Recommended hand, wrist, and elbow surgeons

What is a hand, wrist and elbow surgeon and what is their role?

A hand, wrist and elbow surgeon specializes in diagnosis, treatment and prevention of diseases affecting these joints and upper limbs. They treat conditions such as complex fractures, tendon injuries, nerve compressions, arthritis and deformities, in addition to performing microsurgical reconstructions. Their role goes beyond surgery, also encompassing preventive medicine, rehabilitation and therapeutic planning in conjunction with other health professionals, such as physiotherapists and occupational therapists. To become a specialist, the doctor must complete residency in orthopedics or plastic surgery, followed by specialization in hand surgery, recognized by the Brazilian Society of Hand Surgery.

Main conditions treated by hand, wrist and elbow surgeons

Surgeons specialized in hand, wrist and elbow treat various conditions that can significantly compromise upper limb functionality and patients' quality of life.

Carpal tunnel syndrome

Condition characterized by compression of the median nerve at the wrist, affecting approximately 3-6% of adult population, being more common in women and individuals over 40 years old. Symptoms include tingling, numbness and weakness in the hand, especially in the first three fingers, with frequent nighttime worsening. Risk factors include repetitive movements, diabetes, hypothyroidism and rheumatoid arthritis. Treatment varies from conservative measures such as orthoses and physiotherapy to surgical decompression, which presents success rates superior to 90% when well indicated.

Trigger finger

Stenosing tenosynovitis that causes blocking of finger flexion and extension movement, affecting about 2% of general population and 10% of diabetics. It manifests as palpable nodulation and sensation of "locking" when moving the finger, frequently accompanied by pain in palm of hand. Treatment includes conservative measures such as anti-inflammatory medication and corticosteroid infiltrations, with surgery recommended for refractory cases, with minimally invasive procedure performed under local anesthesia.

Wrist and hand fractures

Distal radius fractures represent 17% of all fractures treated in emergencies, being more common in elderly after falls and in young people involved in high-impact accidents. Management varies from immobilization with cast to surgical fixation with plates and screws, depending on fracture complexity and stability. Carpal bone fractures, especially scaphoid, require special attention due to high risk of non-union and avascular necrosis. Modern imaging techniques such as computed tomography and magnetic resonance allow precise diagnosis and detailed surgical planning.

Lateral and medial epicondylitis

Commonly known as "tennis elbow" and "golfer's elbow", respectively, they are tendinopathies affecting forearm muscle insertion at elbow. They are characterized by localized pain that worsens with use of corresponding musculature. Initial treatment is conservative, including activity modification, physiotherapy and infiltrations. For persistent cases, there are surgical options such as debridement of affected tendon and minimally invasive techniques such as ultrasound-guided percutaneous tenotomy.

Hand and wrist arthrosis

Degenerative disease mainly affecting thumb base joint (trapezium-metacarpal joint) and interphalangeal joints. It manifests with pain, stiffness, deformity and progressive decrease in strength and manual dexterity. Affects about 60% of people over 65 years, predominantly postmenopausal women. Conservative treatment includes analgesic medication, orthoses and occupational therapy, while surgical options include arthroplasties, arthrodeses and osteotomies, depending on affected joint and patient profile.

Common examinations and procedures performed by hand, wrist and elbow surgeons

Electroneuromyography

Neurophysiological examination that evaluates nerve conduction and muscle function, fundamental for diagnosis of compressive neuropathies such as carpal tunnel syndrome and ulnar nerve compression. Allows quantifying degree of nerve compression and defining exact location of lesion, assisting in therapeutic planning. Examination combines electromyography, which records electrical activity of muscles, and nerve conduction study, which measures velocity and amplitude of electrical impulses in peripheral nerves.

Wrist and elbow arthroscopy

Minimally invasive procedure that allows visualizing and treating internal joint problems through small incisions. Uses arthroscope with high-definition camera connected to monitor, allowing precise manipulation of specialized instruments. In wrist arthroscopy, triangular fibrocartilage complex lesions, synovial cysts and scaphoid fractures are frequently treated. In elbow, technique is used for removal of loose bodies, treatment of osteochondroses and contracture release, providing faster recovery and lower morbidity compared to traditional open surgeries.

