The Upper Limb Clinic

Complications of Hand Surgery

General:

Most hand surgery has a low complication rate but as with any form of surgery there is always a potential for things to go wrong.

Scars

Scars around the hand and wrist can sometimes be slightly thickened and tender. They benefit from being massaged and moisturised as soon as the wound has healed. Sometimes this is actually uncomfortable to do but it does help enormously with the recovery of the skin and underlying tissues.

Infection

Infection can occur after any operation. The hand and wrist have a very good blood supply and therefore the incidence of infection is very low. Should you get an infection this is usually treated with antibiotics and only rarely requires further surgery.

Return of Function

The hand and wrist are complex structures. Therefore, operations in this area often cause a loss of function during the recovery period. Depending on the type of surgery you have this may cause an enforced period of time off work. Do ask your Surgeon how your particular operation will affect your line of work and your ability to get back to it.

Stiffness

The hand and wrist are highly mobile and any surgery can cause stiffness in the joints. This usually settles rapidly with exercises and physiotherapy after surgery. A very small percentage of patients get a condition called Complex Regional Pain Syndrome (CRPS). It is difficul to predict who is likely to get this but if it does occur it is a nuisance because the recovery time tends to take months rather than weeks. Virtually all patients who get this condition do eventually return to normal function but they require more therapy than usual.

Nerve Injury

There are small nerves that run around the hand and wrist. Should they be stretched or injured during surgery they may give post-operative symptoms. The most common thing to happen is that a nerve gets stretched and becomes hypersensitive for a while. This means that touching the area supplied by that nerve causes discomfort or a tingling sensation. These symptoms usually settle spontaneously as the nerve recovers. Should a nerve be particularly hypersensitive hand therapy can be beneficial to speed up the recovery. Only rarely is surgery required as most nerves settle down on their own. Occasionally a nerve may be divided at surgery. This would be followed by immediate repair at the time of operation. Nerves repaired in this way normally regain most of their function but a small loss of sensation may be permanent.