mtheman said:
This may sound stupid, but I was wondering, what is the most common case treated by hand surgeons? Also do hand surgeons(who have gone through ortho residency) treat fractures of the hand wrist and arm. Additionaly does going through plastic surg. training make a difference in the cases seen.
Any input would be great
Delayed response but may help someone...
Much of what you do as a hand surgeon depends on where you trained (your fellowship) and what you're interested in. There are some hand surgeons who do shoulder, elbow and wrist/hand and they're "upper extremity" surgeons. Others focus on elbow and distal. Most orthopaedic hand surgeons do elbow cases as well but this varies depending on the complexity of the case. The setting in which you practice also determines the pathology you see. For example, a patient with elbow instability from a sports injury is more likely to see a sports doctor than a hand surgeon. Patients with elbow arthritis or nerve compression are more likely to be referred to a hand surgeon.
Plastic surgeons usually focus on wrist and hand. It is rare for plastic surgeons to do elbows and shoulders in terms of bony work. They may do flaps, nerve repairs, decompressions, etc., but again it would be rare for them to do bone work in these areas. Whether they treat hand fractures depends on the setup at the hospital but most do treat hand fractures. At some hospitals, plastics takes care of soft tissue stuff and ortho does bony work. This is variable and probably less common. As far as cases, I think the issue is level of comfort. Plastic surgeons by virtue of their training feel more comfortable with soft tissue work and I think in many cases prefer this over bony procedures. This is a gross generalization but I think has some merit.
Bottom line is that much of what you do as a "hand surgeon" depends on where you trained and what exposure you had. Again, there are "upper extremity" fellowhips that give you broader exposure. Some fellowships are more focused. There are fellowships that give you plenty of elbow work but others that focus mostly on wrist/hand. So it's really variable.
Common hand procedures are carpal tunnels (by far most common), DeQuervains, ganglion cysts, mucous cysts, joint fusions (PIP, DIP), arthroplasties (MCP, PIP), tendon repairs, and fracture care which is very common. Hand surgeons also treat rheumatoid problems (tendon transfers, etc), do carpal fusions, treat ligament injuries in the wrist, etc. There is such a variety of cases and much of it depends on where you practice and the particular pathology that is prevalent in that area.
