Long- term effects depend on the type of liver disease present. For example, chronic hepatitis can lead to:

• cirrhosis of the liver
• liver failure
• illnesses in other parts of the body, such as kidney damage or low blood counts

Other long-term effects of liver disease may include:

• Gastrointestinal bleeding. This includes bleeding esophageal varices, which are abnormally enlarged veins in the esophagus and/or the stomach.
• encephalopathy, which is deteriorating brain function that may progress to a coma
• peptic ulcers, which erode the stomach lining
• liver cancer

Liver disease can be caused by a variety of factors. Causes include:

• congenital birth defects, or abnormalities of the liver present at birth
• metabolic disorders, or defects in basic body processes
• viral or bacterial infections
• alcohol or poisoning by toxins
• certain medications that are toxic to the liver
• nutritional deficiencies
• trauma, or injury

• Symptoms partly depend on the type and the extent of liver disease. In many cases, there may be no symptoms. Signs and symptoms that are common to a number of different types of liver disease include:
• jaundice, or yellowing of the skin
• darkened urine
• nausea
• loss of appetite
• unusual weight loss or weight gain
• vomiting
• diarrhea
• light-colored stools
• abdominal pain in the upper right part of the stomach
• malaise, or a vague feeling of illness
• generalized itching
• fatigue
• hypoglycemia (low blood sugar) low grade fever
• muscle aches and pains
• loss of sex drive

• I suffer from indigestion, gas and Bloating.
• My bowel moments are not satisfactory.
• I cannot digest Milk.
• Certain foods tend to upset my stomach.
• I get recurrent abdominal pain.
• I tend to rush to toilet after eating food.
• I am passing blood while passing motions
• I have had vomiting of blood.
• There is family history of colonic cancer.
• My Ultrasound shows a fatty liver.
• My stomach has started swelling up.
• I have had recurrent Jaundice.
• My Hepatitis B test is positive.
• I am on long term pain killers. So do I need protection with medicines?
• What do I do for Gall Bladder Stones?
• What is Pancreatitis?

A small camera fixed to the end of a narrow fiber-optic tube (2.7mm wide) is inserted through a small incision in the skin (about 5mm long) directly into the back of the wrist joint.The camera lens magnifies and projects the small structures in the wrist onto a television monitor, allowing for more accurate diagnosis. Several small incisions (portals) are used to allow the surgeon to place the camera in different positions to see different structures inside the joint as well as to place various small instruments into the wrist joint to help diagnose and treat various problems in the wrist. The wrist is usually distracted and fluid is infused into the joint to expand the joint and allow improved visualization during the procedure. Sometimes wrist arthroscopy is combined with open procedures.

Wrist arthroscopy allows the visualization of the cartilage surfaces of all bones in the wrist and better evaluation of the ligaments between the various bones of the wrist. Frequently after an injury, pain, clicks, and swelling may be indicative of an internal problem in the wrist. Arthroscopy is often the best way of assessing the integrity of the ligaments, cartilage, and bone. When wrist problems are encountered, many are treated through these small incisions using specialized equipment available for wrist arthroscopy. Often arthroscopy is used to aid in the reduction of fractures of the bones of the wrist. Wrist arthroscopy is also used to assess the integrity of the TFCC (triangular fibrocartilage, or meniscus of the wrist). Today, wrist arthroscopy can even be used to remove some ganglions of the wrist and to assess the extent and treatment of various types of arthritis of the wrist.

After a fracture of the wrist, the fragments of bone associated with the fracture may erode the tendon that straightens the tip of the thumb. In this situation, the thumb tip would not be able to move upward (extend). The muscle that extends the tip of the thumb is the extensor pollicus longus (EPL). In this example, the EPL tendon typically cannot be directly repaired because it is too frayed. There are two muscles that extend the index finger. Just like the body has two kidneys, so that one can be spared if necessary, the body also has two tendons that extend the index finger. One tendon is left intact on the index finger so that it won’t lose extension, and the “extra” tendon can be transferred over to the thumb to replace the lost function. The tendon insertion of the “extra” index finger extensor tendon (Extensor indicus proprius—EIP) is detached. The EIP tendon is then re-directed and sewn into the thumb bone or thumb tendon (EPL). After this type of surgery, a splint or cast is used for one month, after which supervised therapy may be started to re-learn how to use the transferred tendon to extend the thumb. Gentle movement with a protective splint may be used for an additional month. If adequate progress is made, the therapy may be advanced one month later to re-learn activities and to strengthen the muscle, with restoration of the ability to extend the thumb.

