The hands are an intricately complex part of the body, and are essential for everyday life and function. Common conditions that can compromise the use of the hands include bone fractures, carpal tunnel syndrome, arthritis, tumors, tendinopathies, congenital problems, nerve disorders, and injuries.
Because of their complexity, both plastic surgeons and orthopedic surgeons can pursue further training in order to specialize in hand surgery. The division of Hand Surgery within the department of Plastic & Reconstructive Surgery is comprised of board-certified plastic surgeons who specialize in hand disorders. Hackensack University Medical Center also has a Physical Therapy department with a certified hand therapist who deals solely with the rehabilitation of patients with hand injuries.
Division of Hand Surgery Staff
Trauma and Work-Related Injuries
Hand injuries are common both at home and in the workplace. Injuries can occur as a result of trauma or from overuse. Bone injuries include dislocations and fractures of the hand, wrist, and forearm. Tendon injuries include lacerations and tendinitis from overuse, such as tennis elbow, golfer's elbow, and trigger fingers. Nerve injuries can lead to muscle weakness or decreased sensation to a part of the arm. Ligament injuries can lead to painful motion of the fingers, hand, and wrist. Minimally invasive arthroscopic surgery can be used to aid in the diagnosis and repair of a number of these injuries.
Occasionally, an injury can lead to the loss of a body part. Amputations can occur at the finger, hand, wrist, forearm, and arm levels. Plastic surgeons within the division of Hand Surgery are trained in microvascular surgery and can perform replantation surgery with the use of a precision microscope.
The hand surgeons within the division of Hand Surgery are also adept at dealing with the long-term effects of previous injuries and surgeries. These conditions include non-healed bones, mal-united bones, stiff joints, loss of sensation, and limited motion secondary to scarring. Through the combined efforts of the specialized hand surgeons and hand therapists, one can regain vital hand function after injury.
Arthritis leads to both painful and limited joint motion. Arthritis commonly affects the base of the thumb, the finger joints, and the wrist. The chance of developing hand arthritis steadily increases with age. Post-traumatic arthritis can occur following a previous joint injury. Other types of arthritis, including rheumatoid arthritis and juvenile arthritis, are predominantly inherited. Arthritis can be managed with non-surgical and surgical methods. Surgeries to correct arthritis include state-of-the-art joint replacement and joint reconstruction, arthroplasty, and surgery.
Injuries to one of the nerves in the arm can lead to sensory and motion deficits. Nerve conditions can also stem from chronic compression, such as in carpal tunnel syndrome and cubital tunnel syndrome. Nerve deficits can occur from a myriad of other conditions, such as birth trauma, infections, and polyneuropathies. The management of nerve conditions hinges on the appropriate work-up, which may entail electromyography, nerve conductions studies, or MRIs.
Tumors and Infections
Slowly-growing masses in the hand and wrist occur quite frequently. Many of these growths are either ganglion cysts, lipomas, benign giant cell tumors, or Dupuytren's nodules. Bone tumors can also occur and can be either benign or malignant. Hackensack University Medical Center is equipped with a state-of-the-art 3.0 Tesla MRI scanner, which has a higher sensitivity in detecting hand and wrist conditions.
Infections can range from minor fingernail infections to industrial high-pressure ones. Hand/wrist infections require close medical management and may need surgical drainage.
Congenital hand deformities such as syndactyly (webbed fingers), absent or duplicate thumbs, short or missing fingers, multiple extra digits, joint contractures, and spasticity can interfere with a child's dexterity and normal hand development. Due to the temporal sequence of fetal limb development, congenital hand deformities are often associated with heart conditions such as atrial/ventricular septal defects.
Hackensack University Medical Center offers a team approach to the management of congenital hand conditions. Hand specialists work in conjunction with the pediatric cardiology and genetics department in managing these children.
All children requiring hospital stays will be admitted to the Joseph M. Sanzari Children's Hospital on the Hackensack University Medical Center main campus. The Joseph M. Sanzari Children's Hospital has been selected twice as one of the top 25 Children's Hospitals in the country and the top ranked Children's Hospital in New Jersey by Child Magazine. For children with conditions requiring surgical intervention, all surgeries are performed in specialized pediatric operating rooms staffed with pediatric anesthesiologists.
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