Dramatic advances have been made in recent years in treating patients with hand injuries, degenerative disorders, and birth defects of the hand. At the forefront of these advances have been orthopedic surgeons-specialists whose major interest is improving both function and appearance. Plastic surgeons undergo intensive training in hand surgery, and they (along with orthopedic surgeons and general surgeons) treat patients with a wide range of hand problems.

This information is designed to give you a basic understanding of the most common hand problems-what they are, what plastic surgeons can do for them, and the results you can expect. It can't answer all of your questions, since each problem is unique and a great deal depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don't understand.

If You're Considering Hand Surgery

If you're considering hand surgery, a consultation with a orthopedic surgeon is a good place to start. The surgeon will examine you, discuss the possible methods of treatment for your problem, and let you know if surgery is warranted. If it is, the surgeon will discuss the procedure in detail, including where the surgery will be performed (in the surgeon's office, an outpatient surgery center, or a hospital), the anesthesia and surgical techniques that will be used, possible risks and complications, the recovery and rehabilitation period, and the probable outcome in terms of function and appearance.

Don't hesitate to ask your orthopedic surgeon any questions you may have during the initial consultation-including any concerns you have about the recommended treatment and the costs involved. (Since hand surgery is performed primarily to correct physical abnormalities, it usually is covered by insurance. Check your policy or call your carrier to be sure.)

Orthopedic Hand Surgery Risks

All Orthopedic Surgery Carries Some Uncertainty and Risk

Thousands of successful hand orthopedic operations are performed each year. While the procedures are generally safe when performed by a qualified and experienced plastic surgeon, complications can arise.

In all types of orthopedic hand surgery, the possible complications include infection, poor healing, loss of feeling or motion, blood clots, and adverse reactions to the anesthesia. These complications are infrequent, however, and they can generally be treated. You can reduce your risks by choosing a qualified orthopedic surgeon and by closely following their advice.

A qualified hand surgeon is trained to diagnose and treat all problems related to these different structures in the hand, wrist, and forearm.

Hand surgeons have received specialized additional training in the treatment of hand problems beyond their board certified specialty training in orthopaedic surgery, plastic surgery, or general surgery. To become members of the American Society for Surgery of the Hand, hand surgeons must have completed a full year of such additional training and must pass a rigorous certifying examination.

Many hand surgeons also have expertise with problems of the elbow, arm, and shoulder. Some hand surgeons treat only children, some treat only adults and some treat both. Common problems treated include:

carpal tunnel syndrome
tennis elbow
wrist pain
sports injuries of the hand and wrist
fractures of the hand, wrist, and forearm
trigger finger
Other problems treated by hand surgeons include arthritis, nerve and tendon injuries, and congenital limb differences (birth defects).

Hand and Wrist
The team members of the Hand and Microsurgery Service evaluate and manage problems involving pain or injury in the arm, forearm, wrist, and hand. Patients frequently come to us for the management of:

Fractures and dislocations
Sprains, strains, and muscle or ligament tears
Injuries to tendons, nerves, or vessels
Numbness or weakness in the hand or arm (including carpal tunnel syndrome)
Arthritis
Contractures
Swelling or inflammation