Hand Surgery and Microsurgical Treatments
The procedures on this page include treatment approaches evaluated and performed by Prof. Dr. Osman Kelahmetoğlu, who actively carries out surgical interventions in the field of hand surgery and microsurgery.
Injuries involving the hand, fingers, tendons, and nerves are special situations that require timely intervention, accurate surgical planning, and microsurgical experience. Therefore, each case is handled individually.
Hand and Finger Amputations (Replantation Treatment)
When an extremity such as a hand or finger is completely detached from the body, restoring circulation to the severed part using microsurgical techniques is called replantation. The aim of this treatment is not only to reattach the limb, but to achieve functional and sensory recovery.
Amputations above the wrist level are considered major replantation, while amputations below the wrist level are considered minor replantation. Surgical success depends on the level of amputation, the time elapsed, and proper preservation of the severed part.
Clinical approach: In patients with a possibility of replantation, prompt microsurgical evaluation directly affects surgical success.
First Aid in Hand or Finger Amputation
- Bleeding should be controlled.
- The severed part should be wrapped in a clean cloth and placed in a bag; disinfectants should not be used.
- The severed part must not come into direct contact with ice.
- The patient should present to a center with microsurgical expertise as soon as possible.
Tendon Injuries and Surgical Repair
Tendons are strong structures that transmit force from muscles to bones and joints, enabling movement. In cases of cuts, ruptures, or advanced damage, surgical repair may be required.
For tendon injuries, the ideal timing for surgery is within the first 3 weeks after the injury. Early intervention increases the likelihood of regaining mobility.
In the postoperative period, a splint or cast is typically used to protect the tendon (in most cases for 4–6 weeks). This is followed by a structured physical therapy and rehabilitation program.
Nerve Injuries and Microsurgical Repair
Nerve injuries may result in loss of sensation, reduced muscle strength, and functional impairment. In cases of laceration or severe crushing, microsurgical nerve repair may be considered.
Early evaluation and the correct surgical approach are critical for functional outcomes. In delayed cases, the risk of permanent damage may increase.
Specialist assessment: Patients with suspected nerve injury are advised to be evaluated by a hand surgery/microsurgery specialist as soon as possible.
Nerve Compression Syndromes
Nerve compression, which occurs when nerves are placed under pressure by tendons, muscles, bones, or connective tissue, can cause symptoms such as pain, numbness, tingling, and weakness.
One of the most common examples is carpal tunnel syndrome. In the initial stage, non-surgical methods (rest, medication, physical therapy, etc.) are preferred; however, if symptoms cannot be controlled or worsen, surgical decompression may be necessary.
Dupuytren’s Contracture
Dupuytren’s contracture is a progressive condition characterized by thickening of connective tissue in the palm, leading to finger flexion and difficulty extending the fingers.
In early stages, non-surgical options may be considered; in advanced cases, the goal is to restore hand function through surgical treatment. Adhering consistently to the recommended rehabilitation program after treatment is important for long-lasting results.
Congenital Hand Anomalies
Congenital hand anomalies refer to differences that occur during hand development while the baby is in the womb. The two most common conditions are polydactyly (extra fingers) and syndactyly (webbed fingers), both of which can be corrected surgically with appropriate planning.
Polydactyly (Extra Finger)
In simple cases, the extra finger may be attached only by skin, and a more limited procedure can be planned early. In cases involving bone/joint structures, a planned surgical approach is performed to achieve the best functional and aesthetic outcome.
Syndactyly (Webbed Fingers)
This is a condition in which fingers are fused at the level of skin or bone. In cases with risk of functional impairment, surgical separation is usually planned in early childhood; skin grafting may be required when necessary.
Assessment and Treatment Planning
In conditions requiring hand surgery and microsurgery, a personalized treatment plan is created by considering the type and level of injury, the time elapsed, and the patient’s functional expectations. In suitable cases, surgery is planned; in unsuitable cases, alternative treatment options are evaluated in detail.