Risks and side effects

Some medical conditions that affect your hands may hinder your ability to perform daily activities, which can have a negative impact on your quality of life. Hand reconstruction surgery may help restore your hand’s functionality, strength, and appearance.

Reconstructive surgery of your hand is a procedure to repair damaged bones, joints, tendons, nerves, or tissues to improve your hand’s functionality, strength, and appearance.

Keep reading to learn more about hand reconstruction surgery, including the purpose, types, procedure, and effectiveness.

The purpose of hand reconstruction surgery is to restore normal function to your fingers and hand so you’re able to perform daily activities.

Hand reconstruction surgery may also alleviate pain and improve your hand’s appearance, which has psychological benefits.

Hand surgery was among the five most common reconstructive surgeries in 2023. Surgeons performed more than 207,800 hand reconstruction surgeries that year.

Doctors may recommend hand reconstruction surgery to treat conditions such as:

bone fractures
tendon disorders like trigger finger
joint osteoarthritis
Dupuytren’s contracture, a disorder that may cause your fingers to become stuck in an atypical position
congenital anomalies like an extra finger or thumb (polydactyly)
an injury that causes detachment of a finger or your hand

There are several types of hand reconstruction surgery. These include:

Microvascular surgery: For complex reconstructions, a surgeon uses a special microscope and very small needles to repair nerves and blood vessels.
Nerve reconstruction: This procedure repairs severed or injured nerves so you regain sensation and motor function.
Tendon repair: Tendon repair corrects damaged tendons to allow movement.
Joint replacement: This replaces or reconstructs damaged joints to relieve pain and increase mobility.
Soft tissue reconstruction: This uses skin grafts or flaps from another part of your body or a donor to repair wounds like burn injuries. Unlike grafts, flaps remain connected to a blood vessel.
Polydactyly correction: This procedure removes extra fingers or thumbs.
Fixation: This procedure repairs broken bones or joints to correct their alignment.
Fasciotomy: A fasciotomy treats Dupuytren’s contracture by removing fascia tissue in the palm of your hand.
Replantation: This procedure rejoins a severed finger or hand.
Osteotomy: This procedure involves removing or fusing bones together to correct bone deformities.

The side effects and risks of hand reconstruction surgery may include:

infection at the surgical site
bleeding or blood clots
loss of movement or feeling in your hand
incomplete healing
damage to structures like nerves or blood vessels that may be permanent

The success rate of hand reconstruction surgery depends on the procedure. For example:

A 2023 German study of 28 surgeries to remove an extra thumb (radial polydactyly) reported an 88% success rate.
A 2023 study found that 92% of 218 people in Switzerland who had flexor tendon repair surgery regained good to excellent motion after 1 year.
Researchers of a 2019 review reported that open trigger finger release surgery had a 99% success rate.
Surgery for Dupuytren’s contracture had a 66.6% success rate for 19 people in Turkey, according to a small 2017 study.

However, researchers in a 2024 study wrote that while many routine hand surgeries are deemed “highly successful,” few studies have examined how satisfied people are after the surgeries.

The study found that 52% to 88% of 1,905 people in the United States who had hand surgeries for conditions like carpal tunnel or trigger finger would repeat the surgery.

While this could indicate that the surgeries were successful, the researchers noted that the percentages should be higher.

The specific procedure for hand reconstruction surgery depends on the type of surgery. In general, most procedures follow this path:

Before

You will either be given a local anesthetic to numb your hand or general anesthesia so you sleep through the surgery.

During

A surgeon makes an incision in your hand. Depending on the type of surgery, they will reconstruct your hand using various techniques, including:

attaching a skin graft
realigning broken bones with wires
reconnecting severed nerves or tendons
fixing fractures with plates or screws
repairing injured blood vessels
sewing tendons together

After

The surgeon will close the incision with sutures that are either removable or nonremovable. A healthcare professional may fit a plaster splint to your hand to prevent you from moving it.

To help reduce swelling, a doctor may advise you to keep your hand elevated above the level of your heart.

The surgeon may prescribe medications to help relieve pain and prevent infection.

You may prepare for hand reconstruction surgery by taking the following steps:

Avoid taking herbal supplements and anti-inflammatory medications like aspirin, since they could cause bleeding.
If you smoke, stop smoking a few weeks before your surgery.
Arrange for someone to drive you home and stay with you for the first night or longer.

You may need to wear a plastic hand splint for up to 6 weeks. For the 2 weeks after that, you’ll only wear it overnight.

To help restore your hand’s functionality after reconstruction surgery, you will usually receive physical therapy. A therapist will show you exercises that will help increase your hand’s strength and flexibility.

How long does it take to recover from hand reconstruction surgery?

The recovery time after hand reconstruction surgery depends on the type of surgery.

For microsurgery procedures, it may take a year to fully recover your hand’s function.

Following hand tendon repair, it may take about 12 weeks for your tendon to regain strength and up to 6 months before a full range of movement returns. You may be able to resume light activities like typing after 6 to 8 weeks and activities like heavy lifting after 10 to 12 weeks.

You will need to work with a physical therapist who focuses on hand injuries.

To avoid injuries, you should get approval from your medical team before returning to your previous activities.

In some cases, such as reconstruction surgery for a traumatic injury, your hand may not regain complete function.

Although surgery may provide the best outcome, some nonsurgical treatments may help restore your hand’s function, especially if you have a mild condition.

Some alternative treatments that may alleviate pain and improve movement in your hand include:

The cost of hand reconstruction surgery varies depending on the complexity of the procedure and other factors, such as where you have the procedure done and the experience of your surgeon.

According to a 2022 study, the costs for various outpatient hand surgery procedures in the United States in 2016 ranged from $2,325 to $3,733.

Reconstructive surgery may be covered by health insurance plans. To receive coverage, many insurance companies require pre-certification, so it’s a good idea to contact your provider before your surgery.

Depending on the procedure, hand reconstruction surgery may be performed on an outpatient basis. After surgery, it may take several months to fully regain function of your hand.

Speak with a doctor to determine whether hand reconstruction surgery is right for you.

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Overview of Hand Reconstruction Surgery