Hand and Finger Amputations (Replantation Treatment)

The procedure of reattaching completely severed limbs such as hands and fingers through microsurgical intervention is called replantation. This special surgical technique aims to restore the functional use of the amputated part. Wrist amputations are classified into two groups in terms of replantation: If the amputation occurs above the wrist level, these cases are considered major replantation; if it is below the wrist level, it is called minor replantation.

The first critical step affecting the success of treatment in hand and finger amputations is the evaluation of the patient’s overall health condition and the proper preservation of the amputated part. After trauma, the patient may experience low blood pressure, loss of consciousness, and heavy bleeding due to shock. In this case, bleeding must be controlled first, the patient calmed, and the amputated limb carefully preserved. The amputated part should be wrapped in a clean cloth, placed in a bag, and if dirty, gently rinsed with drinking water only. Disinfectants should never be used as they may damage the tissue.

Another important point in such cases is that the amputated part should not come into direct contact with ice. If the tissue touches the ice, freezing damage may occur, leading to tissue death. Therefore, both the ice and the amputated part should be placed in separate bags and then kept together in a third bag. With this method, the amputated part can remain viable for up to 12 hours.

The success rate of replantation may vary depending on factors such as the mechanism of injury, the level of amputation, and the intervention time. However, thanks to advanced microsurgical techniques today, significantly successful results can be achieved. In these operations, motor functions, sensory perception, and joint mobility can be restored at a rate of 60% to 80%, which is considered medically successful.

Tendon Injuries and Treatment Process

Tendons, which transmit the force generated by muscles to bones and joints, are tough and durable fibrous structures. Tendons exist throughout the body and can be damaged by both open and closed trauma. Tendon injuries can occur in people of all ages and genders, but are more common in athletes and those working in physically demanding jobs.

Diagnosis of tendon damage is usually made easily through physical examination. However, in suspicious cases, advanced imaging methods such as ultrasound (USG) or magnetic resonance imaging (MRI) can be used for detailed evaluation. In some cases, tendon injuries may be accompanied by nerve or vascular damage, which directly affects treatment planning.

Tendon repair requires surgical intervention. Ideally, such operations should be performed within the first 3 weeks after injury. The earlier the surgery is performed, the more successful the recovery of mobility and muscle function. In delayed cases, tendon ends may retract, making the surgical process more complex.

After surgery, the tendon must be immobilized with a splint or cast to prevent re-rupture. This immobilization period usually lasts between 4 to 6 weeks. At the end of this period, it is very important for the patient to start a physical therapy and rehabilitation program. Physical therapy is one of the key factors directly affecting the success of post-operative recovery and should be personalized. This process may take 3 to 6 months and plays a decisive role in regaining full function.

Nerve Injuries and Repair Methods

The nervous system in the human body functions both centrally and peripherally. Nerves not only transmit signals from the brain to the muscles but also carry sensory information from different parts of the body to the brain. They are basically divided into two main groups: motor nerves and sensory nerves. While motor nerves transmit brain commands to muscles for movement control, sensory nerves carry sensations such as pain, temperature, touch, and pressure to the brain.

Traumas, accidents, or surgical complications encountered in daily life can cause nerve damage such as cuts, crushes, or ruptures. Such nerve injuries may result in sensory loss, reduced or completely lost muscle function in the affected area. Especially when peripheral nerves are damaged, the person’s daily life and work capacity are directly affected. Depending on the severity of the damage, nerve repair becomes vital. If untreated, permanent loss of function, muscle atrophy, or involuntary motion restrictions may develop.

Early diagnosis and proper intervention are very critical in nerve injuries. If surgical treatment is not performed when necessary, nerve regeneration may not be possible. Therefore, after severe injuries, evaluation should be carried out within a few days by an expert hand surgeon or microsurgery specialist, and nerve repair surgery should be performed if required. In these operations, nerve ends are reconnected using microsurgical techniques, and sometimes nerve grafts may be needed.

