Our Summary

Chronic hand ischemia is a condition where blood flow to the hand is reduced, leading to symptoms like cold intolerance, pain, ulcers, and tissue death. If medications and other non-surgical treatments don’t work, surgery may be needed. This study looked at outcomes from different surgical techniques used to treat this condition, including sympathectomy, arterial bypass, and venous arterialization. The study found that all three techniques were effective in treating chronic hand ischemia. Sympathectomy had the lowest rate of new ulcers, bypass was best at healing existing ulcers, and arterialization was best at reducing pain, but had the most complications. The study concluded that surgical intervention is an effective last resort treatment when other measures fail. The best type of surgery for a patient can be determined through a systematic approach.

FAQs

  1. What is chronic hand ischemia and what are its symptoms?
  2. What are the different surgical techniques used to treat chronic hand ischemia and how effective are they?
  3. Which surgical technique is considered the best for a particular patient suffering from chronic hand ischemia?

Doctor’s Tip

Additionally, after hand surgery, it is important to follow your doctor’s post-operative instructions carefully to ensure proper healing and recovery. This may include keeping the hand elevated, following a specific rehabilitation program, taking prescribed medications, and attending follow-up appointments. It is also important to communicate any concerns or changes in symptoms to your doctor promptly. By following these guidelines, you can help ensure the best possible outcome from your hand surgery.

Suitable For

Some other types of patients who may be recommended hand surgery include those with:

  • Carpal tunnel syndrome
  • Dupuytren’s contracture
  • Trigger finger
  • Arthritis in the hand or wrist
  • Tendon or nerve injuries
  • Fractures or dislocations in the hand or wrist
  • Ganglion cysts
  • Tumors or growths in the hand or wrist

Overall, hand surgery may be recommended for patients who have conditions or injuries that are affecting the function or mobility of their hands and wrists, and for whom non-surgical treatments have not been successful.

Timeline

Before hand surgery:

  1. Patient experiences symptoms of chronic hand ischemia such as cold intolerance, pain, ulcers, and tissue death.
  2. Patient undergoes non-surgical treatments such as medications to try to alleviate symptoms.
  3. If non-surgical treatments are unsuccessful, patient may be recommended for surgery.

After hand surgery:

  1. Patient undergoes the recommended surgical technique, such as sympathectomy, arterial bypass, or venous arterialization.
  2. Depending on the surgical technique used, patient may experience different outcomes such as reduced ulcers, healed ulcers, or reduced pain.
  3. Patient may experience complications from the surgery, with arterialization having the highest rate of complications.
  4. Overall, surgical intervention is found to be effective in treating chronic hand ischemia when other measures have failed.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with the surgery?
  2. How long is the recovery process and what can I expect in terms of pain and discomfort?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. What are the success rates of the different surgical techniques for treating chronic hand ischemia?
  5. How do I know if surgery is the best option for me, and are there any alternative treatments available?
  6. Will I need to make any lifestyle changes or follow a specific treatment plan after the surgery?
  7. How long will the effects of the surgery last, and will I need any additional procedures in the future?
  8. Can you provide me with information on the surgeon’s experience and success rates with hand surgery procedures?
  9. Are there any special accommodations or preparations I need to make before the surgery?
  10. What can I do to optimize my recovery and ensure the best possible outcome from the surgery?

Reference

Authors: Colen DL, Ben-Amotz O, Stephanie T, Serebrakian A, Carney MJ, Gerety PA, Levin LS. Journal: J Hand Surg Asian Pac Vol. 2019 Sep;24(3):359-370. doi: 10.1142/S2424835519500462. PMID: 31438795