Who are hand surgeons?
Orthopedic, plastic, or general surgeons specializing in treating the hand and upper extremities are known as 'hand surgeons.' Hand, wrists, forearms, elbows, and fingers are the body parts that hand surgeons treat.
Our hands have a wide range of uses. Ligaments, tendons, bones, joints, muscles, nerves, skin, and blood vessels comprise the distinctively constructed hand, an essential human body part. Our hands need mobility, strength, and sensation to work. When the hand is hurt or malfunctioning, care must be taken with all tissues that enable a hand to function.
Hand surgeons offer both surgical and nonsurgical treatment for various issues. They have specialized training to perform when called upon. A hand surgeon works toward form and function restorations from your initial consultation until your last visit, from the tiniest fracture to the most sophisticated reconstruction or replantation. They concentrate on conditions and wounds affecting the skin, nails, muscles, tendons, nerves, bones, joints, and ligaments. Congenital hand differences may also be treated by hand surgeons who solely work with children.
What do hand surgeons do?
Hand surgeons treat a variety of disorders, including, but not restricted to:
- Carpal tunnel syndrome
- Arthritis in the hand, wrist, and fingers
- Cubital-tunnel syndrome
- Finger, hand, and wrist fractures
- Hand and wrist ganglion cysts
- Wrist and hand infections
- Hand and wrist nerve injuries
- Finger, hand, and wrist tendon injuries
- Pull-string finger
Additionally, hand surgeons who treat elbows may also address the following conditions:
- Elbow biceps tendon rupture
- Osteoarthritis in the elbow
- Dislocated elbow
- Fractured elbow
- Tennis elbow or lateral epicondylitis
- Golfer's elbow or medial epicondylitis
Hand surgeons treat both surgical and nonsurgical problems. Typically, they split their time between:
- Surgery-related conditions are treated with procedures done in the operating room.
- Non-operative conditions, preparing patients for surgery, and following up with them after surgery
Medical students, residents, and fellows are all trained by hand surgeons in academic medical centers. Additionally, they might participate in studies, write articles, and impart knowledge at conferences.
What special training do hand surgeons receive?
Hand surgery is a distinct subspecialty for orthopedic, plastic, and general surgeons. A hand surgeon:
- Completes at least one year of hand surgery-specific training after their 5-7-year residency.
- Spend a significant amount of time (typically at least 70%) in their practice treating ailments of the hand and upper extremities.
- Obtains certification in hand surgery from the relevant medical board.
The American Board of Orthopedic Surgery (ABOS) accredits hand surgeons in orthopedic surgery. The certificate in 'orthopedic surgery of the hand' is received by board-certified orthopedic surgeons who have undergone additional training, demonstrated qualifications in hand surgery through practice by volume and diversity of cases, or have made significant contributions in this field.
Different types of hand surgery
Hand surgery can be categorized into different types depending on the condition and its causes. These include the following:
- Tendon repair - Tendons are fibrous tissues that bind the muscles with the bone. Trauma, sudden rupture, or infection can cause injury to the tendons, which may require tendon repair surgery. Depending on the damage, tendon repair surgery can be divided into three types: primary, delayed primary, and secondary repairs.
- Skin grafts - Skin graft surgery involves attaching healthy skin to the affected hand area where the skin is missing. In this surgery, healthy skin is taken from the donor site (usually another part of the body) and attached to the injured part of the hand. Hand surgeons recommend skin grafts for fingertip injuries or amputations.
- Skin flaps - Skin flaps surgery is similar to skin grafts. However, in this procedure, the skin taken from the donor site has its blood supply, including blood vessels, muscles, and fat. Hand surgeons recommend skin flap surgery when the affected area does not have proper blood supply due to extensive tissue and blood vessel damage.
- Replantation - Replantation surgery helps reattach a part of the hand wholly severed or cut from the body. The chief objective of the surgery is to restore physical functions in the reattached part of the hand. Replantation involves complex microsurgery using minute tools and is conducted under a microscope. Severe injury cases may require multiple surgeries to restore essential functions in the severed part.
