Hand Surgery - Medical Experts

The field of hand surgery is extremely broad.

Hand surgeons treat:

• Burns
• Injuries
• Congenital abnormalities
• Malformations
• Inflammation
• Chronic degenerative diseases
• Chronic pain and
• Tumors of the hands, fingers, and arms

In addition, hand surgeons can amputate finger joints and parts of the hand and replace them with appropriate prostheses.

Hand surgery can replace damaged joints with joint prostheses @ sytnik /AdobeStock

Injuries and Malformations of the Hand

Injuries caused by accidents damage not only bones but also soft tissues (muscles, tendons, nerves, blood vessels).

As a result, the affected person suffers not only from limited mobility and pain but may also experience numbness and paralysis, which must be treated by a hand surgeon.

Overuse can also cause pain and changes in the position of structures in the arms and hands. This can lead, for example, to tendon insertion problems (golfer’s elbow, tennis elbow).

Sometimes, the hand surgeon also deals with congenital malformations such as polydactyly: Patients—usually young children—have too many fingers on their hands. Over the course of their lives, the extra fingers can become a nuisance, so one or more are surgically removed.

A very common condition treated at the clinic or medical center is a ganglion cyst. In this condition, a joint or tendon is protruding outward. This protrusion contains an accumulation of tissue fluid. Since a ganglion cannot be treated conservatively, surgery is necessary.

Dupuytren’s contracture is also one of the most common conditions. In older adults, men are 6 to 9 times more likely to be affected than women.

The patient suffers from an increasingly severe curvature of several fingers, which progressively restricts the mobility of the hand. 

This condition is characterized by excessive growth of subcutaneous connective tissue on the palm side of the hand. The cause of the condition is not yet fully understood.

If conservative treatment with the enzyme collagenase is ineffective, a hand surgeon surgically removes the excess tissue. Collagenase is produced biotechnologically from a species of bacteria (Clostridium).

By Efstathios Chronopoulos, Nikolaos Ptohis, Christos Karanikas, Alkis Kalliakmanis, Spyros Plessas, Ioannis Neofytou, Fotios Laspas, Ioanna Tzovara, and Athanasios Chalazonitis - Efstathios Chronopoulos, Nikolaos Ptohis, Christos Karanikas, Alkis Kalliakmanis, Spyros Plessas, Ioannis Neofytou, Fotios Laspas, Ioanna Tzovara, and Athanasios Chalazonitis: Patient presenting with a lipoma of the index finger: a case report. In: Cases Journal 3, 2010, 20. doi:10.1186/1757-1626-3-20 PMID 20205806 (Open Access), CC BY-SA 2.0, Link

Inflammatory Conditions

Tendinitis is one of the inflammatory conditions treated by hand surgeons. It results from an infection of the soft tissues, overuse, or injuries (strains) to the hand or wrist. 

Chronic cases of tenosynovitis require surgical treatment to prevent the tendons from becoming pinched later on.

If the patient suffers from polyarthritis (rheumatic inflammation of the joints), the joint inflammation will destroy the entire joint as the disease progresses. Polyarthritis requires treatment by a hand surgeon.

Signs of Wear and Tear in Hand Surgery

Thumb osteoarthritis often occurs following accidents or as a result of naturally loose joint ligaments. Signs of wear and tear in the thumb saddle joint are more common in patients aged 40 and older and cause pain and limited thumb function. If pain-relieving medications are no longer effective, the thumb saddle joint is surgically removed.

Nerve Entrapment Syndrome

Trapped nerves are also part of the hand surgeon’s area of expertise. If the median nerve runs through a narrowed bony canal, this causes:

• Pain
• Numbness and 
• Paralysis

Carpal tunnel syndrome occurs in women in connection with hormonal changes (menopause, pregnancy) and can also be congenital. If conservative treatment is unsuccessful, a carpal ligament release is performed at the clinic.

If the other two nerves in the hand are affected, the condition is referred to as Guyon’s canal syndrome or supinator syndrome. To prevent permanent nerve damage, surgery is performed if corticosteroid therapy is unsuccessful.

Treatment of Circulatory Disorders

Circulatory disorders affecting bones and soft tissues, such as lunate malacia, also fall within the scope of hand surgery. Occasionally, the hand surgeon must even remove benign or malignant tumors in the hand, arm, and shoulder regions. 

Enchondroma, for example, is a benign growth of cartilage tissue attached to a hand bone. It often occurs in large numbers.

If too much tissue has been destroyed, amputation is often the only option. In the hospital, a finger joint, the entire finger, or the entire hand is amputated.

Other patients receive a replacement finger joint or an endoprosthesis to replace the damaged joint that was removed.

In Germany, hand surgeons are board-certified specialists in:

• Orthopedics
• Orthopedics and Trauma Surgery
• Surgery
• Plastic Surgery / Aesthetic Surgery

After passing their board certification exam, they complete an additional 36 months of specialized training in hand surgery. This specialty originally emerged from the fields of surgery and orthopedics.