# Trauma Surgery (Reconstructive Surgery) > Comprehensive surgical treatment for hand injuries including tendon, nerve, and fracture repair - Canonical page: https://doctormaresky.co.za/procedure/trauma-surgery - Category: [Hand Surgery](https://doctormaresky.co.za/procedure-category/hand-surgery) - Procedure directory: https://doctormaresky.co.za/procedures.md - Medical disclaimer: https://doctormaresky.co.za/medical-disclaimer ## Overview The hand consists of **27 bones** and hundreds of nerves, arteries, veins, muscles, tendons and joints. This intricate design and function mean that any injury, especially trauma injuries, to the underlying structure could lead to a potentially devastating handicap. **Dr Maresky** specializes in emergency hand trauma surgery, providing assessment and surgical care aimed at function, comfort, and recovery. ## The procedure Due to the range of potential injuries to the hand, a trauma surgery could require anything from a few simple stitches to a complete skin graft or microsurgical reconstruction. During the initial assessment, the surgeon will evaluate the extent of damage to bones, tendons, nerves, blood vessels, and soft tissues. Treatment may involve fracture fixation, tendon repair, nerve grafting, vascular reconstruction, or complex tissue reconstruction using advanced microsurgical techniques. ## Candidate information - **Description:** Hand trauma surgery is indicated for patients who have sustained acute injuries to the hand requiring immediate surgical intervention. **Candidates include:** ### Criteria - Patients with acute hand injuries from accidents, machinery, or sports - Those with deep lacerations involving tendons, nerves, or blood vessels - Patients with hand fractures requiring surgical fixation - Individuals with crush injuries or amputations - Those with burns or high-pressure injection injuries - Patients with infections requiring surgical drainage - Anyone requiring emergency hand reconstruction ## Preparation - **Timeline:** **2-4 weeks** before surgery ### Medical tests - **Complete blood count (CBC)** - **ECG if over 40 years old** - **Chest X-ray if indicated** - **COVID-19 test if required** ### Medications #### Medications to discuss stopping - **Stop** aspirin and blood thinners **2 weeks** prior - **Stop** NSAIDs (ibuprofen, naproxen) **1 week** prior - **Stop** herbal supplements (ginkgo, garlic, ginseng) **2 weeks** prior - **Stop** vitamin E supplements **1 week** prior #### Medications to continue - **Continue** essential medications as advised by **Dr Maresky** - **Inform Dr Maresky** of all current medications during consultation ### Lifestyle - **Smoking:** **Quit** smoking at least **4 weeks** before surgery to promote proper healing and reduce complications - **Alcohol:** **Avoid** alcohol **48 hours** before surgery - **Fasting:** No food or drink after midnight the night before surgery (**NPO after midnight**) ### Arrangements - **Arrange** transportation home after surgery - you cannot drive - **Arrange** for a responsible adult to stay with you for the first **24-48 hours** - **Prepare** recovery space at home with comfortable clothing and easy access to essentials - **Stock** up on prescribed medications and recommended supplies - **Arrange** time off work (**1-2 weeks** recommended, varies by procedure) - **Plan** for help with childcare and household tasks during recovery ## Recovery and aftercare The recovery from a trauma surgery will depend entirely on the patient and the nature of the trauma. Some hand injuries can heal within a few weeks while others can take several months to heal completely. Early mobilization and hand therapy are crucial for optimal recovery. Patients typically begin gentle exercises within days of surgery, progressing to more intensive rehabilitation as healing allows. ## Expected results With proper surgical intervention and rehabilitation, most patients can expect significant improvement in hand function and appearance. The goal is to restore maximum function while minimizing pain and disability. Early assessment and appropriate surgical planning can support functional recovery. ## Risks and considerations ### Normal Side Effects - **Description:** Normal side effects following hand trauma surgery include: #### Effects - Swelling and bruising - Pain and discomfort - Stiffness - Temporary numbness ### Other Side Effects - **Description:** Potential complications of hand trauma surgery may include: #### Effects - Infection - Nerve damage or persistent numbness - Tendon adhesions or rupture - Joint stiffness or arthritis - Chronic pain or complex regional pain syndrome - Need for additional surgeries - Incomplete return of function - Scarring and contractures - **Disclaimer:** The specific risks depend on the nature and severity of the injury. All risks will be discussed in detail during your consultation. ## Frequently asked questions ### What types of hand injuries require emergency trauma surgery? Emergency hand trauma surgery is required for severe lacerations involving tendons or nerves, open fractures, crush injuries, amputations, high-pressure injection injuries, severe burns, and any injury with compromised blood supply to the hand or fingers. ### How quickly should I seek treatment for a hand injury? Hand injuries should be evaluated immediately, ideally within **6-8 hours** of injury. Some injuries, particularly those involving nerve or blood vessel damage, require surgery within hours to maximize the chance of successful repair and function recovery. ### Will I regain full function of my hand after trauma surgery? The extent of functional recovery depends on the severity and type of injury, timing of treatment, and your commitment to rehabilitation. While complete restoration isn't always possible, significant improvement in function can usually be achieved with proper surgical care and therapy. ### What should I do immediately after a hand injury? Control bleeding with direct pressure, elevate the hand, apply ice wrapped in cloth, and seek immediate medical attention. For amputated parts, wrap them in moist gauze, place in a plastic bag, and keep cool (not directly on ice). ### How long will I be unable to work after hand trauma surgery? Time off work varies greatly depending on your job and the extent of injury. Office workers may return within days to weeks with modifications, while manual laborers may need several months. **Dr Maresky** will provide specific guidance based on your injury and occupation. ### Will I need hand therapy after surgery? Yes, hand therapy is typically essential for optimal recovery. It helps restore movement, strength, and function while preventing complications like stiffness and adhesions. Therapy usually begins within days of surgery and may continue for several months. ### What are the signs of complications after hand trauma surgery? Contact **Dr Maresky** immediately if you experience increasing pain, swelling, redness, warmth, discharge, fever, numbness, tingling, or inability to move your fingers. These may indicate infection or other complications requiring prompt attention. ### Can hand trauma surgery be performed under local anesthesia? Simple repairs may be performed under local anesthesia, but complex trauma surgery often requires regional blocks or general anesthesia. The choice depends on the extent of injury, expected duration of surgery, and patient factors. ### How much does emergency hand trauma surgery cost? Costs vary significantly based on the complexity of the injury and required procedures. Emergency trauma surgery may be covered by medical aid or insurance. **Dr Maresky's** team will help coordinate with your insurance provider and discuss payment options. ### What makes Dr Maresky qualified for hand trauma surgery? **Dr Maresky** is a specialist plastic and reconstructive surgeon with extensive training in hand surgery and microsurgery. He has experience treating complex hand trauma cases and uses surgical techniques selected for the injury and patient goals. ## Indicative pricing - Estimate: R15,000 to R100,000 ZAR - Cost factor: Highly variable — depends on injury severity and extent - Cost factor: Often covered by medical aid - Detailed cost page: https://doctormaresky.co.za/cost/trauma-surgery - Final pricing is confirmed after an individual consultation. ## Consultation and contact - Consultation: https://doctormaresky.co.za/procedure/general-consultation - Contact: https://doctormaresky.co.za/contact