HAND SURGERY; It is a science related to the diagnosis and treatment of hand, wrist, forearm, elbow disease and injuries, shoulder injury and diseases, hand, arm and nerve incisions, congenital anomalies of upper extremity, brachial plexus injuries. For this reason, it is also called “Hand and Upper Extremity Surgery” in many countries.
HAND SURGERY; Orthopedic, microsurgery, reconstructive surgery trained surgeon who treats injuries (fracture, dislocation, rupture) and diseases on hand and upper extremity. In the treatment of hand diseases and injuries, the operator can manipulate the tissues 10-15 times under the microscope to the bones (plaque, screws and nails), muscle, tendon (joints) and joint ligaments, veins and nerves under the same surgery session.
MICROCERRAHISE is a special technique that is made with very small special surgical instruments by enlarging the tissues with a microscope. Although this technique can be used in almost all surgical branches, it is imperative that this technique is learned for the hand surgeon. Because the most widely used surgical branch of microsurgery is the hand surgeon.
Microsurgery was first practiced by Nylen in 1921 in the world. In 1962, Malt replante a child’s broken limb with this technique. The first finger replantation in our country was realized in 1978. Today, microsurgery is performed more frequently with increasing knowledge and skill and more successful results are obtained.
Microsurgery in hand and upper extremity can be applied in many discomforts. If we count some of them; Congenital hand anomalies, fractures and dislocations, hand dislocation of the toe instead of the missing finger, congenital hand anomalies, congenital hand anomalies, congenital hand anomalies, Anomalies and hand and upper limb disorders that we can not count here.
Microsurgery operations can last longer than 2-3 hours. The success of these surgeries depends not only on the well-being of the surgery. In addition to the ability of the surgeon in success, patient compliance (the patient’s working with physician and physiotherapist taking into account the pre- and post-operative warnings) and post-operative rehabilitation are very important. Because of these reasons, these surgeries need to be done by specialized surgeons at specialist centers.
Microvascular Vessel Anastomosis: Vascular anastomosis should be done very carefully and meticulously. In our body, there are two vascular structures, artery (artery carrying clean blood) and ven (blood carrying polluted blood). Venous anastomosis is technically more difficult because the venous walls are thinner, with no change in vascular anastomotic principles. On the other hand, minor errors made during anastomosis may not cause significant problems later on venous anastomoses. Arterial anastomoses should be done more carefully and atraumatic. Although technically easier, if arterial anastomosis is not good, there may be complications such as thrombosis, spasm and anastomosis after surgery.
Peripheral nerve repair: Peripheral nerve repair requires knowledge of good anatomy. However, since surgery is time-consuming, it requires the surgeon to concentrate well and make intensive efforts. Here, after the nerve endings are separated into fascicule groups by microsurgery technique, they are sewn by being reciprocated. Nerve repair after these procedures should be supported by a special rehabilitation. Rehabilitation is not done well and when the patient exhibits incompatible behaviors, this treatment is adversely affected and the healing rate is reduced. The most important problem in this regard is that functional results can be taken in the late period (after 6 months) as opposed to microvascular surgery. For this, the physician should inform the patient well before the operation and explain that patient must be treated in order to get the result.