What Is Amputation?

The first question you may ask yourself is, what is amputation? Either due to traumatic injury or surgical operation, amputation is the removal of a hurt or deformed body part. An amputation of the finger or hand will result in the complete loss of the appendage.

Amputated fingers can sometimes be reattached depending on the severity of the injury and how quickly the patient can receive surgical care. In many cases, however, this is not an option. Often, amputation is the answer to a more threatening condition. For example, a patient with a tumor on their finger may undergo amputation if the tumor is malignant.

How Is an Amputation Performed?

During surgery, the doctor must safely remove the injured body part while prepping the amputation site for future prosthetics. The skin, muscles, bones, and nerves must be treated very carefully to ensure the patient will be comfortable when the time comes for prosthetics. The doctor will determine the length of the remaining body part based on medical and prosthetic factors.

What Can You Expect After Surgery?

In the first couple of weeks following surgery, patients will experience some pain and discomfort. Pain can be managed with medications prescribed by the physician. The doctor also teaches patients how to care for and bandage the surgical site.

After surgery, most patients are prescribed rehabilitation exercises to build strength and increase the range of motion. Touching and moving the skin will help to mobilize and desensitize the area.

Finger and Hand Prosthetics

In today’s times, patients are fortunate enough to be eligible for prosthetics. Prosthetics increase functionality by restoring length to a partially amputated finger or hand. Increasing the length of the finger allows patients to hold objects between the thumb and affected finger again. An electric or mechanical hand prosthetic might be given to a patient who has experienced a hand amputation above the wrist.

What Type of Prosthesis Will You Get?

The type of hand or finger prosthesis you will use depends on the location and length of your residual finger or hand. The doctor will also take your lifestyle needs into consideration. It’s important to communicate with your doctor and prosthetist to let them know which activities are most important. You may also choose not to use a prosthetic.

What Is Dupuytren’s Disease?

Dupuytren’s disease, also called Viking’s disease, is an abnormal thickening of the fascia (the tissue just beneath the skin of the palm).

It often starts with firm lumps in the palm, with some patients developing firm cords beneath the skin that stretch from the palm into the fingers. Gradually, these cords may cause the fingers to bend into the palm.

Although the skin may become involved in the process, deeper structures such as the tendons are not. Occasionally, the disease will cause thickening on top of the finger knuckles (knuckle pads) or nodules or cords within the soles of the feet (plantar fibromatosis).

What Causes Dupuytren’s Disease?

The cause is unknown but may be associated with certain biochemical factors within the involved fascia. Dupuytren’s disease is more common in men over age 40 and in people of northern European descent. There is no evidence that hand injuries or specific occupational exposures lead to a higher risk of developing Dupuytren’s disease.

Signs and Symptoms

Symptoms usually include a small lump or series of lumps and pits within the palm. The lumps are generally firm and adherent to the skin.

A cord may develop gradually, which will extend from the palm into one or more fingers (the ring and little fingers are most commonly affected). Although the cords may be mistaken for tendons, they actually lie between the skin and tendons. In many cases, both hands are affected, although the degree of involvement may vary.

While the initial nodules may produce discomfort, Dupuytren’s disease is not typically painful.

You may first notice it due to difficulty placing your hand flat on an even surface. As your fingers are drawn into the palm, you may notice increasing difficulty with activities such as washing, wearing gloves, shaking hands, and putting hands into pockets.

The progression of the disease is unpredictable. Some individuals will have only small lumps or cords, while others will develop severely bent fingers. More severe disease often occurs with an earlier age of onset.

Treatment for Dupuytren’s Disease

In some cases, our doctors may simply observe the nodules and cords that contracted.

If you have more advanced contractures, you may require surgery to improve function. There are various surgical techniques that can correct finger position. The doctor will discuss which method is most appropriate for you based on the stage of the disease and joints involved.

Surgery should help improve finger position, and thereby hand function. Even after surgery, the disease may reoccur, and the fingers may begin to bend into the palm once again.