All surgery has some risk, although those risks may be small. All surgeries produce a surgical scar. Surgical incisions may develop infection. All surgeries require the use of anesthesia, and will require a complete history and physical examination by your primary care physician to determine if you have medical risks associated with anesthesia. Evaluation by the anesthesiologist will help outline your risks and options.

When a tendon is transferred and sewn into another position, the tendon transfer will need a period of time to heal, usually about one to two months. A splint or cast may be used, followed by therapy to teach you the new tendon function. Finally, exercises will be needed to strengthen the muscle after your hand surgeon feels the tendon transfer has sufficiently healed. You will need to follow post-operative instructions. Movement too early can lead to rupture of the tendon transfer. Movement too late can lead to excessive scarring of the tendon with resultant stiffness. Discussion of your individual case with your hand surgeon will help you further understand the risks and benefits associated with tendon transfer surgery.

You can discuss other treatment choices with your hand surgeon. Other options may include repairing the nerve that has been injured, or repairing the tendon or muscle that has been injured. In some cases, tendon grafts can be used, in which a portion of intact tendon is removed, without its muscle, and used to bridge a gap in an injured tendon. In other cases, tendon lengthening or bone fusions may be necessary as part of reconstructing hand function.

Below the elbow, there are over forty muscles. Each different muscle has a different function. For example, there are 9 muscles that move the thumb. Each muscle has a starting point (origin), and tapers down from its muscle belly into a tendon that then attaches onto bone (insertion) in a specific place; when the muscle fires (contracts), it causes a certain motion (action).

During tendon transfer surgery, the origin of the muscle is left in place; the nerve supply and blood supply to the muscle is left in place. The tendon insertion onto bone is detached and re-sewn into a different place. It can be sewn into a different bone, or it can be sewn into a different tendon. After its insertion has been moved, when the muscle fires, it will produce a different action, depending on where it has been inserted.

Many different conditions can be treated by tendon transfer surgery. Tendon transfer surgery is necessary when a certain muscle function is lost because of a nerve injury. If a nerve is injured and cannot be repaired, then the nerve no longer sends signals to certain muscles. Those muscles are paralyzed and their muscle function is lost. Tendon transfer surgery can be used to attempt to replace that function. Common nerve injuries that are treated with tendon transfer surgery are spinal cord, radial nerve, ulnar nerve, or median nerve injury.

Tendon transfer surgery may also be necessary when a muscle has ruptured or been lacerated and cannot be repaired. Common muscle or tendon injuries that are treated with tendon transfer surgery are tendon ruptures due to rheumatoid arthritis or fractures. Also, tendon lacerations that cannot be repaired after injury may be treated with tendon transfer surgery.

Tendon transfer surgery may also be needed if a muscle function has been lost due to a disorder of the nervous system. In this situation, the nervous system disease or injury prevents normal nerve signals from being sent to a muscle, and imbalance in hand function occurs. The muscle imbalance or muscle loss due to nervous system disease may be treated with tendon transfers. Common nervous system disorders treated with tendon transfer surgery are cerebral palsy, stroke, traumatic brain injuries, and spinal muscle atrophy.

Finally, there are some conditions in which babies are born without certain muscle functions. In these situations, the missing muscle functions can sometimes be treated with tendon transfer surgery. Common conditions treated this way include hypoplastic thumbs and birth brachial plexopathy.

Tendon transfer surgery is a type of hand surgery that is performed in order to improve lost hand function. A functioning tendon is shifted from its original attachment to a new one to restore the action that has been lost.

