What is Hand Surgery?

Hand surgery is a branch of surgery that deals with the diseases and treatment of the upper extremity, which starts from the shoulder and extends to the fingertip. Our hands are of great importance to meet our basic needs and to be able to produce. It is an organ in which many complex tissues work together and in great harmony. Due to this multifunctional structure of our hands, diseases and injuries should be evaluated in accordance with this special structure. Inappropriate treatment of many hand problems that are considered simple can have serious consequences that affect the quality of life of the person. Many temporary or permanent problems, especially injuries that impair hand functions, affect our lives significantly. Bone, muscle, tendon (muscle tendons), vessels, nerves, Different structures, such as bond structures, work in great harmony in the same environment. Hand surgery is concerned with situations where this harmony is disrupted due to various diseases, traumas (injuries), congenital problems. Hand surgery; negatively affecting the hand and accordingly the wrist, forearm, elbow, arm and shoulder functions; It is a specialty that treats problems such as cutting or crushing injuries, congenital disorders, overuse, infection, arthritis (calcification). Due to their anatomical similarities, similar injuries to the legs are included in the field of expertise of hand surgery. negatively affecting the hand and accordingly the wrist, forearm, elbow, arm and shoulder functions; It is a specialty that treats problems such as cutting or crushing injuries, congenital disorders, overuse, infection, arthritis (calcification). Due to their anatomical similarities, similar injuries to the legs are included in the field of expertise of hand surgery. negatively affecting the hand and accordingly the wrist, forearm, elbow, arm and shoulder functions; It is a specialty that treats problems such as cutting or crushing injuries, congenital disorders, overuse, infection, arthritis (calcification). Due to their anatomical similarities, similar injuries to the legs are included in the field of expertise of hand surgery.

 

What is Microsurgery?

Microsurgery is a surgical technique applied by magnifying the operating field using an operating microscope or special glasses. In this way, it is possible to surgically treat problems in structures such as nerves and vessels, which are normally difficult to see with the naked eye. It can also be used in microsurgical vascular and nerve repairs, and in vascular tissue transplants from one part of the body to another. Repair of injured limbs as a result of work accidents, traffic accidents, glass cuts, falls or similar accidents, which increase rapidly in our daily lives, and suturing broken parts are possible with microsurgical methods.

Shape: Surgical microscope / magnifying lens / surgical magnifying glasses

What Diseases Does Hand Surgery and Microsurgery Deal With?

It would be more accurate to examine the basic treatment scheme of this specialty under 2 main headings according to the urgency.

Emergency Injuries

• Fractures and dislocations in arms, elbows, forearms, wrists, hands and fingers, including the shoulder
• Open injuries that cause damage to tendons (muscle tendons), vessels and nerves
• Microsurgical interventions (arm, forearm, limb amputations such as hands, fingers and feet) (Amputations)
• Skin cuts, nail disorders
• Infections

 

non-emergency diseases

• Bone transfer with vessels in femoral head avascular necrosis
• Congenital anomalies (congenital limb deficiencies and disorders)
• Congenital injuries (congenital and traumatic brachial plexus injuries, cerebral palsy)
• Infections
• rheumatic diseases
• Recognition, surgical and non-surgical treatment, rehabilitation and post-operative care of tumors (soft tissue and bone reconstructions)
• Correction of poorly or incorrectly fused fractures and dislocations
• Sequelae of hand and wrist after previous injuries
• Deformities and burns
• Paralysis due to nerve cut as a result of an accident or loss of function due to circulatory disorder
• Tissue/organ transfers (Transplantation) in finger and hand losses
• Calcifications involving the thumb and other fingers
• Nerve entrapments such as Carpal Tunnel, Cubital Tunnel Syndrome
• trigger finger
• Dupuytren's contracture
• De Quervain tendinitis,
• Tendon problems such as tennis elbow
• Ganglion cyst
• Scaphoid bone fractures
• Kienbock's disease
• Restoring loss of function due to paralysis due to various reasons through tendon/muscle transplants
• Finger adhesion (syndactyly)
• Finger excess (polydactyly)
• Burn-related hand and foot disorders

How to Give First Aid in Severed Limbs?

