Your hands do something in almost every minute of your day. When one stops working properly, the disruption is immediate and hard to work around.Hand surgery is the speciality that treats the bones, joints, tendons, nerves, blood vessels and skin of the hand, wrist and forearm. It covers everything from a numb finger to a crushed hand, and the range is wide because the anatomy is dense. A small area contains structures that are millimetres apart.
At Mangal Anand Hospital in Chembur, Mumbai, hand and wrist conditions are managed by fellowship-trained hand surgeons with additional training in microsurgery and peripheral nerve surgery. Not every hand problem needs an operation. Many are managed with splinting, injection or hand therapy. When surgery is needed, the technique is chosen for the injury in front of us, and recovery is planned alongside it.
The hand contains a complex combination of bones, joints, tendons, ligaments and nerves. An injury or condition affecting any of these structures can interfere with grip, finger movement or everyday activities.
Hand surgery may be considered for conditions such as:
The treatment required depends on the structure involved, the severity of the problem and how long the condition has been present.
Dr. Bipin Ghanghurde has over 12 years of specialised experience in hand, wrist and peripheral nerve surgery. He completed advanced fellowship training at Ogori Daiichi General Hospital, Japan, and University Hospital Ghent, Belgium, and holds the European Diploma in Hand Surgery (EDHS).
Areas of practice:
He is a Life Member of the American Society for Surgery of the Hand, the Indian Society for Surgery of the Hand and the Bombay Orthopaedic Society.
Dr. Kiran M. Ladkat is an orthopaedic surgeon specialising in hand, wrist, peripheral nerve and microvascular surgery. He has over 12 years of clinical experience and has performed more than 2,500 surgeries.
He completed advanced fellowship training at Ganga Hospital, Coimbatore, and the National University Hospital, Singapore, with a particular interest in hand trauma, nerve compression disorders, congenital hand conditions and brachial plexus injuries.
Areas of practice:
Nerves running from the neck to the fingertips pass through several narrow points. Where a nerve is squeezed, it produces tingling, numbness and eventually weakness in a pattern that identifies which nerve is affected.
The two most common sites are the wrist and the inner elbow. Diagnosis usually combines clinical examination with a nerve conduction study, because the treatment decision depends on how compressed the nerve actually is, not on how uncomfortable it feels.
Carpal Tunnel Syndrome Treatment
Tendons slide through sheaths as they cross the wrist and fingers. Where a sheath narrows or a tendon thickens, movement becomes painful, catches or locks. This group includes triggering of a finger or thumb, and tendon sheath inflammation on the thumb side of the wrist, which is common in the months after childbirth and in people doing repetitive lifting. Most respond to splinting, activity change or injection. A small procedure is used when they do not.
→Trigger Finger Treatment
Fractures range from a finger bone that will heal in a splint to a joint-surface fracture that needs fixation to restore alignment. Two are worth knowing about. Scaphoid fractures, in the wrist below the thumb, are frequently missed on the first X-ray and can fail to unite if left untreated. Fractures involving the finger joints heal quickly but stiffen quickly too, so early controlled movement is part of the treatment, not an afterthought.
→Hand Fracture Treatment
Arthritis in the hand affects the small finger joints, the wrist, and very commonly the joint at the base of the thumb. Thumb base arthritis makes pinching, turning keys and opening jars painful, and is often mistaken for a wrist problem. Treatment starts with splinting, activity modification and injection. Where these stop working, surgical options include joint reconstruction, fusion or replacement, selected according to which joint is involved and what the hand needs to do.
A ganglion is the most common lump in the hand and wrist. It is a fluid-filled swelling arising from a joint or tendon sheath, and it is not cancerous.Many need no treatment at all. Removal is considered if the cyst is painful, restricts movement or presses on a nerve. Not every hand lump is a ganglion, so a swelling that grows, is firm or is painless should still be examined.
Dupuytren's is a gradual thickening of the tissue layer under the palm. Over years it forms cords that pull one or more fingers into a bent position, most often the ring and little fingers.
