Hand surgery

At Circle, we have surgeons, orthopaedic and plastic, who specialise exclusively in hand surgery. Many of our surgeons are eminent in their field with a wealth of experience and have significant national and international profiles.

Virtually the whole spectrum of hand surgery is managed, treating patients above the age of three. This covers congenital hand surgery, elective reconstruction after trauma, surgery of deterioration of joints, tendons and ligaments, as well as surgery of the nerves. The surgery of nerve compressions, e.g. carpal tunnel syndrome, is the single commonest area of treatment.


The hand surgeon uses a variety of tools to arrive at a diagnosis and to plan customised, effective treatment. It is an important aspect of hand surgery that the patient be involved in resolving the problem since many/most conditions require compliance and collaboration, as well as a commitment to hand therapy and splintage.

The most important tool is the clinical assessment of the patient, including a careful history and examination. This may require supplementation by investigation which may include one or more of:

Hand surgeons work in close collaboration with hand therapists. Rehabilitation is often as important as the surgery itself and this must be understood and planned for from the outset.


Treatment is selected from a range of conservative management, splintage, injection, a modification of activity and, ultimately, surgery and rehabilitation.

Most hand surgery is performed under a regional block where the patient is awake but the arm or hand can be anaesthetised at various levels, from shoulder to digit. Patients may prefer general anaesthesia or this will be recommended by the surgeon. Most patients are treated as outpatients with a minority staying overnight.

All hand surgery benefits from elevation of the hand following operation. In general the hand needs to be held above the level of the heart, with, or without, use of a sling. Most hand surgery will involve resting the hand and a period of inactivity after operation.