What is Hand Surgery?
Hand surgery is a surgical specialty concerned with preserving and restoring the function of the hand and upper limb, structures that are essential to countless everyday activities. When injury or disease affects the bones, joints, tendons, nerves, or soft tissue of the hand, the impact on a person's independence and quality of life can be significant, since even a small loss of hand function can affect basic tasks such as writing, dressing, or holding objects.
Hand surgeons are trained to treat both traumatic injuries, such as fractures, cuts, and crush injuries, and a wide range of underlying conditions, including rheumatic diseases such as osteoarthritis and rheumatoid arthritis, tendon and nerve disorders, and congenital deformities. Because the hand is such a complex and finely coordinated instrument, treatment often calls for a high degree of surgical precision, alongside structured rehabilitation to restore movement, strength, and sensation.
Understanding Hand Surgery
The hand is one of the most anatomically complex parts of the body, containing 27 bones, numerous small joints, and an intricate network of tendons, ligaments, nerves, and blood vessels, all working together within a small space to allow for both fine, precise movements and considerable strength. This complexity means that even a relatively minor injury or degenerative change can have a disproportionate effect on function.
Hand surgery addresses this complexity through both surgical and non-surgical care. Surgical treatment ranges from repairing a single damaged tendon or nerve to more extensive procedures such as joint replacement, microsurgery, or reconstruction following trauma, tumor, or infection. Non-surgical approaches, including therapy, medication, and bracing, are often used either as the primary treatment or alongside surgery to support recovery and preserve function.
Key Areas of Focus
Hand surgeons manage a wide range of interconnected conditions and procedures involving the bones, joints, nerves, tendons, and soft tissue of the hand and upper limb:
- Trauma Surgery
Repair of fractures, cuts, crush injuries, and lacerations affecting the bones, tendons, nerves, and soft tissue of the hand and wrist.
- Joint and Arthritis Surgery
Management of joints damaged by osteoarthritis, rheumatoid arthritis, or injury, including joint replacement, reconstruction, and small joint arthroscopy.
- Arthritis
Conditions that affect the joints of the hand such as rheumatoid arthritis and osteoarthritis.
- Nerve Surgery
Repair and reconstruction of injured peripheral nerves, and release of nerves compressed by conditions such as carpal tunnel syndrome.
- Tendon Surgery
Repair of torn or lacerated tendons, and treatment of tendinitis and other overuse-related tendon disorders.
- Congenital and Reconstructive Surgery
Correction of congenital upper limb deformities such as clubhand, and reconstruction of soft tissue and bone following trauma, tumor, or infection.
- Microsurgery
Highly precise surgery under magnification, used to reattach or reconstruct small blood vessels, nerves, and tissue in the hand.
Common Conditions Treated in Hand Surgery
Hand surgeons diagnose and manage a broad range of conditions affecting the hand and upper limb, including:
- Trauma: Injuries such as fractures, cuts, and lacerations affecting the bones, tendons, nerves, or soft tissue of the hand.
- Deformities: Congenital or acquired deformities of the hand, such as clubhand or Dupuytren's contracture, a condition in which tissue beneath the skin of the palm thickens and pulls the fingers inward.
- Arthritis: Conditions that affect the joints of the hand, such as rheumatoid arthritis and osteoarthritis, causing pain, stiffness, and reduced function.
- Nerve injuries: Injuries that damage the nerves controlling sensation and movement in the hand, which may result from trauma, compression, or underlying disease.
- Tendinitis: Inflammation of the tendons, often caused by repetitive strain or overuse, leading to pain and restricted movement.
- Carpal tunnel syndrome: A condition caused by compression of the median nerve as it passes through the wrist, leading to numbness, tingling, and weakness in the hand.
Recognising the Signs of a Hand Condition
Because the hand is involved in so many everyday tasks, problems affecting its structures can present in a variety of ways. Signs that may point to an underlying hand condition include:
- Persistent pain or swelling: Ongoing pain, swelling, or tenderness in the hand or wrist, particularly if it worsens with use or does not settle with rest.
- Numbness or tingling: A pins-and-needles sensation or numbness in the fingers or hand, which can indicate nerve compression such as carpal tunnel syndrome.
- Stiffness or reduced range of motion: Difficulty fully bending or straightening the fingers or wrist, which can result from arthritis, tendon problems, or injury.
- Weakness or loss of grip strength: A noticeable decline in the ability to grip or hold objects securely.
- Visible deformity: A finger or joint that appears bent, locked, or misshapen, such as in Dupuytren's contracture or a trigger finger.
- Difficulty with fine motor tasks: Increasing difficulty with activities such as writing, buttoning clothing, or picking up small objects.
- A lump or thickened tissue: A palpable lump or band of tissue in the palm or fingers, which can be a sign of a developing deformity or growth.
How Hand Surgeon Diagnose Hand Conditions
- Clinical examination: A detailed physical examination of the hand and wrist, assessing movement, strength, sensation, and any visible deformity.
- Imaging studies: X-rays, ultrasound, or MRI scans may be used to assess bone, joint, tendon, or soft tissue injuries in detail.
- Nerve conduction studies: Tests that measure how well electrical signals travel along a nerve, used to confirm conditions such as carpal tunnel syndrome.
- Functional assessment: Evaluation of grip strength, range of motion, and the ability to carry out everyday tasks, often performed together with a hand therapist.
Treatment Approaches in Hand Surgery
Treatment can be surgical or non-surgical, and often includes structured therapy as part of the recovery process.
- Surgical repair of tendons, nerves, or bones: Direct repair of damaged tendons, nerves, or fractured bones to restore structure and function.
- Joint replacement and reconstruction: Replacement or reconstruction of joints in the hand or upper limb damaged by arthritis or injury.
- Congenital deformity correction: Surgical correction of congenital upper limb deformities to improve function and appearance.
- Microsurgery and peripheral nerve surgery: Highly precise surgery to reconnect or reconstruct small nerves, blood vessels, and tissue, often following severe trauma.
- Small joint arthroscopy: Minimally invasive surgery used to diagnose and treat problems within the small joints of the hand and wrist.
- Soft tissue and bone reconstruction: Reconstructive surgery following trauma, tumor, or infection, aimed at restoring both function and appearance.
- Non-surgical treatment: Physical therapy, medication, and bracing or splinting, used either as primary treatment or to support recovery following surgery.
Hand Surgery and Related Body Systems
Because hand function depends on the coordinated action of bones, joints, nerves, and soft tissue, hand surgery often intersects closely with other areas of medicine, and hand surgeons frequently coordinate care with specialists in these related fields.
- Orthopaedics: Fractures, joint damage, and reconstructive procedures in the hand are closely related to broader orthopaedic and musculoskeletal care.
- Rheumatology: Conditions such as rheumatoid arthritis are frequently co-managed with rheumatology to control the underlying disease alongside surgical treatment of the joints.
- Neurology: Nerve injuries and compression syndromes may require coordination with neurology, particularly where nerve function needs to be assessed in detail.
- Rehabilitation and hand therapy: Recovery of strength, movement, and sensation after surgery or injury is closely supported through structured hand therapy and rehabilitation.
Our dedicated teams of experienced multidisciplinary specialists and healthcare professionals work together to provide treatment plans tailored to the needs of our patients on their recovery journey.
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