Your hand and wrist are among the most complex parts of your body. Each hand is a complicated network comprising 19 bones, 34 muscles, plus nerves, tendons and ligaments, blood vessels and parts of your lymphatic system.1
That’s why, if you’re experiencing pain or considering surgery, it’s important to see a hand surgery specialist for an accurate diagnosis and optimal treatment.
“The hand is sufficiently complex that it would be beneficial to a patient to see someone who focuses particularly on that area of the anatomy,” said Dr. Christopher Miskovsky, M.D., an orthopedic surgeon on the medical staff at Texas Health Center for Diagnostics and Surgery, specializing in hand, wrist and elbow surgery.
A hand surgeon completes at least a year of specialized training in hand surgery, after an initial 5- to 7-year residency and dedicates a substantial portion of their practice to conditions of the hand and upper extremity.2
“It’s important to choose a physician who is comfortable treating the problem that you have and who sees that problem on a regular basis,” Dr. Miskovsky said. “If I had a knee problem, I would go to a knee specialist, because I want the person who treats a hundred, 200, or 300 patients with knee problems every year, as compared to the person who sees it once a month. The same holds true for hand, wrist, and elbow problems.”3
Physicians with specialized expertise can often provide a diagnosis and treatment more quickly, because of their fellowship training and extensive experience. A condition that a general practitioner sees once a month or once a year may be a common problem that a specialist treats often.4
Specialists are also more prepared to handle more complex surgeries, such as joint replacement surgery in the hand.
“With joint replacement surgery, the type of arthritis will dictate what type of replacement that we use,” he said. “We will use a silicone prosthesis in patients with rheumatoid arthritis of the hand, where their joint is essentially dislocated and fallen down to the side, and we'll replace all four of these joints with a silicone replacement that allows them to be in a more functional position for their hand and therefore have a more functional arc of motion.”
Patients with osteoarthritis at the MP joints, or metacarpophalangeal joints (the large joints in the hand at the base of each finger) often benefit from a pyrocarbon joint replacement.
“That is a more durable joint replacement for an individual who has arthritis of the hand from working with their hands heavily, such as a mechanic,” he said. “That replacement tends to be more capable of undergoing force, such as heavy gripping and heavy lifting activities compared to the silicone prosthesis.”5
Another common condition treated by hand, wrist and elbow specialists is carpal tunnel syndrome. Symptoms include pain, numbing and tingling, caused by a compressed nerve in the wrist.
For many patients, carpal tunnel may be treated successfully with night splinting and/or medication. But when carpal tunnel surgery is needed, early studies suggest that endoscopic surgery may offer benefits over traditional open surgery, in terms of pain relief, symptom resolution, patient satisfaction, duration to return to work and fewer complications.6
Typically, surgery is recommended only after more conservative carpal tunnel treatments are tried and failed to provide relief. Knowing when to try more conservative treatments, and when to recommend surgery, is another key advantage of turning to a specialist for guidance and treatment.
“Specialists can benefit a patient quite a bit when they come in with a common hand, wrist, or elbow problem: by treating them efficiently, by treating them in a cost-effective fashion, and also by diagnosing them correctly at the beginning and getting them on the proper treatment plan,” Dr. Miskovsky said.7
The physicians on the medical staff at Texas Health Center for Diagnostics & Surgery in Plano, Texas, provide a wide range of nonsurgical and surgical treatment options for conditions affecting the hand and upper extremities. For more information, please call the THCDS patient navigator at 972-543-1250.
[1] Anatomy of the Hand, Cleveland Clinic. https://my.clevelandclinic.org/health/body/25060-anatomy-of-the-hand-and-wrist
[2] What is a Hand Surgeon, Ortho Info. https://orthoinfo.aaos.org/en/treatment/what-is-a-hand-surgeon/
[3] Dr. Miskovsky video, Why you should see a hand surgeon: https://www.youtube.com/watch?v=5LoQDt6dukU
[4] Dr. Miskovsky video, Why you should see a hand surgeon: https://www.youtube.com/watch?v=5LoQDt6dukU
[5] Dr. Miskovsky video, Joint replacement in the hand: https://www.youtube.com/watch?v=HQrW2vjQtBw&t
[6] Endoscopic carpal surgery in carpal tunnel syndrome: A systematic review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10262635/
[7] Dr. Miskovsky video, Why you should see a hand surgeon: https://www.youtube.com/watch?v=5LoQDt6dukU