Hand surgery
This article needs more primary sources. (January 2022) |
Occupation | |
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Names |
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Occupation type | Specialty |
Activity sectors | Medicine, Surgery |
Description | |
Education required |
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Fields of employment | Hospitals, Clinics |
Hand surgery deals with both surgical and non-surgical treatment of conditions and problems that may take place in the hand or
History
The historical context for the three qualifying fields is that both plastic surgery and orthopedic surgery are more recent branches off the general surgery main trunk. Modern hand surgery began in World War II as a military planning decision. US Army Surgeon General, Major General Norman T. Kirk, knew that hand injuries in World War I had poor outcomes in part because there was no formal system to deal with them.[6] Kirk also knew that his civilian general surgical colleague Dr. Sterling Bunnell had a special interest and experience in hand reconstruction. Kirk tapped Bunnell to train military surgeons in the management of hand injuries to treat the war casualties, and at that time hand surgery became a formal specialty.
Orthopedic surgeons continued to develop special techniques to manage small bones, as found in the wrist and hand.
In a few countries such as Sweden, Finland and Singapore, hand surgery is recognized as a clinical specialty in its own right,[9] with a formal four to six years hand surgery resident training program. Hand surgeons going through these programs are trained in all aspects of hand surgery, combining and mastering all the skills traditionally associated with "Orthopedic hand surgeons" and "Plastic hand surgeons" to become equally adept at handling tendon, ligament and bone injuries as well as microsurgical reconstruction such as reattachment of severed parts or free tissue transfers and transplants.
Scope of field
Hand surgeons perform a wide variety of operations such as fracture repairs, releases, transfer and repairs of tendons and reconstruction of injuries, rheumatoid deformities and congenital defects.[10] They also perform microsurgical reattachment of amputated digits and limbs, microsurgical reconstruction of soft tissues and bone, nerve reconstruction, and surgery to improve function in paralysed upper limbs. There are two medical societies that exist in the United States to provide continuing medical education to hand surgeons: the American Society for Surgery of the Hand and the American Association for Hand Surgery. In Britain, the medical society for hand surgeons is the: British Society for Surgery of the Hand (BSSH). In Europe, several societies are brought together by the Federation of European Societies for Surgery of the Hand (FESSH).[11]
Indications
The following conditions can be indications for hand surgery:
- Hand and Wrist injuries
- Tendon conditions e.g. trigger finger
- Nerve Compression Disorders e.g. Cubital tunnel syndrome
- Carpometacarpal bossing
- Rheumatoid arthritis
- Dupuytren's contracture
- Congenital defects
Complications
Some complications of hand surgery include:
- Infection - sometimes termed surgical site infection, infection is the most common and costly complication of surgery. This is equally true within the hand whereby the overall risk is ~5%.[12]
- Bleeding is uncommon and the available evidence indicates that the risk of bleeding is not related to the use of oral antiplatelet or anticoagulants.[13]
- Stiffness
- Contractures
- Complex Regional Pain Syndrome
See also
- Tetraplegic upper limb surgery
References
- ^ a b "About Hand Surgery". American Society for Surgery of the Hand. 2014. Archived from the original on 2014-04-13., American Society for Surgery of the Hand. Retrieved on 2011-02-24.
- ^ "Why Visit a Hand Surgeon". American Society for Surgery of the Hand. Retrieved 2011-02-24.
- ^ "Certificate of Added Qualifications in Surgery of the Hand". The American Board of Orthopaedic Surger. Archived from the original on 2011-07-21. Retrieved 2008-11-20.
- ^ "Specialties & Subspecialties". AOA. Archived from the original on 13 August 2015. Retrieved 25 September 2012.
- ^ "SOTH, formerly CAQSH". American Society for Surgery of the Hand. 2011. Archived from the original on 20 March 2012. Retrieved 25 September 2012.
- ISBN 0-443-07761-4
- ^ International Federation of Societies for Surgery of Hand (2001). Terminology for hand surgery (PDF). Harcourt Health Sciences.
- PMID 22032599.
- ^ "List of Recognised Specialties". www.healthprofessionals.gov.sg. Retrieved 2019-02-04.
- ^ "Reconstructive Hand Surgery". The Iowa Clinic. Retrieved 20 Sep 2020.
- S2CID 199572258.
- PMID 37606593.
- S2CID 219329754.