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H H S Department of Health and Human Services
U.S. Department of Health and Human Services
Health Resources and Services Administration

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Hand/Foot Reconstructive Surgery

Special Surgical Procedures: Wound Debridement, Grafting, Osteotomy, Tendon Release, Tendon Transfer, Amputation>

In the upper extremities, surgery is used to treat entrapment neuropathies related to Hansen's disease.

Surgical consultant performing reconstructive hand surgery image.
Surgical consultant performing
reconstructive hand surgery

Carpal tunnel release is performed for the median nerve at the wrist and anterior transposition of the ulnar nerve at the elbow.

Tendon transfers are performed to rebalance the paralytic hand in order to distribute the forces equally.
An intrinsic minus hand with clawing is corrected by tendon transfers. Tendon transfers are performed on the thumb to improve the power of key pinch and to provide opposition to the fingers.

Surgical arthrodesis is used to stabilize unstable or destroyed joints.

Surgical debridement and limited amputations may be required for infections related to wounds on the insensate hand.

Skin grafts can surgically release contractures, if needed.

Cosmetic procedures are available to improve the overall appearance of the hand thus reducing some of the stigma of Hansen's disease.

More about Surgical Reconstruction of the Hand  

In the lower extremities, surgical procedures are available to assist wounds to heal or as reconstructive procedures to prevent ulceration.

Patient undergoing a surgical debridement of the lower extremity image.
Patient undergoing a surgical
debridement of the lower extremity

Surgical debridement, including debridement of infected bone in osteomyelitis, is often required for open wounds with non-viable tissue.

Skin grafts or flaps may aid in wound healing once a wound is devoid of all non-viable tissue,

Either arthrodesis or osteotomy may be used to correct rigid bony deformities in high-pressure areas. Correction of toe deformities, such as claw-toe, may prevent ulceration in high-pressure areas.

Tendon transfers are available to rebalance a paralytic foot, such as posterior tibialis transfer for foot drop.

Tendon release procedures, such as a tendo Achilles lengthening, will help reduce high-pressure areas.

Amputation may be required for uncontrollable sepsis, an avascular extremity or when function will be increased by prosthetic usage.