What is Hand Surgery?

Hand Surgery is surgery of the hand, the wrist and the peripheral nerves of the upper limb. It also encompasses reconstructive surgery that improves upper limb function after nerve injury.

Many disorders and injuries of the hand are treated without surgery, using splints, taping, injections and hand physiotherapy.

A typical hand surgery operation is performed as a day-case under a regional anaesthetic (injected in the armpit or above the shoulder, to numb the entire arm); the patient is awake or lightly sedated, according to preference. General anaesthesia and/or overnight stay in hospital are unusual but are required for some operations on the hand, such as in children or when surgery is prolonged. A few operations can be performed under local anaesthesia (injected beneath the skin at the site of surgery).

The surgeon uses fine instruments to handle the delicate structures in the hand, and may use magnifying glasses (loupes) or an operating microscope for repair of the small nerves and arteries in the hand.

Post-operative treatment by a hand therapist is essential for optimal recovery after some types of hand surgery.

The BSSH 2007 report "Hand Surgery in the UK: manpower, resources, standards and training" is here (pdf)