Pediatric hand surgery places completely different demands on doctors than hand surgery for adults: children's hands are still growing. Hand surgery is considered when conventional methods do not produce the desired results. Due to the complexity of the hand, especially in children, you should consult a specialist in pediatric hand surgery.
Here you will find further information and selected hand surgeons for children.
The hand not only has a very complex structure with bones, muscles, tendons, blood vessels and nerves. It is also the most important human tool. We are dependent on being able to perform fine motor movements with the hand.
In children, the hand is not yet fully developed. Surgical interventions must allow the hand to continue to grow after the operation. Hand surgery is therefore even more difficult to perform on children than on adults.
Doctors from the following specialties are primarily responsible for hand surgery in children:
As many nerve tracts run through the hand, a neurologist is often also consulted.
The hand is a complex tool. In children, the further growth of the hand must be taken into account during hand surgery © bilderzwerg | AdobeStock
Surgery on the hand is considered when conservative treatment does not bring the desired success.
The most common hand surgery condition in both children and adults is tendovaginitis. It is also known as 'rapid finger' or 'fixed finger'. Tendovaginitis is a blockage of the normal gliding ability of the flexor tendons in the hand. The finger cannot be stretched at first (it is 'fixed'), but then 'snaps' out suddenly.
Conservative measures include rest, massage and cortisone. If these do not help sufficiently, outpatient surgery is usually performed under local anesthesia.
Another common condition that requires hand surgery is a ganglion. A ganglion is a hemispherical swelling on the extensor or flexor side of the wrist in the thumb area. The swelling is harmless, it is a bulge in the joint capsule that is filled with a gelatinous secretion.
If the child finds the protuberance bothersome or painful over a longer period of time, it is surgically removed.
Another area of application for hand surgery in children is congenital deformities of the fingers or the hand itself. The most common are
Overall, however, malformations of the hand only occur in one in 2,500 births. They are then often associated with other malformations on the body.
In this case, the specialist performs corrective surgery so that the hand can grow unhindered.
Other situations in which hand surgery is used in children are
Hand surgery in adults is usually performed under local anesthesia. However, general anesthesia is unavoidable, especially for infants and small children. This is the only way to ensure that the child does not move its hand during the operation. Whether general anesthesia is also necessary for older children is decided by the attending physician in close consultation with the parents.
Hand operations are usually minimally invasive, i.e. only a very small incision is required. Only a small, inconspicuous scar remains.
Which surgical procedure is used depends on the type and severity of the condition.
In the case of malformations, such as fused or supernumerary fingers, the doctor cuts the skin between the fingers or amputates supernumerary fingers.
In the case of a ganglion, the surgeon removes the altered tissue. This procedure is relatively minor and causes little discomfort to the patient. However, some experience is required so that
are not damaged during the operation. It is therefore essential that you consult a recognized specialist for hand surgery in children.
After the operation, the joint is immobilized for some time. The mobility of the hand may still be restricted for a few weeks afterwards. Thanks to modern procedures, good results can be achieved with ganglion surgery. Unfortunately, ganglions recur in around 20 percent of cases, either in the same place or in the immediate vicinity of the old ganglion.
Children who have been diagnosed with tendovaginitis can also undergo hand surgery. This is a minor, outpatient operation that is performed under local anesthesia if the child's age allows.
During the operation, the surgeon splits the ring ligament and removes altered tissue in order to eliminate the restriction of movement.
Every surgical procedure carries the risk of complications, including hand surgery in children.
Wound healing disorders and infections can occur after the operation, delaying the healing process.
It is also problematic to immobilize the hand after the operation. Children have a strong urge to move and are often difficult to persuade to restrain. The risk of the surgical wound being torn open by a fall, for example, is higher than with adults.
Most hand operations are performed on an outpatient basis. A longer stay in hospital is therefore not usually necessary after hand surgery in children. Parents can usually take their child home on the same day, or the next day at the latest.
Aftercare consists of regular check-ups at which the doctor checks whether the surgical wound is healing as expected.
Depending on the type of surgery, he will also carry out various movement tests to ensure that the mobility of the hand has not been impaired by the operation. He may prescribe physiotherapy measures to ensure that the child's hand is fully functional again quickly.
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