Hand Surgeon

The Hand Surgeon: A Medical Malpractice Overview

Hand surgeons are medical doctors who dedicate their practice to the anatomy of the hand, wrist, and forearm. Their procedures can provide good outcomes for patients. However, the complexity of this field also makes it a high-risk area for medical malpractice claims. The Kopec Law Firm provides this webpage to give a comprehensive overview of the hand surgeon’s role. This page includes their education and training, the conditions they treat, common surgical procedures, and the types of malpractice claims brought against them. If you have an injury, then call Baltimore Hand Surgeon lawyer Mark Kopec.

The Education, Training, and Licensing of a Hand Surgeon

Becoming a certified hand surgeon follows a specific path of medical education and training.

• Medical School and Residency: First is four years of medical school. Next is a five to seven-year residency program. Hand surgeons typically come from one of three primary surgical specialties: orthopedic surgery, plastic surgery, or general surgery. Each of these residency programs provides a foundational understanding of surgical principles, but hand surgery specialization extends beyond this initial training.
• Fellowship Training: After completing their primary residency, aspiring hand surgeons must undergo an additional one-year fellowship in hand surgery. This fellowship is where the surgeon gains experience in the diagnosis, non-surgical treatment, and surgical management of a wide range of hand and upper extremity conditions. During this time, they learn techniques for microvascular and reconstructive surgery.
• Licensing and Board Certification: Upon completing their fellowship, a hand surgeon must obtain a medical license to practice. They may also seek board certification. For surgeons from an orthopedic or plastic surgery background, this is often through a subspecialty certification in surgery of the hand, which is offered by the American Board of Orthopaedic Surgery (ABOS) and the American Board of Plastic Surgery (ABPS). This process involves an examination and a review of the surgeon’s professional practice, including their case volume and diversity.

Conditions Treated by a Hand Surgeon

Hand surgeons treat a vast array of conditions, ranging from acute traumatic injuries to chronic degenerative diseases. These conditions affect the bones, joints, tendons, nerves, and soft tissues of the hand and upper extremity. Common conditions include:

• Traumatic Injuries: Fractures of the hand, wrist, and forearm; dislocations; tendon lacerations; nerve injuries; and amputations. Hand surgeons are often on call for emergency rooms to treat severe hand trauma, including crush injuries and complex lacerations.
• Carpal Tunnel Syndrome: A condition caused by pressure on the median nerve as it passes through the carpal tunnel in the wrist. This leads to numbness, tingling, and weakness in the hand and fingers.
• Arthritis: Degenerative joint disease (osteoarthritis) or inflammatory arthritis (rheumatoid arthritis) that affects the small joints of the hand and wrist, causing pain, stiffness, and deformity.
• Dupuytren’s Contracture: A genetic condition where a thick, fibrous cord of tissue forms beneath the skin of the palm, pulling fingers into a bent position.
• Tendonitis and Other Tendon Disorders: Conditions like trigger finger (a painful locking or catching of the finger) and De Quervain’s tenosynovitis (inflammation of the tendons on the thumb side of the wrist).
• Cysts and Tumors: Surgical removal of benign growths like ganglion cysts or more complex procedures for hand cancers.

Baltimore hand surgeon lawyer Mark Kopec can assess the medical condition you had.

Common Hand Surgeries and Their Procedures

Hand surgeons perform a wide variety of hand surgeries, each tailored to the specific condition and patient needs. Here is a description of some common procedures:

• Carpal Tunnel Release: This surgery relieves pressure on the median nerve. In a traditional “open” carpal tunnel release, the surgeon makes a small incision in the palm and cuts the transverse carpal ligament, which forms the roof of the carpal tunnel. This releases the pressure on the nerve. A less invasive “endoscopic” approach involves using a small camera and instruments inserted through a tiny incision to perform the same ligament release, often resulting in a quicker recovery and less scarring.
• Tendon Repair: When a tendon is lacerated or ruptured, the surgeon must reconnect the two ends. Flexor tendons in the palm and fingers are located in a tight sheath. The surgeon sutures the ends of the tendon together using techniques that allow for early motion after surgery, which is for preventing adhesions and restoring function.
• Fracture Repair (Open Reduction and Internal Fixation): For a displaced or unstable bone fracture in the hand or wrist, a surgeon may need to surgically realign the broken bone fragments. This is an “open reduction.” Once realigned, the fragments are held in place with metal plates, screws, wires, or pins (“internal fixation”) to allow the bone to heal properly. The hardware may be left in place or removed at a later date.