After replantation surgery, some patients may need additional surgery at a later time to gain better function of the part. Some of the more common procedures are:
Tenolysis: frees tendons from scar tissue.
Capsulotomy: releases stiff, locked joints.
Tendon or muscle transfer: moves tendons or muscles to another spot so that they can work in an area that needs the tendon or muscle more.
Nerve grafting: replaces a scarred nerve or a gap in the nerves to improve how the nerve works.
Late amputation: removing the part because it does not work well, interferes with use of the hand, or has become painful.

Stay in the flow of life. You have many great gifts. Even with the best medical care, you need to be strong during the course of recovery. Remember that quality of life is directly related to your attitude and expectations — not on just regaining limb use.

Replantation can affect your emotional life as well as your body. When your bandages are removed and you see the replanted part for the first time, you may feel shock, grief, anger, disbelief, or disappointment because the replanted part simply does not look like it did before. Worries about the look of a replanted part and how it will work are common. Talking about these feelings with your doctor often helps you come to terms with the outcome of the replantation. Your doctor may also ask a counselor to assist with this process. You may find it helpful to talk with someone about it, and work through your feelings so you can move on with your life.

Complete healing of the injury and surgical wounds is only the beginning of a long process of rehabilitation. Therapy and temporary bracing are important to the recovery process. From the beginning, braces are used to protect the newly repaired tendons but allow the patient to move the replanted part. Therapy with limited motion helps keep joints from getting stiff, helps keep muscles mobile, and helps keep scar tissue to a minimum. Even after you have recovered, you may find that you cannot do everything you wish to do. Tailor-made devices may help many patients do special activities or hobbies. Talk to your physician or therapist to find out more about such devices. Many replant patients are able to return to the jobs they held before the injury. When this is not possible, patients can seek assistance in selecting a new type of work.

The patient has the most important role in the recovery process. Smoking causes poor circulation and may cause loss of blood flow to the replanted part. Allowing the replanted part to hang below heart level may also cause poor circulation. Younger patients have a better chance of their nerves growing back; they may regain more feeling, and may regain more movement in the replanted part. Generally, the further down the arm the injury occurs, the better the return of use of the replanted part to the patient. Patients who have not injured a joint will get more movement back than those with a joint injury. A cleanly cut part usually works better after replantation than one that has been crushed or pulled off. Recovery of use depends on re-growth of two types of nerves: sensory nerves that let you feel, and motor nerves that tell your muscles to move. Nerves grow about an inch per month. The number of inches from the injury to the tip of a finger gives the minimum number of months after which the patient may be able to feel something with that fingertip. The replanted part never regains 100% of its original use, and most doctors consider 60% to 80% of use an excellent result. Cold weather may be uncomfortable and provide reason for frequent complaint even for those with excellent recovery.

There are a number of steps in the replantation process. First, damaged tissue is carefully removed. Then bone ends are shortened and rejoined with pins or plates. This holds the part in place to allow the rest of the tissues to be restored to a normal position.  Muscles, tendons, arteries, nerves and veins are then repaired.

   “Replantation” refers to the surgical reattachment of a finger, hand, or arm that has been completely cut from a person’s body.The goal of replantation surgery is to give the patient back as much use of the injured area as possible. In some cases, replantation is not possible because the part is too damaged. If the lost part cannot be reattached, a patient may have to use a prosthesis (a device that substitutes for a missing part of the body). In many cases, a prosthesis may give a person without hands or arms the ability to function better than they would without the prosthesis.

   Replantation is usually recommended when the replanted part will work at least as well as a prosthesis. Generally, a missing hand or finger would not be replanted knowing that it would not work, be painful, or get in the way of everyday life. Before surgery the doctor, if possible, will explain the procedure and how much use is likely to return following replantation. The patient or family member must decide whether that amount of use justifies the long and difficult operation, time in the hospital, and months or years of rehabilitation.

The patient must do several things to keep up muscle activity and prevent the joints from getting stiff. Your doctor may recommend therapy to keep joints flexible. If the joints become stiff, they will not work even after muscles begin to work again. When a sensory nerve has been injured, the patient must be extra careful not to burn or cut fingers since there is no feeling in the affected area. After the nerve has recovered, the brain gets lazy and a procedure called sensory re-education may be needed to improve feeling in the hand or finger. Your doctor will recommend the appropriate therapy based on the nature of your injury.