Reconstructive microsurgery

Technique using surgical microscope for high-precision procedures on tiny structures such as nerves, blood vessels and tendons. Allows performing reimplantations of amputated fingers and hands, reconstructions after complex trauma and vascularized tissue transfers (free flaps). Nerve microsurgery enables primary repairs, grafts and nerve transfers to restore sensitivity and motor function. Technological advancement with digital microscopy systems and specific instruments has expanded possibilities for increasingly sophisticated and functional reconstructions.

Musculoskeletal ultrasonography

Non-invasive examination allowing dynamic visualization of tendons, ligaments, muscles and nerves in real time. Particularly useful for evaluation of tendon injuries, synovitis, cysts and foreign bodies. Offers advantage of allowing dynamic evaluation of structures during movement, identifying instabilities and impacts not visible in static examinations. Increasingly used for guided procedures such as specific infiltrations, percutaneous tendon release and cyst aspiration, increasing precision and reducing complications.

Technological advances and innovations in hand, wrist and elbow surgery

Personalized joint prostheses

Joint implants for hand and wrist have evolved significantly with biocompatible materials and anatomical designs. Trapezium-metacarpal prostheses for thumb arthrosis offer movement preservation with pain relief. Proximal interphalangeal arthroplasties allow functional recovery in cases of advanced arthrosis. 3D printing technologies enable creation of personalized implants based on patient's specific anatomy, providing better fit and functionality. New biomaterials such as high-resistance ceramics and advanced polymers have increased implant durability and biointegration.

Tissue engineering and regenerative medicine

Research with growth factors and stem cells shows potential for tissue regeneration such as cartilage, tendons and peripheral nerves. Platelet-rich plasma (PRP) and demineralized bone matrix are used to accelerate tendon healing and bone consolidation. Biocompatible scaffolds serve as three-dimensional structure for cellular growth in cases of large tissue defects. Clinical studies exploring application of mesenchymal cells for cartilage regeneration in hand joints have demonstrated promising results for osteoarthritis treatment in initial stages.

Augmented reality and virtual surgical planning

Intraoperative navigation systems and three-dimensional pre-surgical planning revolutionize precision of complex procedures. Holographic visualization allows surgeon to overlay virtual images reconstructed from patient examinations over real operative field. For complex bone reconstructions, specific guide molds are produced by additive manufacturing from virtual planning, ensuring greater precision in cuts and implant positioning. Technology also facilitates training and simulation of challenging procedures, reducing learning curve and increasing patient safety.

How to choose a qualified hand, wrist and elbow surgeon

Qualifications and specializations

Verify specialist credentials, including training in orthopedics or plastic surgery followed by specialization in hand surgery. A qualified professional should have specialist title recognized by Brazilian Society of Hand Surgery (SBCM) or equivalent international certification. For specific conditions such as microsurgery, reimplantations or peripheral nerve surgery, seek surgeons with complementary training in these areas. Experience with treatment of your specific condition is particularly relevant, especially in complex cases of congenital malformations or post-traumatic reconstructions.

Patient evaluations

Consult evaluations from other patients to understand care quality and functional results obtained. Specialized medical platforms, patient associations with specific conditions and support groups can provide valuable information about experience with certain surgeon. Important aspects include clarity in explanations about diagnosis and treatment, availability for post-operative follow-up and rehabilitation approach. Professionals working in multidisciplinary team with hand therapists generally offer more comprehensive treatment and better functional results.

Infrastructure and equipment

Evaluate if surgeon has access to technological resources necessary for modern hand surgery procedures. Hospitals and surgical centers specialized in hand surgery ideally have surgical microscope, specific microsurgical and arthroscopic instruments. For high-complexity surgeries such as reimplantations, it's essential to verify if surgeon works in institution with 24-hour on-call team for emergencies. Availability of specialized post-operative rehabilitation, with occupational therapists and physiotherapists specialized in hand, is another important differential for final treatment outcome.

The importance of regular consultations with hand, wrist and elbow surgeons

Many degenerative conditions of upper limb joints progress silently before manifesting limiting symptoms, making preventive follow-up essential.

Ergonomic evaluation and prevention of occupational injuries

For professionals who perform repetitive or precise movements with hands, preventive evaluation can identify risk factors and prevent repetitive strain injuries. Specialist can recommend specific ergonomic adaptations for work environment, adjustments in activity execution technique and implementation of strategic breaks. Musicians, typists, surgeons, dentists and other professionals who critically depend on precise manual function particularly benefit from periodic evaluations and personalized preventive guidance for their specific occupational demands.

