Hand Surgery Scope: Conditions, Diseases, Treatments, and Procedures
Hand surgery is a specialty of orthopedic surgery, general surgery, and plastic surgery that focuses on the diagnosis, treatment, and management of conditions and injuries of the hand, wrist, and elbow. It encompasses the treatment of both traumatic, degenerative, acquired, and congenital conditions. Hand surgeons are highly trained specialists who are experts in both the anatomy and physiology of the upper extremity as well as a broad array of medical and surgical treatments.
The scope of hand surgery is quite broad and includes the treatment of injuries and conditions affecting the bone, soft tissue, joints, ligaments, tendons, muscles, and nerves. These may include:
Fractures: Hand surgeons can diagnose and treat fractures to the bones of the hand, wrist, and elbow. This may include surgical repair of broken bones or immobilization with a cast or splint.
Dislocations: Hand surgeons can diagnose and treat dislocations of the bones in the upper extremity. This may involve resetting the bone or surgery to repair ligaments or tendons that have been damaged by the dislocation.
Ligament tears: Hand surgeons can diagnose and repair ligament tears in the upper extremity. This may involve arthroscopic or open surgery to repair the torn ligament as well as physical therapy to help restore strength and range of motion.
Tendonitis: Hand surgeons may treat tendonitis with anti-inflammatory medications, steroid injections, or physical therapy. They may also perform tendon transfers to improve the appearance of the hands.
Arthritis: Hand surgeons may provide treatment for arthritis including injections of steroids or other medications to reduce pain and inflammation. They may also recommend lifestyle modifications such as rest and activity modification as well as assistive devices to help manage pain and improve mobility.
Nerve compression/entrapment syndromes: Hand surgeons can diagnose nerve compression/entrapment syndromes such as carpal tunnel syndrome and cubital tunnel syndrome. Treatment may include physical therapy, splinting, steroid injections, or surgery to release the compressed nerve.
Nerve injury/repair: Hand surgeons are skilled in diagnosing and repairing injured nerves in the upper extremity. This may involve repairing a severed nerve or transferring a nerve from another area of the body to restore function to an injured area.
Dupuytren's contracture: Hand surgeons can diagnose Dupuytren's contracture and recommend appropriate treatment options such as steroid injections or surgery to correct the deformity.
Trigger finger and thumb deformities: Trigger finger and thumb deformities can be diagnosed and treated by hand surgeons using steroid injections or surgery to release tendons or ligaments that are stuck in place due to inflammation or scarring.
Congenital defects: Congenital defects such as syndactyly (fusion of fingers) or polydactyly (extra digits) can be diagnosed by hand surgeons who can then recommend the best course of treatment which may include reconstructive surgery to improve function and appearance.
Hand surgery requires a unique combination of knowledge and skill in order to provide minimally invasive, yet successful treatment for patients. Hand surgeons must be knowledgeable about anatomy, physiology, pathology, radiology, pharmacology, and physical therapy. They must also be proficient in the use of specialized instruments and techniques such as arthroscopy or endoscopic carpal tunnel release.
Qualifications, Training, and Certifications
In order to become a hand surgeon, a physician must first complete an orthopedic, plastic, or general surgery residency program. This is followed by an additional fellowship in hand surgery, which typically lasts from one to two years.
In addition to medical school and residency training, hand surgeons must also receive specialized training in the use of arthroscopy, endoscopic carpal tunnel release, nerve repairs, tendon transfers, joint replacements, and other minimally invasive procedures.
Hand surgeons may also pursue additional certifications such as in microsurgery or arthroscopic surgery.
Related Medical Specialties to Hand Surgery
Hand surgery is closely related to other medical specialties, including orthopedic surgery, plastic surgery, and general surgery, neurology, vascular surgery, dermatology, and burns as well as physical therapists.
Orthopedic surgeons specialize in the diagnosis and treatment of conditions that affect the musculoskeletal system, including bones, joints, ligaments, tendons, and muscles. Orthopedic surgeons may work closely with hand surgeons to diagnose, treat, and manage conditions and injuries of the hand, wrist, and elbow.
Physical therapists specialize in rehabilitative care for people with musculoskeletal injuries or diseases. They may provide treatments such as therapeutic exercise and stretching to help restore strength and range of motion after an injury or surgery. Physical therapists may also provide advice on proper ergonomics for workers or athletes who are at risk for upper extremity injury.
Neurologists specialize in the diagnosis and treatment of disorders of the nervous system. They may work closely with hand surgeons to diagnose nerve compression/entrapment syndromes such as carpal tunnel syndrome or cubital tunnel syndrome as well as to recommend treatments such as physical therapy or surgery to release the compressed nerve.
Plastic surgeons specialize in reconstructive surgery. They may work with hand surgeons to treat congenital defects such as syndactyly or polydactyly as well as to perform tendon transfers or other cosmetic procedures to improve the appearance of the hands.