Achieving Maximal Functional Results

The goal of hand surgery is to achieve a maximal functional result after treatment of an injury or treatment of a diseased hand. An absolutely perfect hand is not always a realistic expectation as it may not be possible to obtain such a result. The hand surgeon and hand therapist work together with the patient to take all the necessary steps to achieve a maximal functional result and make the hand as perfect as is possible. In order to obtain this maximal functional result, the patient's cooperation is absolutely mandatory and instructions of the surgeon and therapist must be followed precisely. The time required to reach a point of maximal improvement (length of recovery) depends on the particular procedure performed and also varies from patient to patient. The normal physiologic response to surgery is an inflammatory response that peaks between the fourth and sixth week after surgery. At this time scar tissue and wound tenderness is usually at its peak. Some patients have a more vigorous inflammatory response than others; these patients tend to form more scar tissue, have more joint stiffness, require more intensive therapy, and take longer to recover fully. It is important for the patient to understand this prior to surgery so the patient will not have the unrealistic expectation of having a fully recovered, perfect hand shortly after surgery. As long as the recovery process is continuing, the hand will not function normally and one cannot engage in normal day-to-day activities. Again, the best possible result is achieved when the surgeon, hand therapist and patient all work together to do everything appropriately to make the hand function perfectly or as close to perfect as is reasonably possible.