Monitoring of degenerative conditions

Patients with genetic predisposition or initial diagnosis of arthrosis, tendinopathies or compressive neuropathies benefit from regular follow-up for early intervention. Imaging monitoring and periodic functional evaluations allow adjustments in conservative treatment and identification of ideal moment for surgical intervention when necessary. For conditions such as rheumatoid arthritis and other autoimmune diseases, hand specialist coordinates treatment with rheumatologist for maximum preservation of joint function through strategic preventive interventions.

It's important to demystify consultations with hand specialist and overcome postponement of seeking specialized care. Periodic consultation allows early identification of subtle functional alterations, specific preventive guidance and intervention in initial phases, when treatments are less invasive and more effective.

Factors that influence upper limb joint health

Adequate nutrition and hydration

Balanced diets with adequate intake of vitamins and minerals contribute to joint health and tissue healing. Vitamin D is essential for bone health, while antioxidants and omega-3 help control inflammation. Adequate hydration maintains viscosity of synovial fluid that lubricates joints. Foods rich in collagen and its precursors favor maintenance of cartilaginous matrix. Body weight control reduces biomechanical stress on joints, especially important for elbows and wrists in patients using walking aids.

Specific exercises and strengthening

Exercise programs directed at strengthening and flexibility of upper limbs prevent injuries and improve joint functionality. Isometric and progressive resistance exercises strengthen joint stabilizing musculature. Proprioceptive training improves neuromuscular control and precision of fine movements. For professionals with high functional demand of upper limbs, specific preventive programs significantly reduce incidence of occupational injuries. Regular stretching exercises of forearm muscles and tendons are particularly beneficial for epicondylitis prevention.

Ergonomics and overload control

Ergonomic adequacy of work environment and daily activities is fundamental for prevention of overload injuries. Correct adjustment of table height, keyboard and mouse positioning, and use of tools with ergonomic design reduce stress on joints and tendons. Task alternation and micro-breaks during repetitive activities decrease risk of tenosynovitis and compressive syndromes. Use of specific orthoses during risk activities or rest periods may be recommended preventively in selected cases.

Avoid risk behaviors such as excessive mechanical overload, repetitive extreme movements without adequate preparation and ignoring initial signs of joint or muscle pain and fatigue.

Hand surgery and functional rehabilitation

Modern hand surgery depends heavily on functional rehabilitation to ensure good results. Treatment success is not limited to surgical technique, but also to personalized rehabilitation program, started in pre-operative period, with detailed evaluation and realistic expectations.

Collaboration between surgeon and therapists is essential, with specific protocols for each type of surgery, considering tissue healing and joint biomechanics. Techniques such as early mobilization, scar molding and proprioceptive re-education are fundamental for complete recovery. Devices such as orthoses and biofeedback systems complement treatment.

Additionally, telemedicine has allowed effective remote follow-up, adjusting therapeutic program as needed. Use of advanced technologies, such as virtual reality and robotic devices, has transformed functional recovery, especially in more complex surgeries, making it more efficient and accessible. To ensure you choose the best specialist, consult doctor evaluations on platforms like AvaliaMed, where you can check other patients' experiences with surgeons specialized in hand surgery and functional rehabilitation.

Why choose consultation with hand, wrist and elbow surgeon at AvaliaMed?

Choosing consultation with hand, wrist and elbow surgeon at AvaliaMed is to ensure specialized care in upper limb health, with highly qualified professionals committed to restoration and preservation of functionality of these essential structures. At AvaliaMed, our specialists offer precise diagnoses and personalized treatments for various conditions, from traumatic injuries, nerve compressions and degenerative problems to congenital deformities and complex sequelae.

Whether for wrist pain evaluation, carpal tunnel syndrome diagnosis, epicondylitis treatment or reconstructive procedure planning, hand, wrist and elbow surgeons at AvaliaMed are prepared to offer the best medical support. By choosing AvaliaMed, you ensure dedicated care with specialists who understand the critical importance of upper limbs for your independence, work and quality of life.

Schedule your consultation and experience the benefits of being treated by reference surgeons on our platform, who work in collaboration with multidisciplinary team to provide excellent functional results in each treatment.