Factors that may affect results after brachial plexus injury include age and the type, severity,time from and location of the injury. Though brachial plexus injuries may result in lasting problems for the patient, care by a physician and proper therapy can maximize function.

To fix a cut nerve, the insulation around both ends of the nerve is sewn together. A nerve in a finger is only as thick as a piece of thin spaghetti, so the stitches have to be very tiny and thin. The repair may need to be protected with a splint for the first 3 weeks to protect it from stretching apart since it is so delicate. The goal in fixing the nerve is to repair the outer cover so that nerve fibers can grow down the empty tubes to the muscles and sensory receptors and work again. The surgeon tries to line up the ends of the nerve repair so that the fibers and empty tubes match up with each other as best as possible, but with millions of fibers in the nerve, not all of the original connections are likely to be re-established. If a wound is dirty or crushed, your physician may wait to fix the nerve until the skin has healed. If there is a gap between the ends of the nerve, the doctor may need to take a piece of nerve (nerve graft) from another part of the body to fix the injured nerve. This may cause permanent loss of feeling in the area where the nerve graft was taken. Smaller gaps can sometimes be bridged with “conduits” made from a vein or special cylinder.

Once the nerve cover is fixed, the nerve fibers generally begin to start growing across the repair site after three or four weeks. The nerve fibers then usually grow down the empty nerve tubes up to one inch every month, depending on the patient’s age and other factors. This means that with an injury to a nerve in the arm 11 or 12 inches above the fingertips, it may take as long as a year before feeling returns to the fingertips. The feeling of pins and needles in the fingertips is common during the recovery process. While this can be uncomfortable, it usually passes and is a sign of recovery.

  Nerves are fragile and can be damaged by pressure, stretching, or cutting. Pressure or stretching injuries can cause the fibers carrying the information to break and stop the nerve from working, without disrupting the insulating cover. When a nerve is cut, both the nerve and the insulation are broken. Injury to a nerve can stop the transmission of signals to and from the brain, preventing muscles from working and causing loss of feeling in the area supplied by that nerve.

  When nerve fibers are broken, the end of the fiber farthest from the brain dies, while the insulation stays intact, leaving empty tubes which used to carry the nerve fibers. The end that is closest to the brain does not die, and after some time may begin to heal. If the insulation was not cut, the nerve fibers may grow down the empty tubes until reaching a muscle or sensory receptor. If both the nerve and insulation have been cut and the nerve is not fixed, the growing nerve fibers may grow into a ball at the end of the cut, forming a nerve scar called a ‘neuroma’. A neuroma can be painful and cause an electrical feeling when touched.

Nerves are the “telephone/electrical wiring” system that carries messages from the brain to the rest of the body & vice-versa. A nerve is like a telephone cable wrapped in insulation. An outer layer of tissue forms a cover to protect the nerve, just like the insulation surrounding a telephone cable. A nerve contains millions of individual fibers grouped in bundles within the “insulated cable.”

Nerves serve as the “wires” of the body that carry information to and from the brain. Motor nerves carry messages from the brain to muscles to make the body move. Sensory nerves carry messages to the brain from different parts of the body to signal pain, pressure, and temperature. While the individual axon (nerve fiber) carries only one type of message, either motor or sensory, most nerves in the body are made up of both.

Many result from crush injuries after getting the fingertip caught in a door. Any type of pinching, crushing, or sharp cut to the fingertip may result in injury to the nail bed.

Injuries to the nail are often associated with damage to other structures that are in the same location. These include fractures of the bone (distal phalanx), and/or cuts of the nailbed, fingertip skin (pulp), tendons that straighten or bend the fingertip, and nerve endings.

Perfect alignment of the bone on x-ray is not always necessary to get good function. A bony lump may appear at the fracture site as the bone heals and is known as a “fracture callus.” This functions as a “spot weld.” This is a normal healing process and the lump usually gets smaller over time. Problems with fracture healing include stiffness, shift in position, infection, slow healing, or complete failure to heal. Smoking has been shown to slow fracture healing. Fractures in children occasionally affect future growth of that bone. You can lessen the chances of complication by carefully following your hand surgeon’s advice during the healing process and before returning to work or sports activities. A hand therapy program with splints and exercises may be recommended by your physician to speed and improve the recovery process.

