Reconstructive Plastic Surgery

Complex Hand Reconstruction

Our RPS surgeons have advanced microsurgical experience treating challenging hand surgery cases, using his extensive plastic surgery skills to reconstruct the most complex of defects or problems when required.

Severe injury, previous surgery, congenital hand differences or advanced degenerative changes can make selected hand surgery cases very complex.

In complex hand surgery cases, treatment with one or more staged operations should be well planned, tailored and performed with the highest attention to detail.

Close collaboration with experienced hand therapists is essential to obtain the best possible result and remaining hand function should be optimised where possible, before addition surgical interventions.

Complex hand surgery can involve bone grafting, joint replacement , tendon / nerve / blood vessel reconstruction , tendon or nerve transfers or other microsurgical procedures.


Recovery following complex hand surgery can take 1-2 years, with management of swelling, optimisation of movement (both passive and active) through the use of splints and hand therapy. Much of this is undertaken by the patient in conjunction with their hand therapist.It may be necessary for additional minor procedures as necessary to continue the pathway to recovery if specific problems arise and your surgeon will follow your progress across this time to ensure that you are progressing as expected.

Tendon Reconstruction

Ideally, injury of the tendons that bend or straighten the fingers (flexor or extensor tendons respectively) are repaired by re-attaching the cut ends with strong sutures, followed by early active motion hand therapy. This will require a period of splinting to allow for appropriate recovery of tendon strength and movement. You may be unable to drive during this period.

Not all cases allow for direct repair of flexor tendon injury. This can be due to delay in diagnosis or treatment or other factors such as associated injury to skin cover or bone. In these cases, a one- or two-stage tendon reconstruction is required.

Also, after any tendon surgery, range of motion can be reduced due to scar tissue keeping the tendons from gliding. If maximal hand therapy efforts did not yield any further improvement in motion, a release of the tendon from scar tissue (tenolysis) may be the best option.

Before, in between and after the operations, ongoing hand therapy is essential to obtain or maintain a good result.

Tendons are the extensions of muscles in the forearms. Muscles pull on the tendons to move joints in the hand and wrist. For different reasons, a muscle or a group of muscles may have lost their ability to contract resulting in loss of active movement.

In selected cases, attaching a tendon connected to a functioning muscle to a tendon of a muscle that doesn’t work, can restore function. This procedure is called a tendon transfer.

Of course, only muscles and tendons that have an “expendable” function will be used to restore another.

More information

What else you should know

Your surgeon will share tips on how to care for your dressings after surgery

You will also need to be aware of any signs of infection, which could include:

  • increased pain
  • bad odour, discharge or pus from your cast or splint
  • red, warm skin around your hand
  • fever.
  • If you believe you may have an infection, contact your RPS team as soon as possible.
Are there complications with hand surgery?

Like any surgery, hand surgery may have some complications. These may include:

  • infection
  • bleeding
  • pain
  • wound complications.

Your Surgeon will take steps to reduce the risk of these complications and will manage them with you if they should occur despite these steps.

How will RPS manage my post-operative care?

Your RPS surgeon will give you specific advice regarding your individual post-operative recovery. They will advise:

  • where you will go after your surgery
  • what medication you will be given or prescribed
  • what bandages and dressings you will need and when they’ll be removed
  • if you require stitches, when they’ll be removed
  • when you can get back to normal activity and exercise
  • when to book your follow-up care.
Our Canberra specialists

The team at RPS Canberra are committed to providing you with the best possible outcome.

The extensive specialist skills of our surgical team ensure that you are provided with surgical options designed to maximise form and function.

Our surgeons hold an impressive array of academic credentials, extensive professional experience and a personal commitment to patient satisfaction.