Accidents caused by workplace, home, traffic accidents and agricultural vehicles, use of weapons during discussion or terrorism, amputation (limb ruptures) may occur during earthquakes or natural disasters. While the number of workplace accidents decreases with increasing workplace safety and accident precautions, robot machines, employing more trained workers and technicians, the number of traffic accidents decreases over time with measures such as safer vehicles, traffic control, advanced technology in road construction. In addition, the severity and damage of accidents increase due to the increasing number of vehicles and faster transportation in traffic, the increase in workload due to cheaper and more mass production in the workplaces, the fatigue caused by the increasing daily stresses, insomnia and distraction.
Transporting the victims to the treatment centers more systematically and earlier, raising awareness in first aid, advances in the technology of production of medical supplies and innovations in surgical methods make the treatment of such problems even more successful.

 

What are the first things that should be applied to the patient at the accident site?

• Apply first aid after the casualty is safely removed from the accident area, bench or machine and placed in a calm and safe place. Especially in injuries such as crushing and squeezing, the hand and arm should be freed from the factor so that the healthy tissues are not damaged. If individual intervention is not possible, fire brigade, 112 etc. institutions should be expected. If there is contact with foreign objects, clean water should be kept to clean them.
• Inform the nearest health unit to the accident site and call the necessary ambulance and medical personnel for transportation. Do not leave the casualty unattended.
• Note down the amount of blood loss.
• If possible, vascular access, tetanus precautions and antibiotics should be applied during the first transport of the patient.
  

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• The amputee stump wound (in the patient) should be washed with plenty of sterile serum if possible. However, if it increases bleeding, this procedure can be abandoned.
• The tourniquet method, which is applied by wrapping rubber or cloth on the upper side of the wound, is one of the most common mistakes. This process increases bleeding as it will stop the blood flow in the veins without stopping the blood flow in the arteries. In addition, the tourniquet usually carries the risk of being forgotten by leaving it attached.
• The wound should be tightly wrapped with plenty of sterile gauze and bandage, and the arm and leg should be kept elevated. Manual pressure on major vessels from above the wound can also reduce bleeding. If bleeding still cannot be controlled, an upper-mounted sphygmomanometer can be used as a tourniquet, but its duration should not exceed 1.5 hours. In addition, blood circulation of healthy tissues should be provided by loosening every 15 minutes.
• The patient should be prohibited from eating and drinking. Smoking should not be allowed in any way and should not be smoked in the presence of the casualty.
• In case of hand injuries, a doctor should be consulted immediately. Early surgeries are more successful, especially in arterial injuries that cause circulatory disorders. This period is roughly 12-18 hours for finger ruptures and 6 hours for ruptures above the wrist.
• One of the most important issues during transportation is the delivery of the piece to the specialist, regardless of its size and condition. It should be kept in mind that even parts that cannot be repaired can be used for tissue closure.

 

How should the amputated limbs be preserved and transplanted?

• After the amputated (ruptured) part is removed under clean conditions and washed with sterile serum, wrap it with sterile gauze impregnated with serum and place it in a dry, waterproof bag. The biggest mistakes during the transportation of the injured organ are the direct contact of the ice to the tissue and the transfer of the tissue by placing it in water.

Pictures showing how the broken piece should be stored

1. The ruptured part is wrapped with sterile serum-impregnated cloth. 2. Waterproof and put in a nylon bag.

 

3. It is carried in a container filled with ice water. 4. It can also be carried with a bag filled with ice water.

 

What are the procedures to be applied in the first aid center?

1. The control and deficiencies of the above-mentioned issues are completed.
2. To combat shock, serum and antibiotics are administered to the patient and a catheter is inserted.
3. The amputated stump (open wound in the patient) is washed with plenty of serum and re-wrapped.
4. Procedures such as capturing, ligating and cauterizing the vessels should never be applied to stop the bleeding.
5. Provided that the patient's blood pressure is monitored, painkillers can be applied, but the correct thing is not to give painkillers until they reach the center to be treated. It will not be possible to evaluate whether the patient's absent-mindedness is due to an accident or the drug given, which may put the anesthesiologist in a difficult situation. No local anesthetic should be applied to the wound area. This procedure may cause the nerve injury examination to be performed incorrectly.
6. In partial amputations (injuries that are not fully detached from the arm/leg), the limb should be straightened and fixed with a splint, even this procedure alone can improve the circulation of the limb by relaxing the vessels under pressure. If the circulation still has not improved and the limb has not warmed up, cooling should be applied with the same methods, but if there is circulation, cooling should not be performed.
7. After the broken piece is washed with serum, it is wrapped with sterile gauze or a compress impregnated with the serum, and then placed in a dry waterproof bag and placed in ice water (it keeps the water stable at 4 degrees). The ice that melts on the road is replenished with new ones. However, it should be prevented that the broken piece is frozen by direct contact with the ice. Dry ice should never be used.
8. Contact the nearest center ready for replantation. Communication with a center will not only prevent the casualty from wasting time by visiting many centers, but also provide an opportunity for the preparation of the hospital and microsurgeons.