- Closed reduction and fixation - This procedure is conducted in case of a broken bone or bone fracture in the hand and fingers. The surgery helps realign the broken bones, immobilizes them, and holds them in position when healing. Internal fixtures like casts, splints, rods, and wires are used to immobilize broken bones.
- Nerve repair surgery - Injury or trauma can damage the nerves in a part of the hand. It could lead to loss of feeling (or sensation) in the hand or loss of hand functions. A few nerve injuries may self-heal, while others may require nerve repair surgery. Surgery is conducted about three to five weeks post-injury in complicated nerve injury cases. In contrast, the hand surgeon may recommend immediate surgery in uncomplicated nerve injury cases.
- Joint replacement - Joint replacement surgery is conducted in severe hand arthritis cases. It is also known as arthroplasty, and in this procedure, the hand surgeon replaces the damaged joints with artificial joints made of silicone rubber, plastic, metal, or body tissues.
When should you visit a hand surgeon?
Hand injuries can occur at any time in different forms. Generally, people often visit their family doctors or the hospital to get it addressed. The condition may range anywhere from crushed fingers and fractures to loss of fingers or traumatic amputation of the hand. Even cuts can lead to infections over time.
It is essential to visit a doctor to identify the extent of the damage. Accordingly, depending on the diagnosis, they will refer you to a hand surgeon near you. However, you can also directly make an appointment with them for the following reasons:
- Severe pain lasting for a few days
- Inability to carry out daily activities
- Pain or stiffness causing loss of mobility
- Trouble using your hand, wrist, or forearm
- Bruising or swelling
- Joint pain in the hand
- Signs of infection
- Numbness or tingling in your fingers or hand
- Weakened grip
- Loss of muscle in the hand
- Obvious deformity
You should also visit them if your condition worsens despite home-based remedies, such as ice packs and rest. Some symptoms may point to a severe condition, such as dislocations or fractures. Moreover, early diagnosis can help the doctor develop the appropriate treatment plan to prevent permanent damage.
Many hand, wrist, and elbow conditions can be treated without requiring surgery. Some other common nonsurgical treatments include nonsteroidal anti-inflammatory drugs, activity modifications, corticosteroid injections, and rest.
At hospitals, they will transfer you to a hand surgeon in case of amputations and multiple-digit injuries. The doctors base their decision on multiple factors, including the patient's age and scope of injury; this is because some amputations have higher chances of replantations in younger patients.
Hospitals will also transfer you immediately if you have complex hand injuries, multiple finger injuries, open fractures, or infections. They may conduct imaging tests and physical examinations to determine the need for transfer. Additionally, patients can consult their doctors with pictures over the phone if they cannot visit. Doctors will guide you in taking the necessary precautions or ask you to see an ER or a hospital with a hand surgeon near you.
What to expect on your first visit to a hand surgeon?
Your hand surgeon will typically review your medical background, including any prior surgeries or injuries, at the beginning of the visit. They will inquire about your daily routine, activities, allergies, relevant family medical history, whether you take any medication, and the specifics and duration of your symptoms.
Subsequently, they will conduct a complete physical examination to assess your condition. This may entail testing your grip and strength, flexibility, range of motion, sensory and fine motor function, and hands' vascular health (color, temperature). Additionally, they will look for any anomalies or malformations.
Additional diagnostic procedures, such as X-rays or blood tests, can also be required to look for anomalies, help determine the source of your symptoms, and ascertain the diagnosis.
Following your physical examination and diagnosis, your hand surgeon will review your findings and develop a suitable treatment plan. Hand surgeons frequently suggest nonsurgical approaches, such as:
- Hand therapy - A mix of physical and occupational treatments used to regain movement and lessen or remove discomfort.
- Injections - It includes steroid injections, which are effective for various hand and wrist disorders.
- Medication - Prescription or over-the-counter treatments, such as non-steroidal anti-inflammatory drugs, effectively treat some illnesses (NSAIDs).
Carpal tunnel syndrome
Carpal tunnel syndrome happens due to the constant pressure on the median nerve in the wrist's carpal tunnel, a narrow passage encased by bones and ligaments on the palm side. Compression of this nerve can lead to numbness, weakness, or tingling in the thumb and fingers. Factors such as wrist anatomy, certain health conditions, and potentially repetitive hand movements can contribute to the development of carpal tunnel syndrome.
