Who are hand surgeons?
Our hands are an integral part of the body that help us function efficiently and assist us in our daily activities. Strength, sensation, and mobility are requisite for our hands to perform everyday tasks. Immediate care becomes necessary if any of these is affected due to an injury to help the tissues heal and retain the proper function of hands.
Hand surgery is a distinct medical specialty focusing on diagnosing, treating, and managing conditions affecting the hand, wrist, and forearm, including traumatic injuries, degenerative diseases, congenital anomalies, and chronic disorders. Some common hand conditions treated with surgery include carpal tunnel syndrome, trigger finger, tennis elbow, and arthritis. Recovery from hand surgery can vary depending on the type and extent of the surgery. Sometimes, patients may need to wear a cast or splint for several weeks and participate in hand therapy to regain strength and function in the affected hand or wrist.
Hand surgeons employ various surgical and non-surgical techniques to treat hand and wrist conditions. Some standard treatments may include physical therapy, medication, injections, or surgery, depending on the nature and severity of the disease. Beyond injury treatment, hand surgeons often collaborate with physical or occupational therapists to help patients recover and regain functionality after an injury or surgery.
Hand surgeons typically come from two medical backgrounds: orthopedic and plastic surgery. Orthopedic hand surgeons have completed a residency in orthopedic surgery and have further specialized in hand surgery. On the other hand, plastic hand surgeons have completed a residency in plastic surgery and further specialized in hand surgery.
Education and clinical training of hand surgeons
The educational path to becoming a hand surgeon begins with a four-year undergraduate degree followed by four years of medical school. After medical school, they must complete an orthopedic or plastic surgery residency, typically lasting five to six years.
Following their residency, aspirants can further specialize by completing a fellowship program in hand surgery. These programs last one to two years and provide additional clinical training in treating and managing hand and wrist conditions. They also include training in microsurgery, which involves using magnification and specialized instruments to perform precise procedures on small structures in the hand and wrist.
In addition to surgical training, hand surgeons receive extensive rehabilitation and physical therapy training to help patients recover from hand and wrist injuries and surgeries. They must also maintain their certification through continuing education and participation in ongoing professional development programs.Â
What are the types of surgeries performed by a hand surgeon?
A hand surgeon may perform several surgeries, depending on the specific condition or injury. Here are some of the most common hand surgeries they perform:
- Tendon repair: Fibers joining the bone and the muscles are known as 'tendons.' The tendon's structure makes it difficult for the hand surgeon to perform surgery; nevertheless, such surgeries are imperative in case of injuries like hand rupture or trauma. Doctors classify tendon repairs as primary, delayed primary, and secondary based on the duration between the damage and the surgery.
Primary repair is the procedure conducted on the same day as the injury. Physicians perform the delayed primary repair within a few days of the hand injury. In contrast, surgeons schedule a secondary repair after two to four weeks of the damage. This time gap is due to the complexity of the process, such as tendon grafting.Â
- Skin grafting: Surgeons usually use skin grafts to treat facial injuries or amputations. The procedure involves taking a part of healthy skin from the body and attaching it to a region that has missing skin or replacing it with the injured skin part.
- Nerve repair: Some hand injuries damage the nerves around the area of the injury. This damage may cause the hand to lose sensation, which hinders the hand's functionality. Such nerve damage can either heal naturally with time or require surgery. Some nerve repairs are done immediately after the injury by replacing them with other nerves from the body (nerve grafts). In contrast, others are done two or three weeks after the injury to reduce complications.
- Skin flap: Surgeons conduct skin flaps when body parts lack proper blood supply and are missing skin. The process is similar to skin grafts, but the only difference is that the surgeon grafts the healthy piece of skin from a body part with good blood flow. The injured parts are replaced with the underlying fats, blood vessels, and muscles to make the hand function normally.
- Fasciotomy: This procedure alleviates pain and pressure from the hand, often caused by an injury. Surgeons commonly perform it on patients who suffer from compartment syndrome. Weakening of the muscles and severe hand pain are symptoms of compartment syndrome, which may even lead to discoloration of nails or fingers.
- Joint replacement: In severe hand arthritis cases, hand surgeons use an artificial joint to replace the damaged one. Manufacturers make artificial joints from silicon rubber, plastic, metal, or body tissues like tendons.
- Debridement or surgical drainage: In extreme cases of hand infections, hand surgeons use the debridement technique to clean up the wound and remove contaminated tissues. If the hand becomes sore from an illness, pus is removed with a needle through surgical drainage, preventing the disease from spreading further.
Common conditions treated by hand surgeons
Some common conditions hand surgeons treat are listed below. Â
- Ulnar nerve entrapment (cubital tunnel syndrome): It occurs when the ulnar nerve becomes compressed, usually around the elbow, causing discomfort along the arm into the hand. This nerve runs from the neck to the hand and can be constricted at multiple points, most commonly behind the inside of the elbow. Compression at this location is known as cubital tunnel syndrome, and it can result in pain, tingling, or weakness.
- Carpal tunnel syndrome: It results from pressure on the median nerve, which causes tingling, numbness, and pain in the hand and forearm. Without treatment, carpal tunnel syndrome typically progresses and can result in permanent hand dysfunction, including finger numbness and weakness.
