Hand and Microsurgery: diagnosis, function and long-term planning
Hand and Microsurgery is considered when trauma, nerve injury, tissue loss or complex reconstruction threatens hand viability or useful function.
Repair priorities follow blood supply and tissue survival first, then stable bone, tendon glide, nerve recovery and coverage; a technically successful flap cannot replace coordinated hand therapy.
Who may be considered?
Specialist review may help when injury or prior treatment creates a complex problem in circulation, sensation, motion or coverage.
- Digit or limb replantation and revascularization.
- Complex tendon nerve or vessel injury.
- Soft-tissue loss requiring free or local flap coverage.
- Selected functional reconstruction after tumor or chronic injury.
What the specialist team must confirm
Review injury timing and mechanism, photographs, radiographs or CT, vascular status, nerve and tendon examination, wound contamination, previous operations, smoking and medical risk, hand dominance, occupation and therapy access.
Key points for this treatment
From tissue survival to purposeful hand function
Timing of motion, splints and staged nerve or tendon work should be documented before the patient travels home.
Function develops through months of protected use and therapy
Early checks monitor flap or digit circulation, swelling, infection, wound condition and splint position while repaired structures are protected.
Therapy measures motion, tendon glide, strength, sensation, pain and return to work, with staged release or reconstruction considered after maturation.
Risks, limits and realistic expectations
Risks include flap or replanted-part loss, thrombosis, infection, nonunion, tendon rupture or adhesion, numbness, cold intolerance, stiffness, chronic pain and repeated surgery.
A reconstructed finger or flap becoming pale, blue, cold, increasingly painful or swollen, or new fever and wound drainage requires immediate microsurgical assessment.