 

How to intervene in emergency hand injuries?

In hand injuries, the degree of injury is determined by performing a full physical examination of the hand first. Simple interventions can be applied in emergency services. However, veins, nerves, tendon cuts, and limb ruptures should be treated by microsurgery under the microscope in the operating room environment.
Crush injuries constitute the group that is more difficult to treat among hand injuries. Here at the micro level the damage is more than meets the eye. In general, the affected structure is repaired and treatment is provided, but especially in cases where the repair cannot be provided, such as crush injuries, vessel, nerve, tendon transplantation may be required. Microsurgical hand surgeries are operations that take a long time, require attention, and require experience.

 

What is the recovery like after painful hand injuries?

Surgery may not be sufficient for full recovery after hand injuries. Physical therapy is necessary in complex injuries due to the dynamic nature of the hand. Even if there is improvement in the structures on the hand surgically, functional recovery may take months. Depending on the complexity of the injury, the recovery period may be longer.

 

What is the place of physical therapy in hand injuries?

It is an organ in which many complex tissues work together and in great harmony. Due to this multifunctional structure of our hands, diseases and injuries should be evaluated in accordance with this special structure. Even in the case of complete and successful repair of the injured limb, many patients require physical therapy due to its complex structure. Compliance and continuation of physical therapy is very important at this point. In order for the patients to use their limbs almost completely after hand injuries, it would be appropriate to follow up with an experienced hand physiotherapist in the rehabilitation of these injuries.

 

What are the ways to avoid hand injuries?

As a result of work accidents and occupational diseases in European countries, 5,500 people die annually, 75,000 people become permanently incapacitated, 149 million working days and 20 billion Euros are lost. In our country, an average of 172 work accidents occur daily, and 4 of these injuries result in death and 6 result in permanent disability. Hand injuries mostly occur with simple carelessness and after work accidents, mostly for preventable reasons. Especially being careful while working with sharp, piercing and pressing tools and taking the necessary precautions for work accidents in the workplaces will reduce these injuries. Occupational safety experts have a great role in this regard. Identification of existing or external hazards in the workplace, It is essential to analyze and rank the factors that cause these hazards to turn into risks and the risks arising from the hazards and to compare the control measures, to provide employee training and to repeat these trainings regularly to prevent these accidents from occurring. Especially in high-risk workplaces, it is essential to have employees who are trained to perform emergency interventions. By taking these precautions, hand injuries that cause serious functional, psychological and workforce losses will be reduced. Especially in high-risk workplaces, it is essential to have employees who are trained to perform emergency interventions. By taking these measures, hand injuries that cause serious functional, psychological and workforce losses will be reduced. Especially in high-risk workplaces, it is essential to have employees who are trained to perform emergency interventions. By taking these measures, hand injuries that cause serious functional, psychological and workforce losses will be reduced.

 

Commonly Encountered Diseases in Hand Surgery

 

Carpal Tunnel Syndrome

The carpal tunnel is the name of a narrow tunnel-shaped cavity through which the nerve (median nerve) that provides sensation and movement in our fingers and tendons that move our fingers pass at the wrist level. Carpal tunnel syndrome is an orthopedic disorder that causes complaints such as numbness, numbness, weakness and pain in the hand as a result of compression or pressure on the median nerve in this tunnel. With its progression, muscle wasting and weakening are observed. This disease, which is more common in women between the ages of 40 and 60, can be seen in both wrists. Carpal tunnel syndrome, which is the most common nerve entrapment disease, is frequently seen in housewives who have a lot of manual work, those who use computers, and people who work in professions that use their hands a lot. However, diabetes, rheumatoid arthritis, obesity,

 

What Are the Symptoms of Carpal Tunnel Syndrome?

It starts with numbness, pain, weakness and weakness in the wrist and fingers, and as the disease progresses, it causes pain that spreads to the arm and shoulder, and aches and numbness that wakes you up at night. Over time, weakness, melting and loss of strength in the hand occur in the hand muscles. The patient cannot even lift very light objects; can drop it.

 

How is Carpal Tunnel Syndrome Diagnosed?

The diagnosis of carpal tunnel syndrome is made with the help of clinical examination and nerve studies called EMG (electromyography). Wrist MRI can be taken if necessary.

