Definition and Overview
The hand is one of the most important parts of the body, as it allows for many functions, including gripping and holding things, as well as providing crucial sensory information. When affected by diseases, injuries, disorders, and malformations, the patient can be advised to see a hand specialist or surgeon for surgical intervention and treatment.
Even before the surgical procedure is performed, follow-up consultations are already scheduled and discussed with the patient. The goals are to:
- Track patient’s recovery
- Ensure the hand regains its function as soon as possible
- Monitor, prevent, or treat complications as soon as they arise
- Ensure the surgery has completely treated the condition. If not, new or additional treatment methods, such as therapy and medications, will be prescribed.
Who Should Undergo and Expected Results
Every patient who has undergone hand surgery should come in for follow-up consultations with his or her specialist. The doctor will set the schedule for follow-up appointments typically ten to 14 days after the surgical procedure.
The expected results of follow-up care are faster and safer recovery for the patient, and making sure that the hand’s functions are regained the soonest possible time.
How is the Procedure Performed?
During a hand surgery follow-up consultation, the doctor will focus on assessing the effectiveness of the surgery and the patient’s current progress. Typically, he will begin by asking the patient how the hand is feeling after the surgical procedure and if certain symptoms were observed.
If dressings, stitches, or splints were used, the doctor is expected to remove them so the wound can be closely inspected for usual signs and symptoms of infection or inflammation. For some patients, especially those who have undergone procedures for the carpal tunnel, trigger finger, or ganglion cysts, the doctor will schedule an appointment three days after the surgery to change the dressings.
Swelling is a natural occurrence after the surgery. The doctor will advise the patient to regularly elevate the arm above the heart to minimize the swelling. One of the most common ways to do this is to lie flat on one’s back and place the hand to rest on a couple of pillows. Applying an ice pack on the hand should the inflammation persist is another way of keeping the swelling down.
It is also best for the patient to ask the doctor whether it is safe to move and flex the fingers after the surgery to prevent stiffness and reduce inflammation in the area.
Some patients still experience inflammation in the hand and fingers two weeks after the surgical procedure. If the inflammation persists during this period, the doctor can remove or loosen the dressing.
During the follow-up consultation, the doctor might prescribe pain medication for the patient. It is important to tell the doctor about other medications taken to prevent unpleasant side effects such as constipation, itching and nausea, among others.
To determine the efficacy of the surgical intervention, the doctor will also perform a thorough physical examination, which could be complemented by x-rays to see if the patient’s recovery is progressing as expected. X-rays can be regularly ordered to determine if the treated problems are recurring.
To regain the function of the hands, the doctor might refer the patient to a therapist, who will then prescribe targeted hand exercises to restore strength, flexibility, function and mobility of the many joints of the hands and fingers. Some of these exercises include raising the arms above the head and behind the neck, flexing and trying out different positions for the fingers and rotating the wrists. To encourage the patient to do the exercises, the doctor and therapist will carefully explain the rationale behind each.
Hand therapists specialize in rehabilitating the hands and upper extremities after surgery. Aside from recommending hand and arm exercises, they can also help the patient learn how to cope with postoperative life, and help in the healing process by providing information on scar prevention and management. They can also issue clearance so patients can return to normal activities and work.
Following the doctor’s advice provided during hand surgery follow-up consultations is very important to ensure the success of the hand surgery.
Possible Risks and Complications
Hand surgery follow-up consultations are generally safe when performed by qualified medical professionals. It is highly important that the patient works only with a licensed hand therapist to maximise the benefits of exercises and minimise the risk of injury to the operated hand.
- Webb CW. Metacarpal fractures. In: Eiff MP, Hatch RL, eds. Fracture Management for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 4.