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Hand Trauma and Peripheral Nerve Microsurgery

“Successful outcome in hand surgery requires compliance with hand therapy.” – Dr. Brian Dickinson

 

Hand injuries are very common. People are always working with their hands and getting into trouble. In fact hand injuries are one of the most frequent surgical visits to the emergency room.

I typically choose to repair hand injuries within the first three days after an injury. Waiting longer than seven to ten days allows the body to generate more scar and can make the repair more challenging for the surgeon.

I enjoy these operations as hand surgery as well as structural and functional anatomy was a significant part of my Plastic & Reconstructive surgical training.

 

 

Q: The ER doctor mentioned I cut I very important nerve in my forearm that controls my hand. How long will it take for the nerves to grow back after you repair them?

Peripheral nerves and the study of the nervous system was a significant part of my undergraduate neuroscience degree at Brown University.

Nerve repair can be very challenging for the surgeon and patient. When nerves get severed, the downstream end of the injury begins to degenerate. After the nerve is repaired, the new nerve endings or axons start to grow through the repair site. The nerves grow at a rate of approximately 1mm/day or one inch a month. If the location of the nerve injury is close to the muscle that it innervates, there is a higher likelihood of better recovery.

Hand Therapy

Occupational hand therapy is of paramount importance to maximize your outcome after hand surgery. Often, after tendon injuries I encourage immediate post-operative mobilization so that the tendons can glide. While an excellent repair is important for good hand function, even more important is patient compliance with hand therapy.

 

Scheduling Hand Surgery After Trauma

Surgery for hand trauma is best done early after your injury. Typically, the hospital will contact Dr. Dickinson to see you in the emergency room or you will be scheduled a follow-up appointment with Dr. Dickinson in his office. You will be placed on the surgery schedule shortly thereafter.