It is painless, which is why people present late. The usual trigger for treatment is when the hand can no longer be placed flat on a table. Treatment options include needle release and surgical removal of the affected tissue.
Children can be born with fused fingers, extra digits, an underdeveloped thumb, a curved forearm or a thumb that will not straighten. Timing is a large part of the decision. Some conditions are best corrected early, before hand function patterns are established. Others are watched and treated later. Assessment includes how the child is actually using the hand, not only how it looks, and both surgeons have training in this area.
Thumb ligament injuries from a fall on an outstretched hand, finger joint sprains, wrist cartilage injuries and overuse tendon problems are common in cricket, badminton, gym training and climbing.
These are often dismissed as sprains. A thumb ligament rupture in particular will weaken pinch grip permanently if not identified early.
Hand surgery treats the hand, wrist, forearm and, in many cases, the elbow. It sits at the meeting point of orthopaedics, plastic surgery and nerve surgery, which is why it exists as a separate speciality with its own fellowship training.
The work falls into four broad areas:
Book an assessment if you have:
Some hand injuries are emergencies and are covered further down this page.
A general orthopaedic surgeon treats the whole musculoskeletal system. A hand surgeon has completed further fellowship training focused on the upper limb, and works with magnification and microsurgical instruments for structures too small to repair reliably by eye.
The distinction matters most in three situations: nerve and tendon injuries, where the repair technique determines the functional result; complex fractures involving joint surfaces of the fingers; and any injury needing microvascular repair. Outside these, both can manage the problem competently.
Some hand injuries are time-critical. Getting to a hospital with a hand surgeon and an available theatre within hours changes what is possible.
Come to the emergency department immediately for:
Replantation is the reattachment of a severed part, restoring bone, tendon, nerve and blood vessels. The vessels involved are around a millimetre wide, and the repair is done under a microscope. Whether replantation is possible depends on the mechanism, the level of injury, how long the part has been without blood supply, and the patient's overall health. A clean cut has better prospects than a crush or an avulsion, where tissue is torn over a distance and the vessels are damaged well beyond the visible injury.
Time matters, and it matters differently by injury level. Fingers contain no muscle and tolerate a longer period without circulation, particularly when cooled correctly. Amputations through the hand, wrist or forearm involve muscle, which is far less tolerant, and the window is considerably shorter.
Not every amputation should be replanted. In some injuries a well-shaped stump gives better function than a reattached but stiff, insensate finger. That assessment is made case by case, with the patient's work and hand dominance taken into account.
If a finger or part of the hand has been severed:
For a crush injury without amputation: remove rings and bangles immediately before swelling makes this impossible, support the hand raised, and come in. Do not wait to see whether the swelling settles.
High-pressure injection injury. A pinhole wound from a spray gun or grease gun can look trivial and cause almost no pain at first. The injected material spreads along the tendon sheaths and causes progressive tissue damage. This needs surgical washout urgently, and delay is a common reason for amputation.
Fight bite. A small cut over the knuckle from striking a tooth introduces bacteria directly into the joint. It looks minor for a day, then becomes a serious joint infection.
Compartment syndrome. Pain out of proportion to the injury, a tight swollen hand or forearm, and pain on passively stretching the fingers. This is a surgical emergency.
Nail bed injury. A crushed fingertip with blood under the nail often has a nail bed laceration underneath. Repairing it properly determines whether the nail grows back normally.
Most hand conditions are treated without an operation, and starting conservatively is standard practice rather than a delaying tactic.
Surgery is discussed when conservative treatment has been given a fair trial and has not worked, when function is deteriorating, when a structure is torn or divided and will not heal on its own, or when a nerve is under enough pressure that waiting risks permanent damage.
Structures below about two millimetres are repaired under an operating microscope with sutures finer than a hair. This applies to blood vessel repair in replantation and free tissue transfer, direct nerve repair after a cut, and nerve grafting where a gap cannot be closed directly. Nerve recovery is slow and follows regeneration, not healing. Sensation and power return over months, moving progressively down the limb.
