Hand & Upper Extremity Reconstruction

What to Expect with Hand & Upper Extremity Reconstruction

When it’s unlikely that non-surgical treatments will provide relief, reconstructive surgery can help alleviate your hand or upper extremity issue. The most common conditions treated by hand and upper extremity reconstruction experts in plastic surgery include:

• Amputees. When an arm, hand or fingers are amputated due to trauma or cancer, reconstruction can improve form and function of the amputated area.
• Arthritis. This describes various types of joint pain and joint disease that cause pain, swelling and a decreased range of motion. Several surgical options can repair or replace joints in the hand, arm and shoulder.
• Brachial plexus injury. The brachial plexus describes the network of nerves crossing the neck and shoulder that control movement and feeling in the arms and hands. Damage to this nerve network can cause pain, weakness, loss of feeling or paralysis in the hand, arm or shoulder. Surgery can reattach damaged nerves and graft or transfer healthy nerve or tissue from one part of the body to the injured area.
• Carpal tunnel. Inflammation or compression of the median nerve at the wrist (i.e., carpal tunnel syndrome) can cause numbness and tingling in the hand. Surgery can help improve nerve function and improve symptoms.
• Cubital tunnel. When the ulnar nerve, or “funny bone” passing through your elbow becomes inflamed or swollen, you may experience pain, tingling, and numbness in the arm and fingers. Surgery can relieve the pressure on this nerve.
• de Quervain’s tenosynovitis. This inflammation of the tendons around the thumb and wrist causes pain and swelling. It can be repaired by surgically widening the tunnel to relieve the trapped tendons.
• Dupuytren’s contracture. This condition causes a thickening of the tissue under the skin of the palm and into the fingers, causing the fingers to bend into the palm and sometimes creating lumps or pits in the skin. Surgery can divide or remove the thickened bands of tissue.
• Fractures. A fracture is a break or crack in the bones of the fingers, hand, arm, elbow or shoulder that can be reset surgically to stabilize and heal the injury with the goal of improved pain and function.
• Ganglion cyst. These small sacs of fluid form around the tendons or joints of your hand and wrist. Sometimes painful, these cysts can go away on their own, but surgery is an option for a persistent cyst or one that returns after draining.
• Peripheral nerve injury. Peripheral nerves connect your brain and spine to the rest of your body. Injuries from trauma and other health conditions can cause stretching, cutting or pressure on a nerve that result in pain, burning or numbness. Depending on the damage, surgery can repair the nerve directly or re-route healthy nerves to take over the work of the damaged nerve.
• Replantation. A severed finger, hand, or arm must be reattached within hours of a traumatic injury. Replantation surgery repairs the bones, tendons, blood vessels, nerves skin and tissue to reconnect the damaged area and restore blood flow and function.
• Spasticity. This condition causes muscles in the arm or hand to contract or spasm, causing stiffness and tightness that affect movement. Spasticity is caused by damage to the area of the spinal cord or brain that controls voluntary movement and is associated with cerebral palsy, stroke, multiple sclerosis and traumatic brain injury. Surgery can treat spasticity by releasing, lengthening or transferring tendons or releasing or fusing joints of the arm.
• Tendon injuries. Tendons are the “ropes” that connect muscles to bones and allow you to move. When your tendon is damaged through injury, laceration or arthritis, surgery can repair the tissue.
• Trigger finger. This condition causes stiffness, pain, popping or locking when you bend your finger. Frequently accompanying rheumatoid arthritis, gout or diabetes, trigger finger occurs when there is a size mismatch of the pulleys (thick lining over the tendons of the fingers) and the underlying tendons of the finger. Surgery releases the constricting pulley at the base of the finger, allowing the tendon to glide freely.

Why Choose IU Health for Your Hand & Upper Extremity Reconstruction?

Plastic surgeons at IU Health have specialized training to treat any hand and upper extremity condition you may experience, ranging from the most common to the most complex procedures.

IU Health Plastic & Reconstructive Surgery offers two unique hand and upper extremity programs that are not available anywhere else in the state:

Targeted muscle reinnervation (TMR)

Following an arm, hand, or finger amputation, this surgery helps reduce pain and improve function by re-assigning nerves from the amputated area to other muscles, effectively giving them something to do other than cause pain. This may also allow better control over an advanced prosthetic limb.

Brachial plexus program

Similar to the pediatric program at Riley Hospital for Children at IU Health, plastic surgeons at IU Health are creating an adult brachial plexus program to treat major nerve damage in the arm and neck.

Whereas most childhood brachial plexus conditions are caused during birth, adults usually experience this kind of nerve damage through traumatic injuries like motorcycle accidents. These rare injuries require highly specialized treatment.