Goal
Elimination of a benign deviation with occlusion of the place of origination – the result is an aesthetic correction as well as elimination of symptoms of pain (if the patient suffers from the said discomfort).

Surgical technology
The deviation is accessed by cutting the skin just above. After it is eliminated, the place of origination is closed up, with the purpose of significantly reducing the possibility of hygroma reappearing in the same place.

Procedure duration and anesthesia
Depending on the localization (on the back of the hand or palm, i.e. in the fingers region), the procedure is performed under local or regional block anesthesia. The surgery lasts between 20 and 45 minutes.

Recovery
The patient returns to normal activities soon after the procedure. Dressing is performed every second or third day. The sutures are removed after two weeks.

Rare complications
Due to the nature and origin of the deviation, relapses are possible – recurrence of the deviation in the same place.

Goal
Eliminating the discomfort of not being able to extend the finger, pain and restoring the normal functions of the finger.

Surgical technology
With an approximately 15 mm skin incision, in the base region of the affected finger on the palm side, the roof of a smaller canal through which the finger flexor tendons are passing is reached. Then it is cut which enables normal sliding of the tendons, thereby eliminating the mentioned discomforts. 

Procedure duration and anesthesia
The procedure lasts between 10 and 20 minutes in local anesthesia. 

Recovery
Post-surgery, patients can use hands and move their fingers. After dressing and removal of sutures, it is safe to return to everyday activities.

Rare complications
Transitory pain in the surgically treated region during movements.

Goal
Removal of the fibrous modified tissue which causes finger contractions (inability to extend one’s fingers – most often of the ring and little fingers).

Surgical technology
With an incision of the skin in the palm region and the base of the finger, if necessary, with careful preparation, the altered connective tissue is removed which enables normal extension i.e. movement of the affected finger/fingers.

Procedure duration and anesthesia
The surgery lasts from 45 to 90 min and is performed with a regional nerve block of the affected hand.

Recovery
Patients are advised to move the fingers of the operated hand immediately after the surgery. After dressings and after the surgical incision has healed, the patients may use their hand as usual.

Rare complications

Delayed wound healing, incomplete correction of the finger contracture (complication occurring if the disease has been present for a longer period of time).

Goal
Relieving the ulnar nerve from the structures that lead to its compression, and thus removing i.e. alleviating the discomforts in the form of tingling, pain and muscle weakness.

Surgical technology
By cutting the skin on the inside of the wrist i.e. the inside of the elbow, the soft tissues are accessed and the structures that press the said nerve are cut (in case of compression in the wrist region) or the nerve is moved to a more adequate bed (in case of compression in the canal in the elbow joint region).

Procedure duration and anesthesia
The intervention lasts between 45 and 60 min and is performed with a regional nerve block of the affected hand nerves.

Recovery
After the surgery, there is gradual improvement. Dressing the surgical incision wound is recommended every second day. The sutures are removed after 14 days – after which it is sometimes necessary for the patient’s recovery to be improved with physical therapy treatments.

Rare complications
Transitory pain, incomplete nerve decompression, and persistent symptoms.

Goal
Removing the tumour within the hand bones (originating from cartilage cells) and pathohistological review.

Surgical technology
The affected bone is reached by means of a small incision, then perforated. Content of the deviation is emptied with a small instrument (the material is sent for histopathological verification). Afterwards the defect is filled by artificial bone, thus strengthening the bone itself.

Procedure duration and anesthesia
The surgery lasts between 30 and 45 min, it is performed in local anesthesia or regional nerve block of the affected extremity.

Recovery
Depending on the enchondroma’s size, a protective gypsum splint can be worn, which ensures safer bone healing. After approximately one month, the patient can start gradually using the hand as usual.

Rare complications
Fracture of the affected bone, remnants of parts of the deviation, swelling and pain.

Goal
Reconstructive treatment of painful and non-functional thumb joint, elimination of symptoms and improvement of finger function as well as that of the whole hand.

Surgical technology
The joint is accessed by a skin incision in the wrist region. The altered and damaged cartilage is removed together with the bone, the ligamentous apparatus is reconstructed, which contributes to the stability of the finger during movements.

