The hand: A small miracle with great significance

Be it grasping, touching, writing or communicating – there is hardly any action that does not involve the hands. Their complex anatomy enables the finest motor skills, but also makes them susceptible to injuries and diseases. Hand orthopedics is dedicated to the diagnosis, treatment and restoration of these sensitive structures – with the aim of maintaining or restoring mobility, function and quality of life.

“The hand is a magnificent but also a very heavily used ‚organ‘. It owes its extraordinary mobility and functionality to the complex interaction of muscles, bones, joints, and vascular and nerve structures,” explains Dr. Sebastian Farr, specialist in orthopedics and hand surgery. He points out that “it is precisely this complexity that means that even the smallest disturbances or pathologies can result in significant discomfort and impairments in everyday functioning.” People who work in professions involving a lot of manual activity and are exposed to high levels of stress often struggle with irritation or osteoarthritis. However, there are also congenital conditions – genetically caused malformations or the consequences of trauma – that can impair the complex structure of the hand and upper extremities.

This is where the hand surgeon comes in

From degenerative to traumatic causes – there are many problems that can affect the hands: the most common are nerve entrapment syndromes such as carpal tunnel syndrome or sulcus ulnaris syndrome in the elbow area, as well as degenerative diseases such as finger arthrosis, rhizarthrosis (thumb) or hand joint arthrosis. Tendon sheath inflammation, ganglion cysts and Dupuytren‘s disease, a contracture in the palm or finger area, are also common. Many patients require arthroscopic surgery due to ligament injuries – after sports accidents, for example.

State-of-the-art technology in use

Orthopedic surgery is sometimes necessary in order to get the hands back into working order as quickly as possible, and there is a range of innovative methods for this purpose that achieve the best possible results. “Free tissue transfer (microsurgery), the latest implants in the joint area or even homologous bone materials such as bone screws are just as much a part of this as arthroscopy, which has made great strides in recent decades – so that many problems can be addressed with minimally invasive techniques,” says Dr. Farr on an essential aspect of modern treatment and care of patients.

How can it be prevented?

Even though prevention in the strict sense is difficult in the case of age- or stress-related wear and tear, “moderate exercise and thus ‚lubrication‘ of the joints in the hand area has proven to be beneficial. However, patients with loose, unstable joints should take care not to injure themselves. For them, occupational therapy to strengthen the hand and forearm muscles and indirectly stabilize the joints is a good choice,” recommends Dr. Farr.

Help for little hands

If parents notice that their child is avoiding moving their hand or fingers, has difficulty grasping objects or complains of pain, they should have their hand examined by a hand orthopedic specialist. Noticeable misalignments, limited mobility, swelling, uneven finger lengths or other visible asymmetries of the hands are also warning signs – in infants, a lack of grasping reflex can be an indication.

Possible diagnoses

• Congenital malformations

• Growth disorders of the bones or tendons

• Cysts or tumors

• Consequences of injuries following fractures or tendon tears

• Functional limitations due to neurological causes

Thanks to microsurgical techniques, special orthoses for children and individualized rehabilitation programs, many malpositions can now be treated early and gently. Minimally invasive procedures and interdisciplinary approaches involving occupational therapy and physiotherapy are also part of a modern treatment concept.