Who is a hand surgeon?
Hand surgeons are certified doctors of medicine (MDs) who specialize in treating disorders of the hands and upper extremities, including fingers, nails, wrists, elbows, and forearms. They also treat wear and tear in the muscles, ligaments, and tendons limited to the upper extremity. Hand surgeons provide surgical and nonsurgical treatment, including hand therapy (physical and occupational therapy to improve range of motion), medication, and steroid injections. However, they generally perform surgery only when necessary.
They typically treat problems such as bone fractures, tendon tears, ganglion cysts, and nerve injuries in adults' hands and wrists. Some hand surgeons specializing in pediatrics treat children as well. In addition to surgery, they conduct physical examinations of pain areas, create treatment plans for patients, and order diagnostic tests to check for nerve disorders. These tests include X-rays, computed tomography (CT) scans, ultrasounds, and magnetic resonance imaging (MRI).
Hand surgeons typically complete over ten years of education, including an undergraduate degree in science, four years of medical school, and a five to seven-year residency program in orthopedic, plastic, or general surgery. To become board-certified, hand surgeons must pass the American Board of Orthopaedic Surgery (ABOS) examination. Some hand surgeons further complete a year of fellowship in arthritis, trauma, microvascular, or reconstructive surgery.
A hand surgeon's practice may center on two areas - the operating room where they perform surgeries on the hands and wrists, or a hospital, private office, or clinic where they provide non-operative treatment options and prepare a patient for surgery if necessary. They may also provide post-operative care. Besides their medical practice, hand surgeons train students in academic medical centers and teach and participate in research.
What common conditions do hand surgeons treat?
Hands are complicated structures of several bones, muscles, and ligaments that allow movement and agility. Therefore, they require a specialist to treat the various problems that may arise due to occupational factors, deformities, or injuries. Here are some common issues hand surgeons treat:
- Arthritis: It is a widespread group of conditions that occur primarily at an older age. Rheumatoid arthritis and osteoarthritis are its most prevalent forms. Its characteristics are inflammation, pain, and stiffness in one or more joints. Due to the body's inflammatory response, arthritic joints may feel warm to the touch. If left untreated, arthritis can cause the joints in the hands to lose shape, worsening the pain and restricting your hand movement. A hand surgeon may diagnose arthritis by ordering X-rays or bone scans, which can help diagnose arthritis in its early stages.
- Carpal tunnel syndrome (CTS): The carpal tunnel is an inch-wide narrow pathway in the wrist. CTS is a condition in which compression of the median nerve (which travels through the upper arm and passes through the carpal tunnel into the wrist) results in pain, numbness, and a tingling sensation in the forearm. CTS tends to worsen over time and can result in weakness and loss of feeling in your hands. Early-diagnosed CTS can be relieved by wearing a wrist splint, exercising, inserting steroid injections, and avoiding activities aggravating CTS symptoms.
- De Quervain's tenosynovitis: It affects the thumb's two tendons, which enable it to move away from the index finger and straighten the joints. This condition causes pain in the thumb side of the wrist, swelling on the thumb, and a snapping sensation while moving the thumb. Tenosynovitis is caused by overworking the thumb and wrist and is more likely to affect those with rheumatoid arthritis. Pain indicated in the Eichhoff maneuver test may help determine tenosynovitis.
What are the various types of hand surgeries?
Providers may perform a variety of procedures on the hand. These procedures depend on the source of the problem. Some hand surgeries include:
- Skin grafts: Skin grafts for the hand include attaching or replacing skin to an area of the hand that is missing skin. Surgeons most commonly perform this procedure for fingertip amputations or injuries. Skin grafts involve attaching a portion of healthy skin to the affected area. This healthy skin portion comes from another body part, the donor site.
- Skin flaps: Surgeons create skin flaps for the hand by removing skin from another body region. However, this treatment uses skin with its blood supply, which contains underlying blood vessels, fat, and muscles. Flaps can be used if an area with missing skin lacks a good blood supply. It may be due to the location, damaged vessels, or significant tissue injury.
- Closed reduction and fixing: Surgeons may perform this if there is a bone fracture or broken bone in a particular part of the hand, such as the fingers.
- Tendon repair: Tendons are fiber-like structures that connect muscles to bones. Tendon repair in the hand is a complex surgery. Your tendons can get injured due to infection, trauma, or unexpected rupture. There are three types of tendon repairs.
Primary repair of an acute or abrupt injury happens within 24 hours following the accident. It is usually a direct procedure for fixing the injury.
Delayed primary repair typically happens a few days after the injury when an opening in the skin from the wound still exists.
Secondary repairs may take 2 to 5 weeks or even longer after the injury. They could include tendon transplants. It occurs when surgeons implant tendons from other body parts instead of the injured tendon. Alternatively, they may perform more complicated procedures if required.
When should you visit a hand surgeon?
People often ignore slight aches and pains in their bodies until they become severe, but it is always better to get evaluated sooner than later. The hand, wrist, and forearm play an integral role in the body's daily functioning, and you must address any pain in them to a doctor on priority. Waiting too long without treatment can lead to altered hand functioning. Also, some ailments worsen, making their treatment more complicated and the recovery time longer.