 

How Is Carpal Tunnel Syndrome Treated?

If the disease is not advanced, non-surgical treatments are applied first;

• Medication (vitamin B to accelerate nerve repair, pain relievers for pain control).
• rest wristbands

• Physiotheraphy

• Surgical treatment

 

Surgical treatment should be applied in moderate-to-advanced patients or in cases that do not respond to other treatments. In surgical treatment, a 2-3 cm incision is made from the wrist and nerve compression is relieved. It is a surgical operation that can usually be performed with local anesthesia. The patient does not need to stay in the hospital and can go home the same day. He can use his hand in 2-3 days. Although the pressure and pain disappear immediately after surgery in advanced and delayed patients, it should be kept in mind that the complete disappearance of the patient's complaints may take 3 to 6 months. This time is the recovery time of the damaged nerve under pressure.

 

Trigger Finger Syndrome

Trigger finger disease is a condition that concerns the tendons (tendons) that allow our fingers to move. Tendons are string-shaped tissues that allow muscles to attach to bones and transmit their strength. After these structures reach the fingers, they are surrounded by ring-shaped tissues called pulleys that prevent the tendon from sliding left and right. The tendon moves inside the tunnel within these rings. The rings in this pulley system become excessively thick in some conditions, tightening the muscle tendon. The tendon becomes trapped in the constricted pulley and gets caught during the finger bending motion. The tendon, which is compressed by force, is released from the narrowed canal and the finger is opened. Patients often describe this as snagging or locking. Using the finger after this problem has started usually leads to further swelling of the structures here. And it causes the table to become heavy. Sometimes complete snagging and finger locks can also occur. The most important cause of trigger finger disease is overuse of the fingers. Using a computer or phone frequently can cause trigger finger disease. Finger pain and throbbing are the first symptoms of the disease. If the disease is ignored, loss of movement in the hands and fingers, and even if it is tried to be opened by force, conditions that can progress to rupture of the muscle beams occur.

 

Treatment

The aim is to eliminate pain, snagging and locking, and to restore normal hand functions. Anti-edema drug therapy to relieve swelling, finger splints for rest are used. It is suitable for sudden and new-onset cases.

Within 3 weeks to 3 months, complaints such as pain and morning stiffness are mentioned, and the locking of the finger may start much later. If the complaints do not regress, local cortisone injection is made into the thickened area of the tendon in the second stage. The relief brought by this treatment differs from patient to patient and lasts from a few weeks to a few months. However, cortisone applications are not recommended due to the long-term damage to tendon structures. With this application, temporary relief can be provided. However, permanent treatment cannot be provided with local injections.

 

In patients who have complaints for more than 3 months and cannot respond to medical treatment (diabetes, rheumatic disease or dialysis patients), the pulley system that causes compression should be surgically loosened. The aim of the treatment is to prevent the finger from getting stuck and to eliminate the feeling of discomfort during its movement.

The operation is performed with a small incision in the palm under local anesthesia. It is important to carefully protect the vascular nerve structures around the tendon sheath during the surgery. The tunnel where the tendon is attached is expanded with a one or two cm incision in the area of the disease. After this surgical intervention, patients can easily move their fingers. Cold application and keeping the hand above heart level are recommended in the early postoperative period. Although the process varies depending on the surgery performed and the severity of your disease, a return to normal daily life is expected within 2-3 weeks. In some patients, hardness may occur in the wound area due to excessive healing tissue. This usually regresses over time with home massages.

 

Cystic Hygroma ( Ganglion Cyst)

Ganglion cysts are the most common mass formations around the hand and wrist. Since these cysts are not malignant (malignant and cancerous), they do not spread to other tissues and organs. There is no definite information about why the wrist ganglia are formed, and it is known that it is caused by the strain of the joints or tendons that are overloaded on the wrists. Ganglion cysts occur mostly on the back of the wrist joint. Apart from this, while it is seen in the areas where the fingers articulate or at the bottom of the fingers, they can sometimes be seen on the feet.

 

Ganglion cysts are surrounded by a sheath and change in size over time with the amount of fluid that fills them, they can grow and shrink or disappear completely. Even if it disappears completely, it can occur again as a result of repetitive strains of the joint. While it is more common in women than men, it usually occurs after the age of 30-40. It is more common in women who use keyboards, secretaries, software developers, bankers, musicians, hobbies of lace, embroidery or cleaning the house more. These cystic structures, which vary in size, sometimes cause pain and restrict joint movements. Cysts are often followed without surgery. However, in painful and large cysts, the gel-like liquid can be drained with the help of an injector. Although this method provides relief in the wrist, the risk of recurrence is high in the future. If there is no response despite all the treatments applied, if the cyst causes pain and interferes with daily work, or if it looks bad aesthetically, it should be treated surgically. The cyst is removed with its sheath under local anesthesia. The patient does not need to stay in the hospital. It is expected to return to normal daily life within 2-3 weeks after the surgical removal of the cyst.

