What is an orthopedic hand surgeon?
In 1741, a French physician named Nicolas Andry coined a new word for the title of his “Orthopedie,” a book devoted to methods of correcting skeletal deformities in children. Andry’s methods have not survived the passage of time, but his neologism, combining Greek roots for “straight” and “child,” has lived on as the name of the medical specialty of orthopedics.
Today, orthopedics is the branch of medicine devoted to the musculoskeletal system and an orthopedic surgeon is a physician qualified to treat disorders of that system both medically and surgically.
Qualification in the field requires extensive education and clinical training. An orthopedic surgeon has typically been through four years of undergraduate education and four years of medical school before beginning another five years of residency training. That residency usually begins with one year of general surgery, followed by a four-year residency in orthopedic surgery.
After successful completion of the residency, two years of orthopedic practice and passage of a written and oral examination, the surgeon is eligible to become certified in the specialty by the American Board of Orthopaedic Surgery.
At that point, a surgeon can elect further specialization in certain areas, including surgery of the hand. An orthopedic hand specialist who has evinced hand surgery qualifications beyond those generally typical of orthopedic surgeons can sit for an examination in order to earn the “Certificate of Added Qualifications in Surgery of the Hand.”
What procedures can be performed by a hand surgeon?
Despite the title, the practice of an orthopedic hand surgeon does not end at the wrist, but encompasses the entire arm. Nor is it strictly surgical, as it combines both medical and surgical treatment, with the physician able to choose the approach best suited to the patient’s needs.
The hand surgeon can perform a wide variety of procedures, from post-injury reconstructions and repairs of tendons and fractured bones, to correction of deformities such as those caused by arthritis and by congenital abnormalities. The surgeon’s expertise extends to the diagnosis and treatment of conditions that present without obvious injury, especially those that stem from internal inflammation and swelling and that are no less debilitating for being invisible to the naked eye.
Of necessity, the hand surgeon is well versed in complex structures that contain many interrelated small bones, an apt description of the hand and wrist, and, as a result, the specialty has been one of the pioneers of microsurgical and minimally invasive techniques.
What are some common injuries and conditions that a hand surgeon treats?
Orthopedic hand surgery can come into play whenever a patient presents with pain or loss of function in the hand or arm. On the one hand, surgeons treat the obvious results of trauma, like sprains and fractures, especially if the fracture is complicated by displacement or instability.
Hand surgeons also treat conditions that are less overt, like carpal tunnel and radial tunnel syndromes, trigger finger, tennis elbow, cartilage tears, nerve injuries, vascular disorders and the many manifestations of arthritis in the upper extremities.
The list is long and the few examples above are hardly exhaustive, but they serve to illustrate the unique position occupied by the orthopedic hand surgeon. By virtue of his specialized training and experience, the surgeon can judge the likely efficacy of all of the patient’s available options, basing his judgment on first-hand experience of outcomes from the simplest admonition to give the hand some rest to the most sophisticated of contemporary surgical procedures.