Hand surgery is more an art form. This is because we are dealing with living, moving & gliding delicate tissues that respond positively to gentle handling & react violently to rough interference. No other branch of surgery deals with this much multifarious kind of tissues. Be it a nail bed… be it a nerve… be it a tendon, bone or vessel. Each tissue is unique. In fact, texture & behavior of dorsal and palmer skin of hand is also different. The way of treatment needed for all above mentioned tissue is widely varied. And a hand surgeon is one, who knows the best, how to deal with all of them simultaneously.

Second most important aspect of hand surgery is the final functionality of a repaired hand. It is not all about promoting healing of an injured or diseased hand, but it is about making them a useful and functional hand which is as normal as it was previous. Losing functionality of a hand means loss of jobs… loss of daily household chores and ultimately loss of worthiness of a personality.

When we look back into the history… when hand surgery, as a specialty was in its infancy after World War 2, its main focus was tendon repair, fracture stabilization and skin cover, which were the most common problem after war. After that in 1950s, secondary problems of reconstruction were addressed. This consisted nerve repair, tendon transfers & finally restoration of motion following extensive trauma. Decade of 1960-70 saw an explosion of new techniques & procedures. Flexor tendon repair shifted from secondary to primary & secondary nerve repair went from overcoming deficits by stretching nerve to nerve grafting. Fracture management incorporated rigid anatomical reconstruction and skin cover was revolutionized by use of arterialized pedicle flaps. In the 1970s, joint arthroplasty with various implants was introduced for arthritic joints & nerve decompression becomes routine. All of this advances demanded post operative rehabilitation. So, hand surgeon started believing in proper rehabilitation after surgery to achieve desired result. Today each hand surgeon put equal emphasis on post operative rehabilitation, physiotherapy & splinting. This part of treatment is provided by most of the hand surgeon by themselves only.

At the end of talking about advances in hand surgery, we must mention about the recent advance-HAND TRANSPLANTION. By this time, world has witnessed around more than 85 patients have received hand/arm transplants at institutions around the world, since 1999 when first successful hand transplantation was performed in University of Louisville, USA. On January 13, 2015, doctors at the Kochi based Amrita Institute of Medical Sciences & Research Centre, successfully conducted India’s first hand transplant.

So, let us all pray for more and more future advances in this field of surgery, to restore the body’s most marvelous instrument to its full function