A divided tendon is repaired with a core suture technique strong enough to permit early controlled movement, because tendons that are immobilised completely form adhesions and lose glide. Flexor tendon injuries in the finger are technically demanding and rehabilitation is as important as the repair.
A tendon transfer moves a working tendon to take over the job of one that no longer functions, usually after nerve injury or an unreconstructable tendon rupture. It is a reliable way to restore a specific movement, such as straightening the fingers or opposing the thumb.
Where a nerve is compressed, surgery releases the structure squeezing it. Where a nerve is injured too far from the muscle it supplies for recovery to arrive in time, a nerve transfer redirects a nearby expendable nerve branch to power the important muscle. This has changed what is achievable in brachial plexus and high nerve injuries, and it is time-dependent, so early referral matters.
Wires, screws and low-profile plates are used to hold hand and wrist fractures in position. The aim is fixation stable enough to start moving the hand early, because stiffness after a hand fracture is often a bigger long-term problem than the fracture itself.
A keyhole technique that allows the inside of the wrist joint to be inspected and treated through small incisions, used for cartilage and ligament injuries and persistent unexplained wrist pain.
Where tissue has been lost, coverage is restored with skin grafts, local flaps or free tissue transfer with microvascular anastomosis. Reconstruction also includes joint fusion, joint replacement in the finger, contracture release and reconstruction for congenital differences.
Hand infections spread along tissue planes quickly. Abscess drainage, tendon sheath washout and joint washout are common urgent procedures. Antibiotics alone are not sufficient once pus has formed.
Clinical assessment is the largest part of it. Hand examination is detailed: testing each tendon individually, mapping sensation nerve by nerve, checking joint stability and assessing circulation. Most diagnoses are made here.
X-ray for fractures, dislocations, arthritis and alignment.
Nerve conduction study and EMG where a nerve problem is suspected, to confirm which nerve, at what level, and how severely.
Ultrasound for tendon, sheath and soft tissue problems, and to look at lumps. It also allows movement to be assessed in real time.
MRI for ligament and cartilage injuries, occult fractures, soft tissue tumours and complex wrist problems.
CT for detailed bone assessment, particularly joint-surface fractures and suspected non-union. Not every patient needs imaging. Investigations are requested when the result will change the treatment plan.
Recovery after hand surgery depends more on rehabilitation than most patients expect. A technically good repair in a stiff hand gives a poor result.
The first two weeks. The hand is dressed or splinted. Keep it elevated, keep the dressing dry, and move the joints you have been told to move. Swelling control in this period reduces stiffness later.
Two to six weeks. Sutures are removed and therapy progresses. Depending on the procedure, movement is either encouraged actively or protected within a specific range.
Six weeks to three months. Strengthening begins once healing allows. Grip and pinch power return gradually.
Beyond three months. Nerve recovery, scar softening and endurance continue improving for six to twelve months, sometimes longer after nerve repair. Hand therapy is available on site and works alongside the surgical team, covering movement protocols, oedema and scar management, splint fabrication, sensory re-education after nerve repair, strengthening and return-to-work planning.
Return to work, as a general guide: desk-based work in two to four weeks for many procedures; driving once you can grip and control the wheel safely without a splint; manual and heavy work commonly six to twelve weeks. These vary considerably with the procedure and are confirmed for your case at follow-up.
The cost of hand surgery depends on the procedure, whether it is planned or an emergency, the type of anaesthesia, theatre and implant requirements, room category, investigations and the amount of therapy needed. Because these differ from patient to patient, a written estimate is provided after clinical assessment rather than a standard figure.
Mangal Anand Hospital is empanelled with major health insurers and third-party administrators, and cashless treatment is available subject to your policy terms and approval. Our insurance desk assists with pre-authorisation, documentation and reimbursement where cashless does not apply.
Fellowship-trained hand surgeons. Hand, wrist and peripheral nerve surgery is the focus of practice, not a subsection of general orthopaedics. Training includes recognised international hand surgery centres in Japan, Belgium and Singapore, and Ganga Hospital, Coimbatore.
