Complications of hand surgery

Surgeons hate complications as much as patients do, but both parties must accept there is always risk in surgery, even an operation as "routine" as CTS release.

While a hand surgeon can be judged by his complication rate, equally important is how he deals with any problems.

Dr Rider's approach:

Recognise the complication has happened

It may be human nature to deny a problem, but that doesn't help fix it. Note that this is not the same as admitting error or liability. Many problems "just happen", due to chance or biology. Only occasionally is there a surgical error, or indeed a patient error (such as removing splints).

Make a plan

This may include additional hand therapy, frequent dressing changes, or re-operation. The plan may be "wait and see". Sometimes it is best to delay surgery; the body has an amazing ability to heal itself. Surgeons refer to this approach as "masterful inactivity"; it is occasionally difficult to persist with this in the face of our own instincts (and pressure from the patient) to do something. Experience has taught me it is often the wisest plan.

Provide reassurance that the eventual outcome is usually good

Provide intensive support until the problem is resolved

Possible complications

Some problems are listed below. Fortunately, major complications are very rare in hand surgery.

Stiffness
Tight dressings/plaster cast
Bleeding
Infection
Stitch abscess
Delayed healing
Poor scars
Injury to deep structures such as nerves
Pain
Chronic Regional Pain Syndrome
Complications of anaesthesia