To diagnose carpal tunnel syndrome, healthcare providers assess sensation in the fingers and hand muscle strength. Certain maneuvers, like bending the wrist, tapping on the nerve, or applying pressure, can often trigger symptoms. For imaging, an X-ray may be taken to rule out other wrist pain causes, such as arthritis or fractures. However, it is not the most helpful in diagnosing carpal tunnel syndrome specifically. An ultrasound can visualize the tendons and nerves, helping detect any nerve compression.
Electromyography (EMG) is another diagnostic tool that measures electrical discharges in muscles. During EMG, a fine needle electrode is inserted into specific muscles to record electrical activity during muscle contraction and rest, helping to identify any muscle damage linked to the median nerve.
It's best to begin treatment for carpal tunnel syndrome as soon as symptoms appear. Early interventions like the following can often relieve symptoms:
- Take regular breaks to rest your hands.
- Avoiding activities that aggravate symptoms.
- Frequently use ice packs on the affected area.
Other treatment options include medications, wrist splinting, and, in some cases, surgery. Conservative treatments like splinting are generally most effective for mild to moderate symptoms that have persisted for less than 10 months.
If you experience hand numbness, seeking care from a hand surgeon near you is important.
Surgery is chosen as a treatment option if carpal tunnel syndrome symptoms are severe or don't improve with other treatments. The aim of the procedure is to remove pressure on the nerve by cutting the ligament pressing against it. This can help alleviate symptoms and improve hand function.
Best hand surgeons in Washington, DC
Hands are essential and valuable instruments, and we use them to interact with our environment. We use our hands to support our daily lives, engage in hobbies and sports, and care for our family and ourselves. When our hands are injured, several areas of our lives may be affected. Hence, the choice of a healthcare practitioner is crucial.
Consult a hand surgeon near you if you experience discomfort in your fingers, wrist, arm, or hand or any other problems with your upper extremities. Use Zocdoc to find a hand surgeon close to you because we know you don't want to overlook anything crucial about your health. Zocdoc aims to connect patients with the best medical specialists near them. You can use Zocdoc to find the top hand surgeon in Washington, DC, based on your symptoms, the procedure you need, your desired location and time, and your insurance company and plan.
If your insurance plan is not listed on Zocdoc, you can upload a photo of your medical insurance card (please note that this option is not available for vision or dental plans). Our system will scan the image and identify your likely plan. If you experience difficulty uploading your card, our dedicated service team is available to assist you. You can also check out Zocdoc's patient help center for more information and solutions related to insurance.
Additionally, you can filter the search results to choose a hand surgeon depending on the languages they speak, gender, affiliation with a hospital, and whether or not they treat children.
On the Zocdoc platform, each hand surgeon has a profile with information about their training, experience, specialties, affiliations, awards, certifications, and licenses, among more details. You can review these specifics and make online or in-person appointments based on your needs. You can also look through verified patient reviews to find the best hand surgeon near you in Washington, DC.
All the appointments on Zocdoc are free, easy, and safe!
Hand surgery statistics in the U.S.
Washington, DC, has 261 plastic surgeons, 107 hand surgeons, and one orthopedic surgeon.
As per the American Society of Plastic Surgeons, tumor removal continues to be the most common reconstructive procedure, with about 5.2 million treatments in 2020 (a 4% rise from 2019). Other procedures commonly performed in the U.S. are laceration repair, scar revision, hand surgery, and maxillofacial surgery. In 2020, 6.8 million reconstructive surgeries were performed, a 3% increase over 2019.
As per a U.S. Bureau of Labor Statistics study, the total non-fatal work injury and illness rates in 2022 in the U.S. were 2.7 for every 100 full-time workers.
Sources
University of Michigan Health
American Society for Surgery of the Hand
WebMD
OrthoInfo
U.S. Bureau of Labor Statistics
American Society of Plastic Surgeons
Johns Hopkins Medicine
Mayo Clinic[1]
Mayo Clinic[2]
Mayo Clinic[3]
University of Iowa Health Care
UC San Diego Health
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