Medical evaluation and x-rays are usually needed so that your doctor can tell if there is a fracture and to help determine the treatment. Depending upon the type of fracture, your hand surgeon may recommend one of several treatment methods.

A splint or cast may be used to treat a fracture that is not displaced, or to protect a fracture that has been set. Some displaced fractures may need to be set and then held in place with wires or pins without making an incision. This is called closed reduction and internal fixation.

Other fractures may need surgery to set the bone (open reduction). Once the bone fragments are set, they are held together with pins, plates, or screws. Fractures that disrupt the joint surface (articular fractures) usually need to be set more precisely to restore the joint surface as smooth as possible. On occasion, bone may be missing or be so severely crushed that it cannot be repaired. In such cases, a bone graft may be necessary. In this procedure, bone is taken from another part of the body to help provide more stability.

Fractures that have been set may be held in place by an “external fixator,” a set of metal bars outside the body attached to pins which are placed in the bone above and below the fracture site, in effect keeping it in traction until the bone heals.

Once the fracture has enough stability, motion exercises may be started to try to avoid stiffness. Your hand surgeon may determine when the fracture is sufficiently stable.

Fractures often take place in the hand. A fracture may cause pain, stiffness, and loss of movement. Some fractures will cause an obvious deformity, such as a crooked finger, but many fractures do not. Because of the close relationship of bones to ligaments and tendons, the hand may be stiff and weak after the fracture heals. Fractures that involve joint surfaces may lead to early arthritis in those involved joints.

The hand is made up of many bones that form its supporting framework. This frame acts as a point of attachment for the muscles that make the wrist and fingers move. A fracture occurs when enough force is applied to a bone to break it. When this happens, there is pain, swelling, and decreased use of the injured part. Many people think that a fracture is different from a break, but they are the same. Fractures may be simple with the bone pieces aligned and stable. Other fractures are unstable and the bone fragments tend to displace or shift. Some fractures occur in the shaft (main body) of the bone, others break the joint surface. Comminuted fractures (bone is shattered into many pieces) usually occur from a high energy force and are often unstable. An open (compound) fracture occurs when a bone fragment breaks through the skin. There is some risk of infection with compound fractures.

All babies born with congenital hand differences should be evaluated by a hand specialist to make an individual assessment of the type. Depending on the type of congenital hand difference, treatment may be recommended. For example, webbed fingers are surgically separated. Extra digits can be surgically removed with reconstruction of the remaining digit if necessary. Hand function can be improved if the functions of thumb pinch or finger grasp is compromised. Some congenital hand differences may need therapy to help improve hand function. In some cases, no intervention is necessary.

Immediately after the birth of a child with a a congenital abnormality, the patents may feel shock, anger and guilt. These are normal emotions. All the dreams of a perfect baby did not take place. Each family member must cope with their feelings. Rarely is there anything parents or doctors could have done differently.

Your newborn doesn’t realize that he or she is different. The baby has all the normal needs of any newborn. The way the baby has formed is normal for him or her, without pain and without a sense of loss. Talk to your physician about support groups or professional help.

Because there are so many different congenital hand differences, it is important that your child be evaluated by a hand surgery specialist to help determine if any treatment is needed. Some congenital hand differences are associated with genetic disorders or other medical problems. Your hand specialist may request further genetic evaluation by a geneticist, or may request further medical testing by your pediatrician or family physician.

The most common congenital hand difference in the Caucasian population is webbed fingers (syndactyly).The most common congenital hand difference in the dark skinned population is an extra, sixth digit on the little finger side (post-axial polydactyly).The most common congenital hand difference in the Asian population is an extra thumb (thumb polydactyly).

The upper limb is formed between four and eight weeks after the sperm and egg unite to form an embryo. The embryo develops an arm bud at four weeks. The tip of the arm bud sends messages to each cell as the upper limb forms. Thousands & thousands of steps are followed to form a normal arm. Failure of any of these steps to occur can result in a congenital hand difference. Research continues into further understanding of this embryonic process. Some congenital hand differences may occur due to a genetic cause. Many congenital hand differences just occur without an apparent cause.