Schedule an Appointment

Call South Florida Hand and Orthopaedic Center at (561) 241-4758 to make an appointment with one of our doctors.
Let me know if there are any further changes you need!

Bites Can Be Dangerous

Whether they are by animal or human, bites are extremely painful and can be quite dangerous. If not properly treated and cared for, animal and human bites can lead to infection. It is important to recognize signs and symptoms of infection and seek treatment right away.

Factors That Contribute to Infection

• Type and location of the wound
• Pre-existing health conditions that impair immunity (diabetes, HIV, etc.)
• Extent of delay before treatment
• Presence of a foreign body in the wound
• Animal causing the bite

Animal Bites

Infection is a major concern with animal bites. In the U.S. alone, about 1% of dog bites and 6% of cat bites end in hospitalization. Because cat bites often result in deep puncture wounds that quickly heal over, drainage can become blocked resulting in infection. With proper care and treatment, most animal bite patients completely recover.

Although rabies in domesticated pets is very rare these days, it is an extremely fatal infection that spreads amongst animals in the wild. Your risk of coming in contact with a wild animal infected with rabies is fairly low in the United States. However, if you are bitten by a wild animal, report it immediately to your public health department. The department of public health often needs your assistance locating the animal so they can confine it and test for rabies.

Seek Emergency Treatment if You Experience Any of the Following Symptoms

• Swelling, redness, warmth, or continued pain beyond 24 hours
• Pus draining from the bite wound
• Red streaks extending up the arm or forearm
• Swollen lymph nodes (“glands”) around the elbow or in the armpit
• Loss of mobility
• Loss of sensation in the hand or fingertip
• Fever, malaise, night sweats, or rigors

Animal Bite Examination

The doctor will examine the wound and ask you about the injury. He will need a complete history of the bite, which includes:

• Type of animal and its status (general health, rabies vaccine, behavior, etc.)
• Time and location of the event
• Circumstances of the bite
• Whereabouts of the animal
• Pre-hospital treatment

If you have not had a booster tetanus shot within the past 10 years, it’s crucial to update your status.

Because tooth fragments can break off in the skin and bone, the doctor may take an X-ray of the site and check for further damage to the bones and joints. Patients who leave infection untreated for too long may experience osteomyelitis. Osteomyelitis is the spread of the infection to the bone and can also be observed through X-ray.

Red streaks on the forearm can predict lymphangitis or inflammation of the lymphatic channels. The doctor will look for signs of these red streaks and also look for enlarged lymph nodes on the inner side of the elbow.

If the wound proves to be infected, the next step will be to identify the type of bacteria that is causing the infection. It is necessary to know what is causing the infection in order to properly prescribe the most effective antibiotic and treatment.

Animal Bite Treatment

A common bite site for animals is the hands. These bites require careful cleansing and treatment. The doctor will wash the wound and possibly trim away any dead tissue or damaged skin that could be a source of infection.

The antibiotic you are prescribed depends on:

• Circumstances of the injury
• Your health
• Your sensitivity to medications
• Appearance of the wound

While some animal bites can be treated with oral medications, others might require the patient to receive antibiotics via IV.

It is vital patients follow up on a regular basis with the physician until they are cleared of infection in order to fully recover.

Human Bites

Human mouths contain high amounts of bacteria, making infection very probable if your human bite is not treated properly. Early treatment is essential in order to avoid complications and prevent the infection from quickly spreading.

Sometimes human bites are not an obvious bite. For example, during a fistfight, a person’s fist might be driven into another person’s mouth. If the skin is broken, bacteria can settle into the soft tissue. If left untreated, the infection can essentially destroy the knuckle joint. Complications such as this are easily avoidable with early diagnosis, antibiotics, and if needed, additional treatment such as surgery.

Schedule an Appointment

If you recently sustained a bite, don’t wait to make an appointment with South Florida Hand and Orthopaedic Center. Call (561) 241-4758 today.