The healing process largely depends on the injured nerve segment and the timing of treatment. Recovery in motor nerves may take longer than in sensory nerves. In addition, the further the repair site is from the target organ, the longer the recovery time. However, with successful surgery and a properly planned rehabilitation program, functional recovery can be achieved.

Physical therapy and rehabilitation in nerve injuries are an integral part of the treatment process. This process usually begins around 5 days after surgery and is very important for the patient to regain functions. Exercises contribute to nerve regeneration and help restore muscle strength. Especially for people who work with their hands or affected area, the return to work depends on the success of this treatment. The rehabilitation period may last from weeks to months depending on the severity of the injury.

In conclusion, with early intervention, expert support, and disciplined rehabilitation, it is possible to prevent permanent damage in nerve injuries.

Nerve Compression: Symptoms and Treatment Methods

Nerves, responsible for transmitting both movements and sensations, can be compressed due to accidents or repetitive physical activities. This condition is called nerve compression. It occurs when tendons, muscles, bones, or cartilage tissues put pressure on the nerves, usually manifesting with symptoms such as pain, tingling, and numbness. If untreated, the pain may become unbearable and cause permanent muscle function damage.

The most common type of nerve compression is carpal tunnel syndrome. This syndrome occurs when the median nerve, which runs from the upper arm to the thumb, is compressed around the wrist, causing wrist pain, numbness, and sensory loss in the fingers. Symptoms of carpal tunnel syndrome usually worsen at night and may gradually impair hand function.

Common symptoms of nerve compression include pain in the compressed area, numbness or tingling in fingers, hands, arms, and shoulders. In addition, burning sensation in the neck, shoulders, and arms, weakness in the wrist, and electric shock-like feelings in fingertips are also frequently observed.

Nerve compression diagnosis usually begins with a physical examination. However, if this is insufficient, further tests are used. Nerve conduction tests performed with electrodes placed on the skin, electromyography (EMG) with fine needles inserted into muscles, and magnetic resonance imaging (MRI) for detailed body imaging help confirm the diagnosis.

Treatment of nerve compressions usually starts with non-surgical methods. Lifestyle changes, regular rest, medication, and physical therapy often yield positive results. If nerve pressure cannot be relieved with these methods, surgical intervention may be the last option. In surgery, the anatomical structure pressing on the nerve is removed, relieving pressure and aiming for permanent healing.

Dupuytren's Contracture: Causes and Surgical Repair

Dupuytren’s contracture, which occurs due to thickening of the tissue called fascia in the palm of the hand, causes skin wrinkling and adhesion of tendons in that area. Although the exact cause is unknown, it is more common in individuals with diabetes, epilepsy, or excessive alcohol use. It is especially common in men over 40 years old and can significantly affect hand and finger functions. The applied treatment is called Dupuytren’s contracture repair.

The first symptoms of the disease usually appear as lumps in the palm. These lumps harden over time, causing loss of finger flexibility. As the condition progresses, patients may have difficulty performing basic movements such as grasping, holding, and opening-closing. This directly affects daily quality of life, and if not treated in time, may lead to permanent function loss.

Dupuytren’s contracture diagnosis can usually be made through physical examination. The aim of treatment is to restore hand functions, correct deformities, and eliminate movement restrictions. If the disease is diagnosed early, it may be treated with non-surgical methods such as corticosteroid injections. However, in advanced cases, surgical repair becomes inevitable. After Dupuytren’s contracture surgery, performed based on the doctor’s evaluation, significant functional improvement can be achieved.

After surgery, patients must follow the recommended physical therapy program regularly. This process is critical for restoring hand and finger functions. Rehabilitation ensures surgical success becomes permanent and helps regain mobility.

Studies show that about 20% of patients have a risk of Dupuytren’s contracture recurrence. Therefore, careful follow-up and control are essential after treatment. If symptoms reappear, patients should immediately consult a specialist doctor and restart the treatment process.

Congenital Hand Anomalies: Polydactyly and Syndactyly

Polydactyly (Extra Finger)

Syndactyly (Fused Fingers)