Hands come at the top of the organs that are injured mostly. The reasons for this are mostly doing business with the hands and hiding ourselves with the hands for protection. Occupational accidents, kitchen injuries, playground injuries, sharp object attacks are the most common causes of hand injuries.
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European and Turkish Board Certified Plastic Surgeons
Turkish Plastic, Reconstructive and Aesthetic Surgery Association Certificate of Competence
Before Hand Injuries
The anamnesis (medical history of the patient) and physical examination are very important in a patient who applies with a hand injury. The type and time of injury, the applications performed after the acute intervention, and the general condition of the patient will determine the treatment to be selected for the patient.
The major anatomical structures in the hands are vessels (arteries, veins), nerves, tendons, muscles, bones, ligaments, and skin. The integrity and function of all these structures are evaluated. X-rays or CT for large bones are requested in cases where bone injury or the presence of a foreign substance in the tissue is suspected.
Although the decision for vascular injury is generally obvious during examination, angiography or Doppler US may be performed rarely. In amputations (limb ruptures), the level of amputation, its shape, elapsed time, the form and storage of the amputate, the age, occupation, general condition, other accompanying injuries of the patient will affect the decision of replantation (replanting the ruptured limb).
During Hand Injuries
Hand injuries can range from a nail bed injury to a major amputation. The surgery is planned according to the injury and the patient. While the patient can be treated with a surgery that takes 5 minutes under local anesthesia, sometimes major operations that last 8-10 hours, sometimes gradual regenerations (surgery that will take a few sessions) can be possible.
In hand injury surgeries, all structures are regenerated in accordance with the anatomy as much as possible. However, sacrificing some structures may be healthier. This will be decided by the surgical team. The regenerations after hand injury are generally performed under a microscope and these are called as microsurgery.
After Hand Injuries
Due to the complex and mechanical anatomy of the hands and since they are multifunctional organs, regeneration surgeries that are performed after major injuries will only be the beginning of treatment.
It is very important that patients follow the recommendations of their physician after the surgery. A long period of physical therapy may be required after surgery.