Hand Surgery Philosophy

The hand of the human being is probably the most intriguing and complex engineered bio-advanced miracle known to the human mind. It is therefore not hard to believe in the theory that the brain has developed secondary to the hand. The wealth of sensory input from the hand has been feeding the brain and creating millions of new pathways and synapses that have advanced the human brain beyond our comprehension. The human hand has the ability to grip an object in the palm, but even more so it has the ability to pinch. The pinch grip has been made possible by the thumb that can move in all directions (circumduction) and can hold objects against the index finger. The ability to hold something between your index or even little finger and thumb is truly the most advanced form of life and a miracle!

So when this miracle has been crippled by an injury, pain or chronic disease, the person suffers a great deal. But even more than just a state of suffering, a sense of loss and disability tends to cripple the mind as well. People only realise the multitudes of functions and the need for the hand in all activities of daily living, once it is injured, crippled by arthritis or immobilised for any reason.

Surgery of the hand is rather complex. It deals with pain, loss of function, delicate anatomy, complex biomechanics and to some extent, an intuition or understanding of the complexity of the real problem beyond what is commonly presented. This intuition is probably all about real listening to the patient and then to listen again. The solution is not always clear at first and might never be. The solution is not always surgery. The solution might be intensive hand therapy or sometimes rest from sport, work or even a long holiday. When the solution is surgery, in selected cases, the hand surgeon needs to apply all the foundations of the anatomy and patho-anatomy (when the anatomy goes wrong) and combine it with the art and skill of combined orthopaedic (bone and joints) and plastic (soft tissue) surgical principles to make the patient better. This can be a hard job, but with meticulous attention to detail and application of basic principles, it can bring great relief.

Please share your ideas and ideologies with us. We learn a great deal from patients and we will be delighted to hear from you.