60% of the departmental workload is
trauma related. The department treats patients from the simple
fingertip injuries to the tendon injuries and fractures; and to the
more complex multi-tissue mutilating injuries.
The Department’s contribution includes
development of surgical techniques for fractures treatment and tendon
repair to allow early rehabilitation. Our aim is early definitive
surgery to allow rehabilitation and early return to work.
Wrist Trauma and Disorders
A common affliction especially in
patients doing high demand job and sports. As a tertiary referral
centre, we treat difficult wrist injuries with their problems from
fractures to wrist pain and wrist instabilities. Corrective surgery for
complications arising from severe distal radius fractures are done in
this department. At the present moment, numerous new techniques are
developed to treat these difficult injuries with chronic disabilities.
The most significant are the two new techniques for reconstruction of
carpal and distal radio-ulnar joint instabilities.
Endoscopic Surgery
The department routinely offers
Endoscopic Carpal Tunnel Release in addition to the conventional open
release. This minimally invasive procedure decreases immediate
post-operative morbidity. We provide therapeutic and diagnostic
Arthroscopy of the wrist.
Upper Limb Paralysis
The hand and upper limb may be paralysed
in the following conditions: brachial plexus injuries, obstetrical
brachial palsy, cerebral palsy, stroke and traumatic brain injury, and
tetraplegia. A comprehensive programme for management of these
conditions is provided at the Palsied Hand Clinic. At the Palsied Hand
Clinic integrated multi-disciplinary services include: clinical
evaluation, electrodiagnostic studies, advanced radiological imaging,
functional assessment, conservative management, reconstructive hand
surgery, hand therapy and rehabilitation, support groups, medical
social services and vocational reintegration. Reconstructive surgery
aims to restore shoulder, elbow and hand function.
Microsurgical Reconstruction of the Upper Limb
Since its establishment in 1985 the
Department has become the main centre in Singapore for replantation
surgery. Replantation is a routine emergency “reconstructive” surgery.
We have been successful in replantation surgery ranging from distal
digit tip to proximal arm amputations. Our youngest successful replant
was 8 months old and the oldest was 65 years of age. We have a
comprehensive post-operative microsurgical care which include the
Ambient-Control Device which is developed in this department. Our
success rate is 95 %. We introduced the practice of early mobilisation,
functional reintegration for the replanted hand. This has resulted in a
significant improvement in the functional recovery of the replanted
part.
Comprehensive post-operative
microsurgical care in SGH
Complex microreconstruction for the
severely injured hand and upper limb is being routinely performed in
the department. Our armamentarium include free tissue transfer (skin
flap, muscles, bone and nerves) and composite transfer of toes and
joints.