow-up Appointments: Regular visits to the orthopedic surgeon are important to monitor recovery and ensure there are no complications such as infection or non-healing. Activity Restrictions: During recovery, there may be restrictions on weight-bearing and motion to prevent strain on the healing tissues. Full recovery can take weeks to months, depending on the extent of the surgery. When to Consider Surgery for Hand or Shoulder Issues? Persistent Pain: If conservative treatments (like rest, physical therapy, or medication) do not alleviate symptoms. Functional Limitations: Difficulty performing daily activities due to weakness, pain, or limited range of motion. Failed Non-Surgical Treatments: If non-surgical approaches have not provided relief or improvement over time.