Microsurgical capability. Nerve, vessel and tissue repair under magnification, supporting replantation and reconstructive work.
24-hour hospital. Emergency services, theatres and inpatient care available at all hours, which matters for time-critical hand injuries.
Hand therapy on site. Physiotherapy and rehabilitation within the hospital, coordinated with the surgical team.
Full range of care in one place. Consultation, imaging, nerve testing, surgery and rehabilitation without moving between centres.
Established orthopaedic hospital. Advanced orthopedic hosptital with experienced doctors of the city .
Mangal Anand Hospital is at 48 Swastik Park, Sion-Trombay Road, Chembur, Mumbai 400071.
We see patients from Chembur, Ghatkopar, Kurla, Tilak Nagar, Sion, Wadala, Govandi, Deonar, Mankhurd, Vidyavihar, Sewri and Navi Mumbai.
A hand surgeon treats conditions of the hand, wrist, forearm and often the elbow. This includes fractures, tendon and nerve injuries, nerve compression, arthritis of the small joints, lumps, infections, contractures, congenital differences and complex injuries needing microsurgery.
For nerve or tendon injuries, injuries involving the finger joint surfaces, any wound where a finger will not move properly, hand conditions in children, and injuries needing microsurgical repair. For a simple closed finger fracture, either can manage it.
Often not. Many hand procedures are performed under regional anaesthesia, where only the arm is numbed, or under local anaesthesia. General anaesthesia is used for longer reconstructive procedures, for children, and where regional anaesthesia is unsuitable.
Many hand operations are day care, meaning you go home the same day. Trauma, replantation, microsurgical reconstruction and procedures needing close monitoring of circulation require admission.
Sometimes. It depends on how the injury happened, the level of amputation, how long the part has been without circulation and how it was stored. A clean cut has better prospects than a crush or a tearing injury. Bring the severed part regardless of its appearance, cooled but not in direct contact with ice.
Wrap it in clean, lightly moistened gauze, seal it in a clean plastic bag, and place that bag on ice or in ice water. Do not place the part directly on ice, submerge it in water, or clean it with antiseptic. Get to a hospital with a hand surgeon as quickly as possible.
It varies by procedure. Light activity typically resumes within days to two weeks, desk work at two to four weeks, and manual work at six to twelve weeks. Nerve repairs recover over months. Your surgeon gives a timeline specific to your procedure.
Many patients regain function close to normal, particularly with early treatment and consistent therapy. Recovery is less complete after severe crush injuries, long-standing nerve compression and injuries involving joint surfaces. Your surgeon will give a realistic expectation after examining you.
For most procedures involving tendons, nerves, joints or fractures, yes. Therapy protects the repair, prevents stiffness and restores strength. For minor soft tissue procedures it may not be needed. Skipping recommended therapy is a common reason for a poor result after a successful operation.
Once you can grip and control the steering wheel safely without a splint, and are not taking medication that affects alertness. For many procedures this is two to four weeks. Confirm with your surgeon, and check your motor insurance terms.
Yes. Children's bones are still growing, healing is faster, and the timing of surgery is planned around development and hand use. Congenital hand conditions in particular need assessment by a surgeon with paediatric hand training.
It depends on the procedure, anaesthesia, implants, room category, investigations and rehabilitation. A written estimate is provided after clinical assessment. Cashless treatment is available for empanelled insurers, subject to policy terms and approval.
Medically necessary hand surgery, including trauma, fracture fixation, nerve decompression and tendon repair, is generally covered, subject to your policy terms, waiting periods and sum insured. Purely cosmetic procedures are usually excluded. Our insurance desk assists with pre-authorisation.
Mangal Anand Hospital is at 48 Swastik Park, Sion-Trombay Road, Chembur, Mumbai 400071, near Swastik Chambers. The nearest station is Chembur on the Harbour Line. It is reached via LBS Marg from Ghatkopar and Kurla, Sion-Trombay Road from Sion and Wadala, and the Sion-Panvel Highway from Navi Mumbai.
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