Contents

1. History of Hand Surgery ................................................................................................................................... 1

2. Structural Basis of Functioning of the Hand ................................................................................................... 6

3. Organisation of Hand Injury Services ............................................................................................................ 38

4. Basic Techniques and Instrumentation in Hand Surgery ............................................................................ 48

5. Examination of Hand ....................................................................................................................................... 70

6. Aesthetic Prosthesis in Hand Injuries ............................................................................................................ 84

7. Anaesthesia in Hand Surgery .......................................................................................................................... 94

8. Treatment of Finger Tip and Nail Injuries ................................................................................................... 103

9. Avulsion Injuries in the Fingers ................................................................................................................... 119

10. Refinements of Pedicle Flaps for Soft Tissue Cover in the Upper Limb ................................................. 134

11. Primary Composite Reconstruction of the Hand ........................................................................................ 142

12. Management of Complex Injuries of the Upper Extremity Proximal to the Wrist ................................ 153

13. Osteoplastic Method of Thumb Reconstruction .......................................................................................... 164

14. Pollicisation in Hand Mutilations .................................................................................................................. 171

15. Microsurgical Reconstruction of the Thumb ............................................................................................... 179

16. Trimmed Great Toe Transplantation (TTT) for Thumb Reconstruction ................................................... 195

17. Microsurgical Finger Reconstruction with Toe Transfers .......................................................................... 203

18. Reconstruction of Hand Loss after Wrist and Distal Forearm Amputation ............................................ 216

19. Primary Flexor Tendon Surgery .................................................................................................................... 225

20. Secondary Flexor Tendon Surgery ................................................................................................................ 239

21. Complications of Flexor Tendon Injuries and their Management ............................................................ 255

22. Repair and Reconstruction of Extensor Tendons – Primary Repair ......................................................... 263

23. Principles and Practice of Nerve Repair ....................................................................................................... 288

24. Clinical Aspects of Peripheral Nerve Injuries ............................................................................................. 299

25. Tendon Transfers in Peripheral Nerve Injuries, Principles of Tendon Transfers .................................... 313

26. The Management of Painful Nerves ............................................................................................................. 330

27. Adult Brachial Plexus Injuries ...................................................................................................................... 342

28. Rehabilitation following Primary Surgery in Adult Brachial Plexus Lesion ........................................... 356

29. Pain following Brachial Plexus Injury and its Management ...................................................................... 361

30. Obstetric Brachial Plexus Palsy .................................................................................................................... 366

31. Secondary Reconstruction in Brachial Plexus Injuries .............................................................................. 386

32. Non-operative Management of Fractures of the Hand Skeleton—Metacarpals and Phalanges ........... 404

33. Operative Fixation of Fractures of the Hand .............................................................................................. 411

34. Scaphoid Fractures ......................................................................................................................................... 435

35. Scapholunate Ligament Injuries ................................................................................................................... 451

36. Distal Radio Ulnar Joint Problems and Solutions ....................................................................................... 460

37. Primary and Secondary Reconstruction in Thermal Burn Injuries .......................................................... 478

38. Major Vascular Injuries of the Upper Limb ................................................................................................. 491

39. Organisation of Microsurgery Service ......................................................................................................... 500

40. Replantation of Upper Limb and Rehabilitation ......................................................................................... 504

41. Major Upper Limb Replantations and Rehabilitation ................................................................................. 519

42. Mini Groin Flaps in Finger Reconstruction ................................................................................................. 531

43. Radial Forearm Flap in Hand Reconstruction ............................................................................................. 538

44. Coverage of the Hand with Fascial Flaps ..................................................................................................... 546

45. Anterolateral Thigh Flap in Hand and Forearm Reconstruction .............................................................. 551

46. Lateral Arm Flap in Resurfacing of Hand ................................................................................................... 556

47. Finger Joint Reconstruction by Toe Joint Transfers .................................................................................. 565

48. Surgical Opportunism in Primary Repair of the Injured Hand ................................................................ 577

Index ................................................................................................................................................................. 583