Babies born with hands that are different than the normal hand have a congenital hand difference.

Usually the cause is unknown. Pressure on the nerve can happen in several ways: swelling of the lining of the flexor tendons, called tenosynovitis; joint dislocations, fractures, and arthritis can narrow the tunnel; and keeping the wrist bent for long periods of time. Fluid retention during pregnancy can cause swelling in the tunnel and symptoms of carpal tunnel syndrome, which often go away after delivery. Thyroid conditions, rheumatoid arthritis, and diabetes also can be associated with carpal tunnel syndrome. There may be a combination of causes.

There may not be an association between CTS & computer usage, as was thought, as there is insufficient evidence to support it.

Carpal tunnel syndrome (CTS) is a condition brought on by increased pressure on the median nerve at the wrist. In effect, it is a pinched nerve at the wrist. Symptoms may include numbness, tingling, and pain in the arm, hand, and fingers. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand.Carpal tunnel syndrome happens when pressure builds up from swelling in this tunnel and puts pressure on the nerve. When the pressure from the swelling becomes great enough to disturb the way the nerve works, numbness, tingling, and pain may be felt in the hand and fingers.

The network of nerves is fragile and can be damaged by pressure, stretching, or cutting. Stretching can occur when the head and neck are forced away from the shoulder, such as might happen in a fall off a motorcycle. If severe enough, the nerves can actually avulse, or tear out of, their roots in the neck. Pressure could occur from crushing of the brachial plexus between the collarbone and first rib, or swelling in this area from injured muscles or other structures.

Injury to a nerve can stop signals to and from the brain, preventing the muscles of the arm and hand from working properly, and causing loss of feeling in the area supplied by the injured nerve. When a nerve is cut, both the nerve and the insulation are broken. Pressure or stretching injuries can cause the fibers that carry the information to break and stop the nerve from working, without damaging the cover.

When nerve fibers are cut, the end of the fiber farthest from the brain dies, while the insulation stays healthy. The end that is closest to the brain does not die, and after some time may begin to heal. If the insulation was not cut, new fibers may grow down the empty cover of the tissue until reaching a muscle or sensory receptor.

Some brachial plexus injuries are minor and will completely recover in several weeks. Other injuries are severe enough that some permanent disability involving the arm can be expected.

The brachial plexus is a network of nerves that originate near the neck and shoulder. These nerves begin at the spinal cord in the neck and control the hand, wrist, elbow, and shoulder. Nerves are the electrical wiring system in all people that carry messages from the brain to the rest of the body. A nerve is like an electrical cable wrapped in insulation.

Motor nerves carry messages from the brain to muscles to make the body move. Sensory nerves carry messages to the brain from different parts of the body to signal pain, pressure, and temperature. The brachial plexus has nerves that are both motor and sensory.

Your doctor will examine you and determine whether you have similar symptoms in other joints and assess the impact of the arthritis on your life and activities. The clinical appearance of the hands and fingers helps to diagnose the type of arthritis. X-rays will also show certain characteristics of osteoarthritis, such as narrowing of the joint space, the formation of bony outgrowths (osteophytes or “nodes”), and the development of dense, hard areas of bone along the joint margins.

Arthritis literally means “inflamed joint.” Normally a joint consists of two smooth, cartilage-covered bone surfaces that fit together as a matched set and that move smoothly against one other. Arthritis results when these smooth surfaces become irregular and don’t fit together well anymore and essentially “wear out.” Arthritis can affect any joint in the body, but it is most noticeable when it affects the hands and fingers. Each hand has 19 bones, plus 8 small bones and the two forearm bones that form the wrist. Arthritis of the hand can be both painful and disabling. The most common forms of arthritis in the hand are osteoarthritis, post-traumatic arthritis (after an injury), and rheumatoid arthritis. Other causes of arthritis of the hand are infection, gout, and psoriasis.

