SEVERE HAND, FINGER, AND ARM TRAUMA
“SAFETY FIRST”: this very simple phrase is a constant reminder that many tasks in our modern world—both at work and at home—require our hands to manipulate fast, powerful, automated tools that can cut, tear, and even sever human tissue before we realize what is happening. Lawn mowers, snowblowers, power saws, chain saws, fast-moving, automated factory machines, and even motor vehicles: these common, everyday tools make our lives easier, but at the risk of exposing our hands and fingers to traumatic injury, sometimes so severe that they require precision, complicated surgical procedures to repair the damage, regain functionality, and restore our lifestyle and livelihood.
Unfortunately, severe injuries rarely impact only one part of the hand. More commonly, traumatic injuries involve damage to multiple, complex, and interrelated internal and external structures. Surgical hand reconstruction requires extensive knowledge of and experience with the complicated structures of the hand and upper extremity. Dr. Asad Yalif at Y Plastic and Reconstructive Surgery in Atlanta, Georgia couples extensive training in three different surgical specialties with years of experience repairing traumatic injury and performing successful hand reconstructions. He is Triple Board Certified in Hand Surgery, Plastic Surgery, and Orthopedics (the only surgeon in the greater Atlanta area with this specialized combination of certifications), and is uniquely qualified to perform the complex and difficult surgical techniques required to repair major, traumatic damage, minimize long-term complications, loss of functionality, and scarring, and help you return to a full, active life at home and at work!
TYPES OF TRAUMATIC INJURY
Traumatic injuries can be generally divided into the following categories; many traumatic injuries resulting from industrial accidents, car crashes, and power tool usage involve one or more of these, and any surgical reconstruction will have to take into account multiple levels of injury for complete repair:
- Puncture: multiple layers of skin and soft tissue are pierced; infection can be a major concern
- Laceration: When skin and soft tissue are cut or torn, often resulting in jagged, crooked edges; as with punctures, infection can be especially problematic
- Avulsion injury: a surface trauma in which all the layers of skin have been torn away from the body, exposing underlying structures such as muscle, tendon, or bone
- Blunt or crush injuries: when soft tissue and even bone are subjected to traumatic squeezing between two heavy, stationary objects (or the ground); especially common injury to fingers
- Partial amputation: when portions of the fingertip or hand have been removed, either by being torn or cut away
- Subtotal amputation: more than half of the finger, hand, or lower arm has been torn or cut off
- Total amputation: when the entire fingertip or hand has been cut or torn off and requires reattachment. Reattachment is preferable if it will enable more functionality than would be possible with a prosthetic. This injury is most common for fingers; however, entire amputation of the hand and/or arm is, thankfully, fairly rare.
- Burns and frostbite: severe cases may require reconstruction to repair soft tissue damage
HAND RECONSTRUCTION SURGERY
Hand reconstruction surgery is as unique as the injury it is repairing, and the exact sequence and timing of pre-operative preparation, surgery, and post-surgery recovery must be developed only after a careful examination of the specific injury, an evaluation of the damage, and review of the patient’s medical history. Generally speaking, most hand reconstruction surgeries will involve the following steps:
- Realign any fractured bone(s) into proper position and attach metal plates, pins, or additional hardware to reinforce the bone, hold it in place, and encourage proper healing
- Repair damaged blood vessels to ensure normal blood flow to injured tissues
- Reattach damaged or severed muscles, tendons, and ligaments to facilitate as much of the eventual return of normal movement and functionality as possible
- Reconnect the nerves around the injured area to restore a sense of feeling and touch
- Restore skin to the injured area, including blood vessels. If the injury involves extensive damage to the skin, skin grafts or flaps may be required. A skin graft involves harvesting a thin layer of skin from a donor site on the patient’s body to cover the injured area. A skin flap involves moving a full-thickness layer of skin tissue, including blood supply, from a site close to the injury to cover the injured area.
Unfortunately, in cases of severe injury, further reconstructive surgery may be required after the original surgery to enhance functionality of the injured area. Common procedures include:
- Tenolysis: a procedure to free tendons from any built-up scar tissues limiting movement
- Capsulotomy: a procedure to release stiff, locked joints
- Tendon or muscle transfer: a procedure designed to enhance functionality by moving tendons or muscles from a donor site on the patient’s body (where it is needed less) to the injured area
- Nerve grafting: designed to enhance sensation by replacing scarred or damaged nerves
CONTACT Y PLASTIC AND RECONSTRUCTIVE SURGERY
Dr. Asaf Yalif, lead surgeon at Y Plastic and Reconstructive Surgery, is uniquely qualified to provide advanced, cutting-edge surgical treatment options for degenerative or traumatic hand and upper extremity issues. The only surgeon in the Atlanta area specializing in the rare combination of hand and plastic surgery, Dr. Yalif is triple Board Certified in Plastic Surgery, Hand Surgery, and Orthopedic Surgery. His unique perspective on soft tissue, joint, and bone-related conditions of the hand, fingers, wrist, and elbow enables him to offer a variety of medical and surgical options unavailable at traditional orthopedic practices. Y Plastic and Reconstructive Surgery is a friendly, welcoming boutique medical practice where cutting-edge surgical techniques are coupled with an emphasis on the patient experience; whether you are dealing with a traumatic injury or a long-standing degenerative disease, Dr. Yalif will take the time to listen to your concerns, answer your questions, and work closely with you to develop a personalized treatment plan tailored to ensure that your hands can work as hard as you do!
Y Plastic and Reconstructive Surgery has offices conveniently located in Atlanta, Roswell, and Woodstock, Georgia. If you have sustained a severe, traumatic injury to your hands, fingers, or upper extremity and require surgical intervention and/or reconstruction, we encourage you to contact Y Plastic and Reconstructive Surgery today to schedule an initial consultation. We look forward to hearing from you!