Additional Procedures

• Joint Replacement (Arthroplasty): In cases of severe arthritis, a damaged joint may be replaced with an artificial implant made of silicone, plastic, or metal. The surgeon removes the damaged joint surfaces and secures the implant to the surrounding bone. This procedure aims to reduce pain, improve joint alignment, and restore motion.
• Nerve Repair and Grafting: When a nerve is severed, the surgeon uses a microscope to align and suture the tiny nerve fibers together. If a gap in the nerve is too large for a direct repair, the surgeon may use a nerve graft—a section of nerve taken from a less critical part of the patient’s body—to bridge the gap and allow the nerve to regenerate.

Work Environment and Collaborators

Hand surgeons work in a variety of clinical settings, including private practices, large hospital systems, and academic medical centers. Their work often involves collaboration with a diverse team of doctors and other healthcare providers. These collaborators may include:

• Physicians: Emergency medicine physicians, primary care doctors, and other specialists who refer patients for evaluation and treatment.
• Anesthesiologists: Medical doctors who administer anesthesia during surgical procedures.
• Hand Therapists: Occupational or physical therapists with specialized training in hand and upper extremity rehabilitation. Hand therapy is a component of a successful recovery from hand surgery, as it helps patients regain strength, motion, and function.
• Nurses and Surgical Technologists: The operating room team that assists the surgeon during procedures.

Medical Malpractice Claims with Baltimore Hand Surgeon Lawyer Mark Kopec

Hand surgery, while often successful, carries risks due to the complex and delicate nature of the anatomy involved. Malpractice claims against hand surgeons are not uncommon and can arise from a number of issues. These claims can be complex to litigate, as they often hinge on whether the surgeon’s actions fell below the accepted standard of care.

Some of the most common types of medical malpractice claims brought against hand surgeons include:

• Nerve Injuries: A significant number of malpractice claims involve alleged damage to a nerve during a procedure. This is particularly relevant in common surgeries like carpal tunnel release, where the median nerve is at risk. Allegations may include severing the nerve. The severing can cause a permanent neuroma (a painful nerve tumor). Alternatively, the doctor may fail to properly decompress the nerve.
• Surgical Errors: This is a broad category. It can include allegations of incorrect surgical technique, such as improper tendon repair, leading to a loss of function. It can also include a failed fracture repair that results in a malunion (the bone healing in a deformed position) or a non-union (the bone not healing at all).
• Misdiagnosis or Failure Treat: Claims may arise when a surgeon allegedly fails to properly diagnose a condition, leading to a delay in treatment and a worse outcome for the patient. For example, failing to identify a scaphoid fracture in the wrist, which can have long-term consequences if not treated promptly.

Additional Claims

• Infections: Post-operative infections, especially in the hand, can be devastating. A malpractice claim may allege that the surgeon failed to follow proper sterile procedures. The surgeon may also have failed to adequately manage an infection that developed after the surgery.
• Lack of Informed Consent: This claim alleges that the surgeon did not adequately explain the risks and potential complications of a procedure to the patient, and that if the doctor had properly informed the patient, they would have chosen a different course of action. This is particularly relevant when a patient experiences a known, but rare, complication.
• Wrong Site Surgery: This is rare due to modern safety protocols. However, a wrong-site surgery (operating on the wrong finger, hand, or side) is a “never event.” It is a clear case of negligence.

When a patient brings a malpractice claim, the central question is whether the hand surgeon’s care was “negligent.” This means determining if the surgeon’s actions deviated from the “standard of care.” That standard is what a reasonable and prudent hand surgeon would have provided under similar circumstances. The complexities of hand anatomy and the subjective nature of surgical outcomes can make these cases challenging to prove. The cases require expert testimony from other hand surgeons to establish the standard of care.

A Note on Damages from Baltimore Hand Surgeon Lawyer Mark Kopec

Medical malpractice cases are very expensive to bring and usually take multiple years. Part of the legal assessment is to consider the potential money damages that are customarily available for the injury involved. Instances of significant nerve damage are usually the type of cases we consider. A permanent injury that prevents return to work and/or interferes with activities of daily living is usually needed to investigate a case.

Next Step: Call Baltimore Hand Surgeon Lawyer Mark Kopec

If you have been injured by a hand surgeon, then visit the Kopec Law Firm free consultation page or video. Then contact the Kopec Law Firm at 800-604-0704 to speak directly with Attorney Mark Kopec. He is a top-rated Baltimore medical malpractice lawyer. The Kopec Law Firm is in Baltimore and pursues cases throughout Maryland and Washington, D.C.