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Plastic Surgery

Hand Surgery & Reconstruction

The hand is one of the most intricate and functionally essential structures in the human body, containing 27 bones, over 30 muscles, and a dense network of tendons, nerves, and blood vessels operating within a remarkably compact space. Injuries, degenerative conditions, and congenital anomalies affecting the hand can profoundly impact a person's ability to perform everyday tasks, earn a livelihood, and maintain independence. Hand surgery is a specialized branch of plastic surgery dedicated to restoring the structure, function, and appearance of the hand and wrist.

Common conditions treated through hand surgery include carpal tunnel syndrome (compression of the median nerve at the wrist), trigger finger (stenosing tenosynovitis), Dupuytren's contracture (progressive tightening of the palmar fascia), tendon lacerations, fractures and dislocations of the hand and wrist, crush injuries, and congenital anomalies such as syndactyly, polydactyly, and thumb hypoplasia. Many of these conditions, when left untreated, lead to progressive loss of hand function.

Dr. Amit Agrawal at Amit Aesthetics in Aligarh brings his M.Ch. in Plastic Surgery and over 29 years of microsurgical experience to hand reconstruction. Utilizing magnification-assisted and microsurgical techniques, he performs precise nerve repairs, tendon reconstructions, fracture fixations, and soft tissue coverage procedures. Rehabilitation with a structured hand therapy program is an integral part of treatment, ensuring that surgical repairs translate into meaningful functional recovery.

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Procedures & Techniques

  • Carpal tunnel release (open and minimally invasive)
  • Trigger finger release
  • Dupuytren's contracture fasciectomy
  • Flexor and extensor tendon repair and reconstruction
  • Hand and wrist fracture fixation
  • Nerve repair and nerve grafting in the hand
  • Replantation of amputated digits (microsurgical)
  • Congenital hand anomaly correction (syndactyly, polydactyly)
  • Tendon transfer procedures for nerve palsy
  • Soft tissue coverage and flap reconstruction of the hand

Recovery & Aftercare

Recovery following hand surgery depends on the specific procedure performed. Carpal tunnel and trigger finger release involve light splinting for one to two weeks with a return to most activities within three to four weeks. Tendon repairs require a structured rehabilitation protocol with protected motion exercises beginning within days of surgery, progressing to active use over six to eight weeks — strict adherence to the hand therapy program is essential for optimal tendon gliding and strength recovery. Fracture fixation recovery varies from four to eight weeks depending on the fracture pattern. Microsurgical procedures such as nerve repair or digit replantation require the longest rehabilitation, often three to six months, with progressive improvements continuing for up to a year.

Frequently Asked Questions

How do I know if I need surgery for carpal tunnel syndrome?
Surgery is typically recommended when conservative measures — wrist splinting, activity modification, and corticosteroid injections — fail to relieve symptoms, or when nerve conduction studies show significant median nerve compression. Persistent numbness, tingling, or weakness in the thumb and fingers, particularly if it interferes with sleep or daily function, is a strong indication for surgical release. Early intervention prevents permanent nerve damage.
Can severed tendons and nerves in the hand be fully repaired?
Modern microsurgical techniques allow for precise repair of severed tendons and nerves, and most patients achieve good to excellent functional recovery when surgery is performed promptly and followed by a dedicated rehabilitation program. Nerve recovery is slower — sensation may continue to improve for twelve to eighteen months after repair. Tendon repair outcomes are highly dependent on compliance with post-operative hand therapy protocols.
What is Dupuytren's contracture and how is it treated surgically?
Dupuytren's contracture is a condition in which thickened tissue in the palm progressively tightens, pulling one or more fingers into a bent position and making it impossible to fully straighten them. When the contracture interferes with hand function — typically when the finger cannot be placed flat on a table — surgery (fasciectomy) is recommended to remove the thickened tissue and restore finger extension. Post-operative hand therapy is important to maintain the correction.
How soon after a hand injury should I seek surgical consultation?
Hand injuries involving tendon or nerve lacerations, open fractures, crush injuries, or amputations should be evaluated by a hand surgeon as soon as possible — ideally within hours. Early intervention significantly improves outcomes for tendon and nerve repair, and replantation of amputated digits has the best success when performed within six to twelve hours of injury. Even seemingly minor hand injuries should be assessed promptly to rule out underlying structural damage.

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