Hand surgery
The Hand surgery is an emerged from the U.S. war surgery, given the interdisciplinary necessary treatment of injured soldiers in the upper extremities discipline; it has developed in subdivisions Trauma Surgery ( Traumatology ), neurosurgery and plastic surgery. As a father of hand surgery applies Sterling Bunnel, American surgeon.
General area of responsibility
The Hand surgery is concerned with the diagnosis and treatment of acute or chronic injuries to the upper extremities (shoulder, upper arm, forearm, hand, fingers, thumb).
Special area
Care of injuries to fingers bones, tendons, ligaments, wrist ( scaphoid fracture ), forearm bone ( distal radius fractures ), Ellen -spoke joint ( distal radioulnar joint ) and to blood vessels and nerves ( brachial plexus ). Care of chronic diseases, as well as various arthritis forms, blood flow problems, bone changes ( lunatomalacia ), narrowing of nerve or tendon sheaths ( carpal tunnel syndrome, Loge de Guyon 's syndrome, sulcus ulnaris syndrome ), tenosynovitis stenosing, changes in the connective tissue ( Dupuytren's contracture, tumors ( benign or malignant tumors ) of the hand and arm. functional recovery with motor replacement surgery complex injured upper extremities.
Included is the treatment of children ( child malformations), rheumatism and chronic pain syndromes ( complex regional pain syndrome), the replantation of fingers and entire extremities as well as the care of patients with prostheses and rehabilitation hand injury patients, and the specific requirements for the training of therapist provides.
Subject Requirements
Detailed technical knowledge of anatomical and functional contexts are needed to make a diagnosis and to create a treatment plan. When treatment success makes a large proportion of the complex treatment: physiotherapy, physical therapy and occupational therapy.
Technical requirements and tools
- Gewebsschonendes, differentiated approach ( atraumatic surgical technique )
- Special Instruments
- Magnifying glasses or better telescope glasses
- Surgical microscope
- Tourniquet: to allow an anemic field of operation is interrupted with a pneumatic cuff on the upper arm blood flow
- Ischemia: in order to allow a bloodless surgical field is unwrapped before the tourniquet with an elastic bandage of the arm from the periphery
Education and training
The training in the field of hand surgery is a so- called additional training. The premise of this additional training is being recognized as a specialist in plastic surgery, surgery, trauma surgery or orthopedics and a 36 - month training at a training officer (of which can be completed 12 months during the training in general surgery, pediatric surgery, orthopedics and trauma surgery or plastic surgery, see further education regulations ).
Internationally
In a few countries such as Sweden, Finland and Singapore, Hand Surgery is run as an independent discipline. The budding hand surgeons go through this a training time 60-72 months, and are trained in orthopedic, trauma surgery and plastic hand surgery.