- Elbow osteoarthritis: Elbow osteoarthritis occurs when cartilage in the elbow joint deteriorates, often due to past injuries or age-related wear. While osteoarthritis generally affects weight-bearing joints like the hip and knee, the elbow is less susceptible due to its stable joint structure. Nonetheless, damage to this joint can result in pain and limit arm function, making treatment crucial for maintaining mobility.
- Tennis elbow (Lateral epicondylitis): Tennis elbow, medically termed lateral epicondylitis, arises from overuse, often due to repeated arm motions in sports like tennis. This condition involves the degeneration or microtearing of tendons connecting forearm muscles to the outside of the elbow. Repetitive use can lead to pain and tenderness on the outside of the elbow, affecting daily activities. While racquet sports are common culprits, repetitive arm motion can contribute to tennis elbow.
- Trigger finger: This affects the tendons that control finger and thumb movement, causing a catching or locking sensation when bending or straightening the fingers. Other symptoms include pain and stiffness. Trigger finger commonly impacts the ring finger and thumb, though any digit can be affected. When the thumb is involved, the condition is specifically called trigger thumb.
When should you visit a hand surgeon?
Hand injuries can manifest in various forms at any given time. Typically, individuals turn to their family doctors or hospitals for resolution, addressing conditions ranging from crushed fingers and fractures to the more severe loss of fingers or traumatic amputation of the hand. Even seemingly minor cuts can lead to infections over time. Â
Seeking medical attention is vital for determining the degree of the harm. Depending on the diagnosis, your doctor may recommend seeing a hand surgeon near you. You can also book an appointment directly with them for the following reasons:
- Persistent severe pain: Intense pain lasting several days.Â
- Impaired daily activities: Inability to perform routine tasks.Â
- Limited mobility: Pain or stiffness affecting hand, wrist, or forearm movement.Â
- Difficulty using your hand: Trouble utilizing your hand for various activitiesÂ
- Bruising or swelling: Visible signs of injury.Â
- Joint pain: Discomfort in the hand's joints.Â
- Signs of Infection: Redness, warmth, or other indicationsÂ
- Numbness or tingling: Unusual sensations in fingers or hand.Â
- Weakened grip: Difficulty holding onto objects.Â
- Loss of muscle mass: Noticeable reduction in hand muscle size.Â
- Obvious deformity: Visible abnormalities.
Many hand, wrist, and elbow conditions can be treated without surgery. Non-surgical options include non-steroidal anti-inflammatory drugs, physical therapy, steroid injections, and rest. In cases of amputations and multiple-digit injuries, hospitals may transfer patients to a hand surgeon, considering factors like the patient's age and the injury's scope.
Immediate transfer to a hand surgeon is crucial for complex hand injuries, multiple finger injuries, open fractures, or infections. Hospitals may conduct imaging tests and physical examinations to assess transfer needs. Additionally, patients can seek remote consultations with doctors, providing pictures for assessment and guidance, especially if visiting in person is challenging. In such cases, doctors can recommend necessary precautions and advise on whether urgent attention at the ER or a hospital with a hand surgeon is required.
Finding the best hand surgeon near you in New York, NY
Consulting a hand surgeon is ideal if you constantly feel pain or discomfort in your wrist, arm, hand, or elbow or have concerns about the upper extremities. While finding the right doctor for your requirements may seem complicated, with Zocdoc, you can access a list of verified hand surgeons near you. Our search algorithm suggests doctors best suited for your needs based on your symptoms, location, preferred date of consultation, and insurance plan.Â
Are you unable to locate your health plan? Do not panic! You can use our insurance detector feature for help. To do so, go to account settings and upload a photo of your insurance card. Zocdoc will scan it and then show your likely plan. You can add the information to the search bar and continue looking for in-network providers. Do you have more insurance-related questions? Our Zocdoc patient help center page will have the required answers!Â
You can also check the doctors' profiles for qualifications, work experience, hospital affiliations, professional memberships, and more. Additionally, you can access verified patient reviews to choose the best hand surgeon near you. Whether you prefer an in-person visit or a video consultation, we have you covered.
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Arthritis and hand surgeon statistics in New York
According to a report by the National Center for Biotechnology Information, 2014-15, New York had more hand surgeons than the national average of 53 per state. Hand surgeons were abundant in California, Texas, New York, and Florida, while Wyoming and Alaska had the lowest numbers.
As per America's Health Rankings Annual Report (2021 edition), about 23.6% of New Yorkers suffered from arthritis in 2020. Of these, 48.8% of individuals were 65 years or above. More women in New York (27.3%) were affected by the disease than men (19.6%).Â
Individuals who have rheumatoid arthritis or osteoarthritis are prone to hand injuries that damage their hand structure. Therefore, it is best to consult a hand surgeon when symptoms of discomfort and pain arise.
Sources
Johns Hopkins Medicine
OrthoInfo
Castle Connolly
The Hand Clinique
American Society for Surgery of the HandÂ
America's Health Rankings
National Center for Biotechnology Information
Mayo Clinic
WebMD
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