Are you experiencing the following in your hand, wrist, elbow, or forearm? If yes, then it is ideal to schedule a visit with a hand surgeon near you:
- Swelling
- Bruising
- Tender pain
- Stiffness and weakness
- Numbness and tingling
- Evident finger deformity
- Pain from the hand flowing to the elbow and the arm
- Pain that worsens in the morning or at night
- Not being able to complete routine tasks due to pain or any other symptoms
Once you go to a hand surgeon, they will conduct a physical evaluation and order imaging tests to identify the reason behind your symptoms. This information can help them clinically diagnose you. Depending on your test results, the provider may immobilize your hand using a splint or a brace, prescribe pain and inflammation medications, and advise rehabilitative hand exercises or therapy. By the end of your session, you will be walking out of their office with knowledge of your condition, instructions on the dos and don'ts, and a practical treatment plan.
Your recovery period heavily depends on your specific injury and treatment plan. For instance, if the provider must set a fracture, you may only have to wear the cast for approximately eight weeks.
While other hand surgeries may have more extended recovery periods, especially if they are invasive surgeries that involve installing wires or pins, your provider will keep you informed about your recovery time.
How do you prepare for your hand surgeon visit?
Going to a hand surgeon for the first time can be overwhelming, but not so much if you spend some time preparing for the appointment. When you are well-prepared, it will be easier to communicate with your provider, provide all the information they need, and address your queries to make an informed decision for your health. Where should you begin? The below-mentioned guide is a good starting point:
- Write down your symptoms: It is an excellent idea to help your doctor with as much detail as possible. You must write down your symptoms, including when they started, how severe they are, how often they occur, what made them better or worse, and what treatment strategies you tried.
- Gather medical records: Do you have any medical conditions or allergies? Do you take any over-the-counter or prescription medications? What about supplements? Did you recently sustain an injury? Have you had any surgeries in the past? Do you have a family history of physical difficulties? Answer these questions in advance to quickly provide your complete health background to your doctor.
- List the questions: You can ask anything you want during your consultation, from alternative treatments to lifestyle changes post-surgery. Write down your questions and remember to ask everything.
- Arrive early: You may need to complete initial paperwork, forms, and questionnaires before you meet the provider. So, arrive 15-20 minutes early with your photo ID, insurance card, and other required documents.
- Ask a loved one to accompany you: Having a trusted family member or friend by your side during the hand surgeon appointment can put you at ease. They can also contribute during the discussion with the doctor and take down notes for your later reference.
Finding a hand surgeon near you in Brooklyn, New York
Locating an experienced hand surgeon can be challenging. However, with Zocdoc, you can find one from your home in a few minutes. The platform provides users with a straightforward way of booking video consultations or in-person appointments with doctors. To do so, visit the Zocdoc website and enter your condition or symptoms, location, the date you wish to schedule the appointment, and your insurance plan.
A list of top-rated hand surgeons near you will appear. Browse and filter the results based on time of day, gender, hospital affiliation, languages spoken, distance, and whether a provider treats children. To help you choose the best hand surgeon near you, Zocdoc provides each specialist's educational background, including their medical training, certifications, licensures, awards, and accreditations. Further, you can read honest and verified patient reviews to solidify your decision.
If you only wish to see providers accepting your insurance, select your insurance carrier and plan from the options in the drop-down menu to filter your search results with in-network providers.
On the other hand, if you do not have insurance coverage, mention "I'm paying for myself" in the search bar. You will get an extensive list of providers accepting patients without a health plan. For more insurance-related information, please check out the FAQs on our patient help center's FAQs.
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Prevalence of painful hand conditions in New York
According to a New York State Occupational Health Clinic Network (NYS OHCN) Report, between 1988 and 2003, over 16,000 New Yorkers reported exposure to ergonomic risk factors. These are workplace elements that cause injury and can lead to musculoskeletal disorders. Of the factors, nearly 66% (10,878) were repetitive hand motions due to excessive keyboard use, and around 6% (934) were lifting.
Most (almost 2008) repetitive hand motion exposures were associated with Carpal Tunnel Syndrome (CTS) diagnoses. An estimated 1,058 cases of tenosynovitis of the hand or wrist, including de Quervain's disease, 950 cases of lateral or medial epicondylitis (caused by damage to the muscles that control the wrist and fingers), and over 600 cases of cubital tunnel syndrome were also reported. Among the entire NYS OHCN population, women accounted for around half (73%) of all CTS diagnoses. Of the total CTS cases reported, 89% were work-related. During this period, approximately 12,327 NYS OHCN patient visits were for CTS.
Data collated by the Behavior Risk Factor Surveillance System (BRFSS) in 2020 indicates that roughly 18.7% of New Yorkers aged 18 and above suffer from arthritis. The percentage of cases for women (21.2%) was higher than for men (15.8%). Of the total cases reported, approximately 26.5% were obese, about 45% of adults living in New York with doctor-diagnosed arthritis had physical activity limitations, and 29.3% had severe joint pain.
Sources
Center for Orthopaedic Surgery and Sports Medicine
Greater Pittsburgh Orthopaedic Associates
New York State Department of Health
Centers for Disease Control and Prevention
WebMD
American Academy of Orthopedic Surgeons[1]
American Academy of Orthopedic Surgeons[2]
American Academy of Orthopedic Surgeons[3]
American Academy of Orthopedic Surgeons[4]
John Hopkins Medicine[1]
John Hopkins Medicine[2]
Greater Chesapeake Hand To Shoulder
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