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What is hand surgery?

Hand surgery is a specialized area of plastic and reconstructive surgery that deals with diseases, malformations, and injuries of the hand, wrist, and the associated nerves in the forearm. The goal of hand surgery procedures is to preserve or restore functionality. Aesthetic corrections can also be performed. Both conservative and surgical methods are used, depending on the symptoms and needs of each individual patient.

What topics does Dr. Matiasek cover in the field of hand surgery?

Dr. Matiasek offers comprehensive care for hand surgery conditions. His goal is to restore hand mobility, strength, and function individually and sustainably. Depending on the diagnosis, conservative treatments, minimally invasive techniques, or traditional surgery are employed. His work can be broadly divided into four areas:

Disorders of the tendons and tendon sheaths

A common problem is trigger finger. In this condition, the flexor tendon suddenly snaps forward when the finger is straightened, caused by a narrowing of the annular ligament. In a minor procedure under local anesthesia, the affected ligament is carefully cut, allowing the tendon to move freely again.

Tendonitis often occurs as a result of overuse or repetitive movements. In most cases, conservative treatment with splints, anti-inflammatory medication, or targeted injections is sufficient. If the symptoms do not improve, minor surgery may be necessary to prevent permanent damage.

Dupuytren's contracture is a particular connective tissue disorder. In this condition, nodules and cords form in the palm of the hand, gradually pulling the fingers into a flexed position. Several treatment options are available. These include minimally invasive needle fasciotomy, complete removal of the affected tissue, or enzyme therapy, in which the cords are selectively dissolved without surgery.

Nerve compression syndromes

At the Carpal tunnel syndrome The median nerve is compressed in the wrist area. This often manifests as tingling, numbness, or fingers falling asleep at night. If conservative therapy is insufficient, a minor surgical procedure can help. This involves cutting the constricting carpal ligament. Depending on the situation, the procedure is performed open, semi-open, or endoscopically.

The Cubital tunnel syndrome It affects the ulnar nerve in the elbow area. Symptoms include tingling or numbness in the little and ring fingers, as well as a decrease in grip strength. To prevent permanent nerve damage, the nerve is surgically decompressed. This can be done either in its natural position or by relocating it to more protected tissue.

Joint disorders

A common problem affecting the thumb is rhizarthrosis. This is osteoarthritis of the thumb's carpometacarpal joint, which makes gripping movements difficult and causes pain. In the early stages, conservative measures such as splints, physiotherapy, or targeted injections can help. If the symptoms persist, a customized surgical procedure can contribute to lasting improvement.

Benign tissue changes

Ganglions, Ganglia, also known as joint ganglions, are benign cysts that commonly develop on the wrist. They are filled with synovial fluid and can cause pain or restricted movement. A clinical examination is usually sufficient for diagnosis, sometimes supplemented by ultrasound. If removal is necessary, it is performed on an outpatient basis under local anesthesia. The ganglion, along with its connection to the joint capsule, is removed to prevent recurrence. In specific cases, a particularly gentle endoscopic method can also be used.

What do I need to consider before hand surgery?

Before every hand surgery procedure, Dr. Matiasek takes ample time for a personal consultation. This involves not only thoroughly understanding your symptoms but also examining your hand and providing you with transparent information about all treatment options. Preparation for the surgery plays a crucial role in ensuring a safe procedure. You should avoid nicotine and alcohol for approximately two weeks prior to the surgery, as both can impair wound healing. If you are taking blood-thinning medications such as aspirin, acetylsalicylic acid (ASA), or warfarin (Marcoumar), please discuss this with Dr. Matiasek well in advance. Sometimes it is necessary to temporarily discontinue these medications. Sleeping pills should also be paused if possible.

On the day of the procedure, you should refrain from using hand creams and nail polish to keep the surgical area sterile. If general anesthesia is planned, you must not eat anything for six hours before the operation. You may drink water or unsweetened tea up to four hours beforehand.

How does the treatment work?

The type of procedure depends on the diagnosis and the severity of the symptoms. Minor procedures, such as releasing a pulley or removing a ganglion, can often be performed under local anesthesia. More complex operations, such as those for cubital tunnel syndrome or advanced Dupuytren's contracture, are performed under sedation or general anesthesia.

After the procedure, the operated hand is carefully bandaged and immobilized. In many cases, targeted mobilization with simple exercises follows immediately. If necessary, you will receive a custom-fitted splint. Accompanying physiotherapy can also be beneficial in certain cases to restore mobility as quickly as possible.

Are there any risks and side effects?

As with any surgery, hand surgery can also have side effects. Swelling, bruising, or temporary numbness are common, but these usually subside quickly. Infections, bleeding, or nerve damage are very rare, but cannot be completely ruled out. Dr. Matiasek practices according to the highest medical standards and will explain all possible risks to you in detail beforehand. Most patients recover well and without discomfort within a few days.

What should be considered after hand surgery?

After the procedure, Dr. Matiasek will closely monitor your recovery process – from follow-up wound checks to the restoration of your hand function. In the first few days, it is important to regularly cool and elevate your hand to minimize swelling. The sutures are usually removed after about twelve to fourteen days. Depending on the surgery and the findings, a gradual increase in activity begins over a period of two to six weeks. Occupational therapy or targeted exercises can further promote healing. During this initial period, you should refrain from sports, tanning beds, saunas, and nicotine use to avoid interfering with the healing process.

Do you have problems with your hand? If you are suffering from pain, restricted movement, or numbness, don't hesitate. Schedule a personal consultation with Dr. Matiasek – together you will find a solution that restores your mobility. You are in the best hands with us.

When is a hand surgery consultation advisable?

If you are experiencing pain, restricted movement, or numbness in your hand, you shouldn't wait too long. Early diagnosis can greatly contribute to preserving hand function. Schedule an appointment with Dr. Matiasek for a personalized consultation. Your hands will be in the best hands with him.