In the specialty area of hand surgery, we work together with the Department of Hand Surgery at Södersjukhuset. In Sweden, hand surgery is a unique specialty from orthopaedic and plastic surgery. Specialised hand departments are secondary referral centres for other departments like the emergency, plastic and orthopaedic departments. The Department of Hand Surgery at Södersjukhuset in Stockholm is the largest of it´s kind in Sweden, with about 15 full-time hand surgery specialists and 24/7 on-call duty. We have a separate operation facility with four operating rooms and a staff of around 80 in total, including specialised hand therapists. We treat all kind of hand surgical diagnoses, both traumatic and elective cases. Children under the age of one year are operated at the Astrid Lindgren Children´s hospital.
Our specific areas of expertise include the following:
Brachial plexus injuries; traumatic injuries as well as birth palsy
Our unit has 30 years of experience in the treatment of these injuries, including both primary nerve reconstruction of all types, and secondary reconstructive procedures. See: www.plexusskada.se
Nerve reconstruction in birth palsy
Nerve reconstruction in birth palsy is considered in severe cases and is usually performed at 3 to 12 months of age.
Residual problems are very common in birth palsy, particularly in the shoulder (rotational contracture and subluxation), but also in the elbow, forearm and hand. These problems can often be improved with secondary surgical procedures in the pre-adolescent children.
Postoperative rehabilitation including the use of specialised splints and rehabilitation is crucial and long term follow-up is strongly recommended in order to get good long-term results.
Reconstruction of brachial plexus and other proximal nerve injuries in adults
Injuries of the brachial plexus often occur after high energy trauma, such as motor vehicle accidents and reconstruction of upper extremity function can be very complicated. Reconstruction of these nerve injuries often give very good results and should be performed as early as possible, optimally within weeks, although later repair is also possible. Apart from the brachial plexus injuries, we also treat other nerve injuries involving the major nerve trunks, both in the upper and the lower extremities.
Congenital upper limb anomalies
The different types of congenital upper limb anomalies vary greatly in appearance and functional disability. We work closely in team with paediatricians and geneticists in order to establish a correct diagnosis. In many cases, additional diagnostic screeening is needed to exclude associated anomalies of inner organs, such as heart, gastrointestinal canal and blood. In case of very rare conditions we are part of and interact with international authorities in this field.
After establishing a correct diagnosis and informing parents on future expectations, we make up an individual treatment plan for the child and family. Surgical options and indications vary greatly with the type of anomaly. The most common operations performed are syndactyly releases, reconstruction of polydactylised thumbs and fingers and corrections of angular deformities. Advice concerning functional aids for daily life activities and prosthetic replacements can be given.