The loss of a body part, especially one as visible as a finger or hand, can be emotionally upsetting. It may take time to adapt to changes in your appearance and ability to function. Talking about these feelings with your doctor or other patients who have had amputations often helps you come to terms with your amputation. You may ask your doctor to recommend a counselor to assist with this process. It is important to remember that with time, you will adapt to your situation by finding new ways of doing your daily activities.

Remember that the quality of life is directly related to your attitude and expectations – not just obtaining and using a prosthesis

Prosthesis is fabricated from an impression cast taken from the residual finger or limb and the corresponding part on the undamaged hand. Through this process, an exact match to the details of the entire hand can be achieved. The prosthetic finger or hand is fabricated out of a flexible, transparent silicone rubber. Colors dispersed in the silicone are carefully matched to the individual’s skin tones, which give the prosthesis the life-like look and texture of real skin. The finger or hand is usually held on by suction. The flexibility of the silicone permits good range of motion of the remaining body parts. Fingernails can be individually colored before applying them to the fingers so they can be matched almost perfectly. The nails can be polished with any nail polish and the polish can be removed with a gentle-action nail polish remover. Silicones are resistant to staining. Inks wash off easily with alcohol or soap and warm water. With proper care a silicone prosthesis may last 3-5 years. Creation of your prosthesis usually begins three months after you are completely healed from surgery. This waiting period allows time for swelling to subside and for the remainder of your hand to take its final shape. You may need therapy to learn to use your new prosthesis.

The type of prosthesis depends on the location and length of your residual finger or hand and your functional and lifestyle needs. The prosthesis replaces some of the function and the appearance of the missing body part. It is important to communicate to your doctor and prosthetist the activities you feel are most important so that an appropriate prosthesis can be provided for you. Prostheses can restore length to a partially amputated finger, enable opposition between the thumb and a finger, or in the case of a prosthetic hand, stabilize and hold objects with bendable fingers. If your hand is amputated through or above the wrist you may be given a full arm prosthesis with an electric or mechanical hand. Some patients may decide not to use a prosthesis.

For the first couple of weeks, you should expect some pain, which is controlled with pain medications. While you are healing, your doctor will tell you how to bandage and care for the surgical site and when to return to the office for follow-up care. You may be given exercises to build your strength and range of motion. You may be asked to touch and move your skin to desensitize it and to keep it mobile.

When an amputation is necessary, the surgeon removes the injured body part and prepares the remaining part for future prosthetic use. This means careful treatment of the skin, muscles, tendons, bones and nerves, so that a prosthesis can be worn with comfort. The surgeon decides the length of the remaining body part based on medical and prosthetic factors.

Amputation is the complete removal of an injured or deformed body part. An amputation may be the result of a traumatic injury or may be the result of a planned operation where the finger must be removed. Some traumatically amputated fingers may be replanted or reattached, but in some cases, reattachment of the amputated finger is not possible or advisable. Conditions, such as a tumor, may require that a finger be surgically amputated to preserve a person’s health.

The hand is a unique area of the human body that is made up of bone, joints, ligaments, tendons, muscles, nerves, skin, and blood vessels. These elements must all be in good working order for the hand to function well. The relationship between all these structures is delicate and refined. An injury or disease can affect any or all of these structures and impair the use of the hand.

A qualified hand surgeon is trained to diagnose and treat all problems related to these different structures in the hand, wrist, and forearm.

Hand surgeons have received specialized additional training in the treatment of hand problems in addition to specialty training in orthopaedic surgery, plastic surgery, or general surgery.

Many hand surgeons also have expertise with problems of the elbow, arm, and shoulder. Some hand surgeons treat only children, some treat only adults, and some treat both. Common problems treated include carpal tunnel syndrome, tennis elbow, wrist pain, sports injuries of the hand and wrist, fractures of the hand, wrist, and forearm, and trigger fingers. Other problems treated by hand surgeons include arthritis, nerve and tendon injuries, and congenital limb differences (birth defects).

Not all problems treated by a hand surgeon need surgery. Hand surgeons often recommend non-surgical treatments, such as medication, splints, therapy, and injections. Hand surgeons are specialists devoted to hand care.

If you have pain in your fingers, hand, wrist or arm, or have other upper-extremity related concerns, you may want to consult a hand surgeon.