Dr. Paul Brand Centre for Hand Surgery, Leprosy Reconstructive Surgery & Peripheral Nerve Surgery (HLRS Unit)

This is one of the oldest units in Asia dedicated to Hand reconstruction, Hand therapy and rehabilitation. It was founded in 1951by the legendary Dr Paul W Brand, a Pioneer in Hand reconstruction and rehabilitation (watch an old video of Dr. Brand’s work). The purpose of this unit was to reconstruct deformed hands, feet and faces of Leprosy disabled patients, besides other common hand conditions challenging the developing world. 

This Centre today has evolved into one, treating diverse problems of the hands and peripheral nerve dysfunctions with Reparative, Reconstructive and Replacement surgery supported by excellent hand therapy.

Training of Post doctoral Fellows in Hand Surgery, Orthopaedic Postgraduates, Plastic Surgery postgraduates, PMR postgraduates, Hand physiotherapy technical personnel are a vital part of HLRS’s responsibility.

1.     Complex Orthopaedic hand problems, Plastic hand problems and Peripheral Nerve dysfunctional problems with ALL methods of surgery inclusive of Microsurgery. Hand Injury Repair, early and late Reconstruction and /or Replacement and emergency Re-implantation of hand and digits as needed.

2.     Affordable cost in caring for patients with complicated injury and neglected problems of the hand.

3.     HLRS unit is linked with all CMC Vellore departments which provide specialist care for co-morbid problems seen in HLRS patients. These are specifically with the three general Orthopaedic units, Neurology and Neurosurgery, Dermatology, Endocrinology, Medical units, PMR units, Occupation therapy, Orthotic services, etc.

1.     Orthopaedic management for complex fractures for all Hand & Wrist bones. This includes complex fracture fixation with fine wires, plates and screws as well as free and vascularized bone, joint and bone grafting or transfers.

2.     Plastic surgery skin cover inclusive of pedicle and Free flaps and grafts for hands with injury or contractures.

3.     Microsurgery: Re-implantation of the digits, hand & forearm by Microsurgery [as when a finger is cut off, it can be put back surgically, that is; re-implanted to function as before]. Free tissue transfer [reconstruction of bony, muscle or skin defects following traumatic loss , removal following cancer or absence at birth] using micro surgery

4.     Hand Paralysis: All tendon transfer, tendon replacement and free functioning muscle transfer by microsurgical techniques. [Transfers and replacement provide new tendon/muscle function where ever it is lost]

5.     Hand Tumours & tumour like conditions: After thorough Investigation, biopsy and imaging studies: Removal and/or reconstruction. [Reconstructions make the hand look good and able to work again as much as possible]

6.     Peripheral Nerve Injuries: Adult Brachial Plexus Injuries, Paediatric Brachial Plexus Injuries, Obstetric Brachial Plexus Injuries, paralysis of all nerves in the forearms and hand: Median, Ulnar and Radial Nerves, paralysis of all nerves in the thighs, leg and feet: Sciatic, Common Peroneal and Tibial nerves. Microneurosurgery of the injured nerves and Nerve Grafting with Microsurgery is regularly done for ALL these conditions. [Microsurgery is an excellent technique of precisely joining nerves and blood vessels for improving the results of all surgery for the patients].

7.     Arthritic Hand treatment: Total or partial wrist fusion procedures; Proximal row carpectomy procedures; Joint replacement with toe joint transfers; trapezectomy and ligament interposition surgery

8.     Carpal Tunnel Syndrome (at the wrist) and other Compression neuropathy: in the arms, forearms, hand, knee level and foot to release pressure and compression of nerves

by surgery, including endoscopic carpal tunnel release (key hole surgery). [Compressed nerves in the hand produce tingling sensation in the fingers and thumb and prevent people, especially young and middle age women from doing their work normally]. 

On the right is an image of untreated carpal tunnel syndrome that has caused the muscles at the base of the thumb to have wasted away. 

9.     Congenital deformity correction in Children’s Hands and Fingers: Where there is a deficiency or deformity of the hand from birth, the problems of Absent or short fingers, Unseparated (or fingers stuck together), fingers and thumb looking big or twisted can be corrected by special surgeries. Microvascular transfer of the Toe for congenital deficiency is done.

10.  Paediatric Hand Surgery: for Children’s hand infections, Injuries, Contractures and Paralysis: special forms of orthopaedic, plastic and microsurgery are done to suit these little hands to give back as normal function as possible. Little fingers can be lengthened by special equipment or Toes can be transferred from the foot to the hand by Microsurgery as needed.

11.  All Infections of the Hand: including TB infection and due to Diabetes complications, that are rising in India

12.  Leprosy – Putting right the deformity problems in the hands and feet. Nerves causing severe pain- Neuritis and abscess formation in Leprosy are also treated.

13.  Burns Contracture in the hand – releasing the contractures and Reconstructing the hand.

14.  Volkmann’s Ischaemic Contracture (VIC) in the hand, Cerebral Palsy of upper limb and Poliomyelitis paralysis.

15.  Wrist problems – Scaphoid Fractures including Non union (when the broken bone does not join) and Avascular necrosis (poor blood supply preventing healing), Kienbock’s disease are treated by Carpal Vascularisation (new method of giving fresh blood supply to bones) and Other Wrist problems: TB and Rheumatoid arthritis.

16.  Medical Staff:

Professor	Dr Binu P Thomas *[MBBS, D’Ortho , MS (Ortho), Post doctoral fellowship in Hand Surgery (USA)]
Professor and Head	Dr Samuel Raj Pallapati *[MBBS, DipNB (Ortho), Post doctoral fellowship in Hand Surgery (USA)]
Associate Professor	Dr Anil Mathew *[MBBS, D’Ortho, MS (Ortho), Post doctoral fellowship in Hand Surgery (CMC)]
Assistant Professor	Dr Kiran Sasi [MBBS, D’Ortho, MS (Ortho)]
Assistant Professor	Dr Sreekanth R [MBBS, D’Ortho, MS (Ortho), Post doctoral fellowship in Hand Surgery (CMC)]
Assistant Professor	Dr Jojin Jose

17.  ‘*’ private consultations are possible with the above consultants