 

De Quervain's Tenosynovitis

Tendons (muscle tendons) that enable us to perform movements that lift the thumb up and away from the other fingers pass under a tunnel in the wrist near the base of the thumb. Thickening and stiffness in this tunnel or swelling in the sheaths surrounding the muscle beams make it difficult for the tendons to slide under the tunnel during thumb movements. This picture, which presents with pain and tenderness in the wrist, is described as De Quervain's disease.

It is mostly seen after compulsive and repetitive movements that have just started. The position of the hand when carrying their babies, especially in new mothers; The effects of hormonal fluctuations during pregnancy and breastfeeding facilitate the emergence of this condition. De Quervain's tenosynovitis may also be encountered after previous wrist fractures and weight exercises with unfamiliar weights.

Pain on the thumb side of the wrist is the most typical symptom. The pain often radiates down to the thumb and up to the forearm. Pain increases with strong grasping and wrist rotation movements where the thumb is also used. Swelling may also occur in the painful area of the wrist. Trying to lift something off the floor, trying to open a jar, or trying to open a doorknob causes a significant increase in pain. Pain in the wrist when we bend the wrist in the direction of the little finger, with the thumb in a fist, is typical for diagnosis.

In the initial period, it is very important to rest the hand by using resting splints (stabilizing bandages) that disable the painful movements of the thumb. Again in this period, the swelling of the tunnel and muscle tendon sheaths is tried to be reduced by being supported with painkillers and cold applications.

 

If the symptoms do not go away or get worse, the tunnel that compresses the muscle tendons should be opened surgically. This surgery can be performed by applying local anesthesia to the entire arm or just the wrist. It is not allowed to use the hand in heavy work for 3 weeks after the operation. After 3 weeks, most patients can return to their normal daily life.

 

Cubital Tunnel Syndrome

The ulnar nerve, which is one of the nerves coming from the armpit, receives the sensation of our ring finger and little finger and contributes to the movements in the hand. As this nerve travels towards the forearm, it travels through a channel in the elbow joint. When this nerve is compressed in the canal for various reasons, numbness, pain, weakness and loss of sensation in the little and ring fingers are the symptoms of cubital tunnel syndrome. Numbness in the fingers creates a feeling of electric shock in the hand, even after minor impacts on the nerve at the elbow level. In later periods, it is seen that it is difficult to bring the fingers closer together, and the ring finger and little finger bend backwards while trying to keep the hand straight.

It is more common in women who use keyboards, secretaries, software developers, bankers, musicians, hobbies of lace, embroidery or cleaning the house more. In the diagnosis of this disease and in determining the degree of damage to the nerve, the most important test that helps the examination is the EMG method.

In early cases, the patient should be taught to follow up with the least stress on the nerve by describing the positions where the nerve is stretched and these symptoms are revealed. The use of edema-relieving and pain-relieving drugs is very effective in the treatment of patients presenting in the early period. In some cases, stabilizing rest elbows that keep the elbow straighter can help alleviate complaints.

Despite all these treatments, surgical treatment is applied to patients whose complaints do not improve or who have advanced nerve compression and have long-term complaints. The surgery can be performed with local anesthesia or general anesthesia according to the patient's request. The aim of the surgery is to relieve the pinched nerve and to prevent it from being crushed repeatedly by removing the pressure on it. After the surgery, the patient should stay away from movements that will compress the elbow nerve and change the sitting position based on the elbow.

 

Dupuytren's Disease

Dupuytren's disease; It is a disease caused by the thickening of the layer called 'fascia' under the skin, often in the palm of the hand. Due to the thickening of the fascia as a result of the disease, wrinkling of the skin and adhesions occur in the muscle tendons that move our fingers. This disease is progressive and causes significant limitation in hand functions.

 

What are the causes?

Although the cause is not known exactly, it is thought to occur as a result of changes in the fascia. Often; It occurs on both hands, in men over the age of 40, and in people of northern European descent. The incidence of the disease is increasing in diabetics and alcoholics. Repetitive traumas of the hand can trigger the onset of this disease.