Procedure duration and anesthesia
Intervention lasts between an hour and a half and two hours, and is performed under regional anesthesia of the affected extremity.

Recovery
Dressing is recommended every second day, and the sutures are removed after 14 days. Osteofixation material is removed during the sixth week from surgery (the joint is stabilized during the operation with the so-called Kirschner stainless steel needles – thereby enabling unhindered healing of deep tissues). Recovery lasts several months – during this period, physical therapy treatments are added to the treatment to improve hand function.

Rare complications
Persistent pain, decreased motion amplitude, muscle weakness – symptoms that subside over time and with the aid of physical therapy.

Goal
Surgical treatment is the only thing that leads to permanent elimination of the symptoms in the form of persistent pain that intensifies with thumb movements, or the consequent inability to use the affected finger.

Surgical technology
An incision of the skin in the wrist region and the end part of the forearm identifies a narrow tendon canal whose roof is cut – which enables normal sliding of the tendons ensuring movements of the thumb.

Procedure duration and anesthesia
The surgery lasts between 20 and 30 minutes and is usually performed under local anesthesia.

Recovery
Thumb movements are favoured if the patient does not feel intense pain. The wound from surgical incision is dressed every second day, the sutures are removed 14 days after the intervention. If the symptoms have been long-term, the patient is referred to physical therapy to improve the range of motion and strengthen the musculature.

Rare complications
Pain after thumb movements during recovery.

Goal
Reconstruction of the attachment of the tendon of the finger extensor – the injury of this structure leads to the indicated deformity which results in inability to extend the finger in the distal interphalangeal joint – causing the mallet finger.

Surgical technology
The technology consists of two steps – the first is to cut the scar tissue of the tendon in the back of the hand area of the mentioned joint, after which the healthy ends of the tendon are sutured. The joint is then fixed with a "Kirschner" needle, which enables unhindered healing of the extensor tendon and a better result.

Procedure duration and anesthesia
The intervention lasts about 30 minutes and is performed under nerve block of the injured finger.

Recovery
The steel needle performs the function of joint fixation for 6 weeks (optimal period of tendon healing) – then it is removed and the patient is referred to physical therapy.

Rare complications
Incomplete healing of the tendon with a smaller delay of the finger extension in the distal interphalangeal joint.

Goal
Correction of congenital deformities – polydactyly (excess finger/fingers), syndactyly (congenital non-separation of fingers that form one whole), brachydactyly (reduced finger length), camptodactyly (bending, finger contracture), clinodactyly (bending of the little finger distal phalanx) macrodactyly (enlargement of one or more fingers).

Surgical technology
Interventions are different depending on the malformation – separation of fingers, reduction of enlarged finger, correction of contractures, removal of excess fingers...

Procedure duration and anesthesia
It is usually performed under general anesthesia or under regional block of the nerves of the upper extremity (depending on the patient’s age). The surgery lasts between one to three hours (depending on the deformity).

Recovery
Dressing, removal of sutures and exercise advised together with physical therapy treatments.

Rare complications
Incomplete correction of deformities with long-term bending of small wrist joints – correction by physical therapy procedures.

Goal
Surgical treatment of fractures (recent or old), correction of poorly fused or non-fused fractures.

Surgical technology
The bone fragments are repositioned and fixed with thin steel "Kirschner" needles – thus restoring the bone to its pre-injury condition, i.e. its normal anatomical appearance. In non-fused fractures (e.g. scaphoid bones), osteoplasty with artificial bone or a part of the patient's healthy bone is also performed, which increases the healing potential.

Procedure duration and anesthesia
Regional block anesthesia or nerve block of the injured finger (local anesthesia) is used. The intervention, depending on the complexity of the fracture, lasts from 30 minutes to an hour and a half.

Recovery
If the above mentioned "Kirschner" needles are used, they remain in the bone for about 6 weeks – after which they are removed. The wound after the operation is dressed every second day, the sutures are removed after 14 days. The patient is then referred to physical therapy to improve bone healing and increase the range of motion.

Rare complications
In case of fractures, the already mentioned and very rare complications can occur – poor fusing or lack of bone fusing, as well as infections.