Hand surgery at Leicester Hospital

What is hand surgery?

Hand surgery is surgery carried out on the hand or wrist, including the nerves running through the upper limb. It's used where an injury, an infection, or a long-standing condition needs correcting, and can also involve reconstructive work to restore function lost after nerve damage.

What conditions does hand surgery treat?

Hand surgery is commonly used to treat:

• carpal tunnel syndrome and cubital tunnel syndrome
• trigger finger and De Quervain's syndrome
• Dupuytren's contracture
• rheumatoid and osteoarthritis affecting the hand
• tendon and nerve injuries
• hand fractures and joint injuries
• ganglion cysts
• congenital differences in the hands of babies and children.

Many hand problems respond well to non-surgical care first, things like splinting, taping, injections or physiotherapy sessions.

What are the benefits of hand surgery?

Hand surgery can relieve pain and restore movement, helping with everyday tasks such as dressing, feeding yourself, and working, all things that become difficult when a hand injury or condition is left untreated.

Where a nerve block is a suitable option instead of a general anaesthetic, this can mean a quicker recovery with fewer side effects, and in some cases a shorter wait for surgery, since fewer pre-operative steps are needed beforehand.

Are there different approaches to hand surgery?

A few different methods of anaesthesia can be used, chosen to suit the procedure:

• a regional nerve block, injected near the armpit or shoulder, numbing the whole arm while you stay awake or lightly sedated
• a local anaesthetic, injected directly into the area being worked on, used for some smaller procedures
• a general anaesthetic, less commonly needed but sometimes used, for example for children or for longer operations.

Depending on the condition, the surgeon leading your care might specialise in general surgery, orthopaedics or plastic surgery, and the work itself might focus on bone, soft tissue, or both.

What happens before hand surgery?

Your surgeon will talk you through what's involved and any risks attached, and your general health will be checked over, particularly if you'll be having a general anaesthetic.

• Plan how you'll manage at home afterwards, since you may need to do things one-handed for a while.
• Think about what you'll wear and how you'll get to and from hospital, and arrange help if you'll need it.
• Ask your surgeon to explain anything you're unsure about beforehand.

What happens during hand surgery?

Hand surgery is usually carried out as a day case, meaning you go home the same day. Delicate instruments are needed to work on the fine structures inside your hand, and where a small nerve or blood vessel needs repairing, your surgeon might turn to magnifying eyewear or a specialised operating microscope to help.

The finer detail of what takes place varies with the specific condition being treated, and whether bone or soft tissue is involved.

What does recovery look like?

Aftercare often includes physiotherapy or sessions with a hand therapist, who can help strengthen your hand and monitor its movement and function as you heal. A splint may be used to support the area, and you'll usually have follow-up appointments to check your progress, including removal of any stitches if needed.

Feeling fully back to normal can take a month or more, though the exact timeframe varies considerably depending on the surgery you've had.