 

What are the patient complaints?

The onset is insidious, starting with painless swellings in the palm of the hand, especially at the level of the ring finger and little fingers. Gradually, the swelling increases and thickens in the form of a band. As the swelling and hardening of the skin increase, the flexibility of the fingers is affected. When the patient puts the palm on the flat surface, the palm of the hand does not touch the ground and takes the shape of a dome. As the disease progresses, it can also affect muscle tendons, adjacent vessels and nerves. It becomes increasingly difficult for the patient to open his finger. Therefore, washing his hands, wearing gloves, clapping and grasping objects are impaired. Many patients complain that they cannot put their hands in their pockets.

What are the treatment options?

Surgery is unnecessary for stiffness that does not cause finger tension and limitation of movement. Cortisone injections can be given to eligible patients to reduce progression. Exercises to straighten the fingers, and the use of rest splints that help keep the fingers straight at night slow the progression of the disease. However, due to the progressive nature of this disease, it should be strictly controlled by a doctor and appropriate surgical intervention should be performed as soon as the finger can not open.

Which surgical method is the most successful?

Many surgical methods have been defined and the method to be applied may vary according to the surgeon and the patient. As the surgical intervention is delayed, the chance of obtaining a moving finger decreases after the surgical intervention. Fascia tissue formed in the palm of the patient during surgical intervention; Veins, nerves and muscle beams are removed by preserving Damages that may occur on the skin, especially in people with advanced disease, are covered with skin patches taken from other parts of the patient. Rehabilitation of immobilized hands after surgery is carried out with physical therapy applications.

 

Buttonhole Deformity

Fingers have a wide variety of tendon structures during full opening and closing. When the muscle tendon that allows the finger to work straight on the finger is injured, it will not be possible to open the finger fully lengthwise. Injuries near the middle joint on the finger cause the disease to occur. The disease, which can sometimes be seen due to rheumatic diseases, is easily diagnosed. In cases where physical therapy applications after trauma are insufficient, surgical treatment is in question. It is a disease that causes joint and tendon injuries in the fingers, in which the fingers cannot be fully opened. Angle occurs in the finger joint after injury and if not treated early, it can lead to permanent deformity.

 

reasons

It usually occurs as a result of a blow to a bent finger or rheumatic diseases. It occurs as a result of avulsion fractures of the central slip on the upper surface of the finger or the bones to which it is attached.

 

Clinical Findings and Complaints

A buttonhole deformity called Boutonnière usually develops between 7 and 21 days after trauma. There is pain with movement. There is swelling above the finger joint. Joint movements are restricted.

 

Diagnosis and Treatment

Finger movements are checked during the examination. Finger movements are limited and painful. X-rays are taken and accompanying bone fractures are evaluated. It should be intervened early. Permanent deformity may develop.

 

Non-Surgical Treatment

The finger is fixed for three weeks with a finger splint. For older people, this can be extended to 6 weeks. It is important to use the finger splint at night.

Post splint stretching exercises are recommended. Wearing the splint while doing sports is necessary for protection. Medication is recommended for pain relief.

Surgical treatment

The non-surgical method is the primary choice. But in some cases, surgery is planned;

• In deformities due to rheumatoid arthritis
• If the tendon is ruptured
• In fractures involving a large piece of bone
• If cannot be fixed with a splint

Surgery reduces pain and improves function, but it may not always be possible to restore the finger to its normal appearance and function. If the Boutonniere deformity cannot be corrected in the first 3 weeks, it becomes very difficult to correct it later.

 

Swan Neck Deformity

With the swan neck deformity, the base of the finger and the outermost joint are bent, while the middle joint remains straight. This imbalance in the finger joint causes the finger to curve over time and take on the appearance of a swan neck. The swan neck deformity makes it nearly impossible to bend the finger normally and makes activities such as buttoning a shirt, grasping a glass, and holding a finger difficult. After the correct diagnosis, he can determine the appropriate treatment option, which includes the following.

• Finger plaster or ring plaster
• Surgery to realign the joints or glue the joints so that they can function better

 

Hand Tumors

Sometimes, tumors of unknown cause occur on our hands. Although malignant tumors are rarely seen, benign tumors are frequently observed. Tumors that occur on the hand or on the fingers cause swelling that can be seen from the outside. Sometimes hand tumors due to trauma or foreign body interactions can also be seen. The resulting tumors are surgically removed after the physical examination. When deemed necessary, the condition of the tumor is determined by pathological examinations.