Dr Rajapakse is very experienced in performing a variety of hand surgical procedures.
The aims of hand surgery are to restore the functionality of the fingers, hand and wrist that can be the result of traumatic injury and infection, degenerative condition or birth defect. With all the intricate detail of the hand, it is vital that surgery is performed by trained and certified plastic and reconstructive surgeons.
Conditions that may require emergency hand surgery include:
Common procedures used for the treatment of these conditions and injuries include:
Conditions for which elective hand surgery is done include:
Dupuytren’s contracture is a disease that causes the shortening and thickening of a web of connective tissue called palmar fascia that extends across the palm of the hand to the fingers. As the disease progresses it causes the fingers to be pulled in towards the palm and become clawed and create a contracture.
Most commonly the ring finger and the little finger that are affected, but sometimes any or all fingers may be impaired.
The exact cause of the condition is unknown but the incidence of the disease is generally more prevalent in people with diabetes, older men, people who abuse alcohol and people who are taking anti-epileptic medication. It can also run in families particularly those of Celtic and Northern European ancestry.
The symptoms include nodules that can appear on the palm of the hand and a thickened cord of tissue that runs along the palm to the fingers. Over time the fingers constrict into claws.
Corticosteroid injections can be administered in the early stages of Dupuytren’s Contracture but when the hands are no longer functional surgery is usually the best option to alleviate the condition.
There are a number of surgery options and Dr Rajapakse will discuss these you prior to any surgery taking place..
eg. carpal tunnel syndrome, cubital tunnel syndrome, distal ulnar tunnel syndrome and pronator syndrome
Carpal tunnel syndrome
The symptoms of Carpal Tunnel Syndrome can usually start slowly with a tingling, itching and burning sensation in the palm of the hand and fingers, particularly the thumb, index finger and middle finger. The cause of this disorder is due to compression oth the median nerve which runs down the fore arm into the hand. The median nerve controls sensation to the palm side of the thumb and fingers but not the little finger. It also controls some muscles in the hand which are responsible for movement to the fingers and thumb. The carpal tunnel is a collection of ligaments and bones that form a ‘tunnel’ at the base of the hand. This ‘tunnel’ is where the median nerve and tendons are situated.
such as fused digits, extra digits and missing digits
An inflammation of the tendons, including De Quervain’s tendinitis of the thumb, flexor and extensor tendonitis of the wrist
Removal of tumors of the skin, soft tissue or bone
Locking of the finger or thumb, causing pain and impaired function.
Hand burn reconstruction involves a combination of skin grafting and contracture release procedures to optimize appearance and function.
“Holistic Plastic Surgery in a professional environment Holistic Plastic Surgery in a professional caring environment Holistic Plastic Surgery.”Dr Yosanta Rajapakse
The post operative treatment and recovery period depends on the type of procedure that has been performed.
In general most fractures that are treated by cast alone with a period of immobilization ranging from 3- 4 weeks.
The post operative rehabitation period for hand surgery is vital and compliance with hand physiotherapy is essential for a good functional result.
Certain surgical repairs will be protected in a cast before hand physiotherapy whereas others will have early active motion relatively soon after the procedure.
At consultation Dr Rajapakse will discuss the post operative course in detail.
Depending on the size and location of the skin lesion Dr Rajapakse performs surgery either under local anaesthesia with or without sedation or under general anaesthesia. Some procedures may be suitable for local anaesthetic and can be performed in the rooms.
If general anaesthesia or sedation is required Dr Rajapakse will engage the services of a qualified anaesthetist who is a fellow of the Royal Australian and NZ College of Anaesthetists (FRANZCA).
Your anaesthetist will ask you about all the medications that you are taking or have taken and any allergies that you may have.
Unfortunately scars are an inevitable part of any surgery and depending on how each person heals, there can be no guarantee for a perfect outcome.
Dr Rajapakse is highly skilled to minimize scarring and to keep your scars as inconspicuous as possible by placing the incision in natural crease lines.
Scars do fade and if scarring is a concern for you after surgery, Dr Rajapakse will provide you with specially tailored treatment plan to expedite the healing of your scars.
All surgeries are performed either as a day case or over night stay at reputable internationally accredited facility.
You have the right to be informed about the costs associated with you surgery.
When choosing a surgeon for your reconstructive surgery, remember that factors such as surgeon’s training, qualifications, experience and your comfort them are just as important.
Most hand surgery procedures are covered by private health insurance and carry an MBS code. If your policy covers these item numbers then you are in luck as your insurance will cover a large portion of your hospital and operation costs. If you don’t have private insurance, medicare will reimburse you a portion of the cost(if you are an Australain Resident.)
Costs associated with the procedure may include:
After your consultation an informed financial consent will be sent as well as an information pack to read before the second pre-surgery appointment. This second optional appointment is free of charge and your preoperative photos and measurements for any compression garment taken (if required).