Advanced Hand Surgery

Arthroscopy

Wrist arthroscopy is surgical procedure where a tiny camera and specialized  surgical tools are used to examine or repair the tissues inside or around your wrist. The camera is called an arthroscope. This procedure also known as ‘keyhole surgery’ allows the hand surgeon to detect problems and make repairs to the wrist without making larger cuts in the skin and tissue. This results in lesser pain and faster recovery compared to open surgery. Wrist arthroscopy is used as an adjunct for diagnosis and therapeutic management in select ligamentous injuries of the wrist.

Microsurgery

This refers to surgery that is done using a microscope. This allows surgery to be done under greater magnification (upto 40X) and allows assessment and repair of fine vital structures in the body namely blood vessels and nerves. Very fine sutures (the size of a strand of hair) are used to perform microsurgery.  Attaining microsurgical skill requires years of training and practice. Typically microsurgery is used in the emergency situation to reattach amputated body parts usually fingers and in the elective situation to resurface soft tissue defects resulting from trauma or resection of tumours.

Brachial Plexus Injury

Brachial plexus refers to a group of nerves that arise from the spinal cordin the neck and control the movement and sensation in the upper limb. These nerves can be injured in an accident (usually a motorbike) or rarely during childbirth as a result of traction. This results in varying degrees of loss of function of involved upper limb. Surgery requires microsurgical expertise and options depend on the timing of presentation (acute or chronic) and include exploration and neurolysis (freeing of scar), nerve repair, nerve grafting, nerve transfers and tendon and muscle transfers.

Joint Replacement

 It is also known as implant arthroplasty and refers to replacing a diseased joint with an artificial joint. This joint is typically made of metal (titanium) although ceramic based implants are also available. In the past, fusion of the joint was the most frequently performed surgery for treating diseased joints especially in the hand and wrist. Although joint fusion or arthrodesis corrects the deformity and pain, it results in loss of motion and can be very disabling. Joint replacement allows motion at the diseased joint, thus improving the quality of life