Hand injuries can be divided according to whether they are congenital, tumor or acquired. In addition, acquired hand injuries can be distributed into traumatic or degenerative.
In Spain, hand injuries account for 32-36% of all occupational accidents, so the economic and social impact is very important.
Acquired traumatic injuries
Traumatic acquired injuries can be skin loss injuries, tendon injuries, nerve injuries, bone injuries or a mixture of all of them.
The frequency of these types of problems is frequent as they usually occur due to domestic accidents or, in the case of tendon injuries, from cutting ham, performing “easy openers”, DIY, gardening actions, and so on.
In the case of hand burns, they may require a very specific treatment due to the sequelae that may remain.
Acquired degenerative lesions
Acquired degenerative lesions are those lesions that appear with age and/or associated with other processes. In this way they can be developed by:
- Dupytren’s disease: it is the retraction of the fingers by retraction of the superficial palmar aponeurosis.
- Carpal Tunnel Syndrome: it is the compression of the median nerve within the structures that pass through the carpal canal.
- Stenosing Synovitis (De Quervain’s Disease): it is an inflammation of the extensor tunnel of the thumb.
- Fingers in spring: it is the inflammation of the synovial of the flexors when passing through the A1 pulley. In these cases one of the fingers remains paralyzed in a bent position, when it stops the finger will jump out, as if it were a trigger.
- Rhizoarthrosis: is the wear and tear of the trapeziometacarpal joint, related to osteoarthritis.
- Rare diseases: they affect the hand in a very significant way, it can be due to scleroderma, epidermolysis bullosa, psoriasis, neurological diseases, spastic hand, among others.
How is the surgical treatment?
Hand surgery has specific surgical principles, which together with microsurgical techniques, tendon surgery, bone and skin flaps in all its modalities, allow reconstructive possibilities in which the imagination of the surgeon only has as limits those imposed by anatomy and physiology.
We could say that the fundamental principle is that hand surgery is a dynamic surgery, i.e. it is not only a matter of placing the finger, but it has to move.
In Spain this type of operation does not exist as a specialty, it can be said that it is a “special dedication” to this organ, within the specialties of Plastic Surgery and Traumatology.