Clinical Areas
Hand & Upper Extremity Surgery
Full video transcript
The hand is a precise organ where multiple structures share a small space, and its function depends on tendons gliding freely, healthy nerves, and stable joints — which is why hand surgery differs from every other field.
This section covers conditions such as: carpal tunnel, flexor and extensor tendon injuries, tendon transfers, the stiff hand, the rheumatoid hand, scaphoid non-union, congenital hand differences, hand tumours, and severe hand trauma.
In many hand operations — especially tendons and nerves — physiotherapy and specialised splints are an inseparable part of the plan.
And some situations are emergencies that cannot wait: amputation, or loss of blood supply in a finger or hand.
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Hand surgery treats problems involving the bones, joints, tendons, nerves, blood vessels, and soft tissues of the hand, wrist, and forearm. Its scope ranges from common conditions — such as nerve compression and tendon injuries — to complex reconstruction after severe trauma.
Care is led by Dr. Khalid Almutairi, a consultant plastic surgeon who is board certified in plastic and reconstructive surgery and fellowship trained in hand surgery and microsurgery in Canada and the USA.
Why is hand surgery different?
The hand is a precise instrument in which many structures share a small space. Its function depends on tendons gliding freely, healthy nerves, stable joints, and good blood supply. A single injury may therefore involve skin, tendon, nerve, artery, bone, and joint together, and treatment may require more than simply closing the wound — which is why careful assessment is the foundation of every decision.
Problems this area addresses
The topics assessed and treated within this area include:
- Nerve compression: such as carpal tunnel syndrome and ulnar nerve compression at the elbow (cubital tunnel).
- Flexor and extensor tendon injuries: from recent injury to secondary reconstruction after previous repair.
- Hand stiffness after injury or surgery: release of adhesions (tenolysis) and joint release where appropriate.
- Tendon transfer: using a well-functioning muscle and tendon to replace a movement lost through nerve or muscle injury.
- Hand and wrist arthritis: from conservative treatment to reconstruction or fusion in selected cases.
- The rheumatoid hand: tendon and joint deformity caused by autoimmune disease — noting that surgery treats the structural consequences, not the underlying disease.
- Congenital hand differences: such as joined or extra digits, planned with function, growth, and development in mind.
- Hand lumps: such as ganglion cysts and tendon-sheath tumours, with appropriate diagnostic assessment.
- Severe injuries and secondary reconstruction: staged rebuilding after tissue loss or previous unsuccessful treatment.
Rehabilitation is part of the treatment
In much of hand surgery — especially tendon and nerve surgery — hand therapy, occupational therapy, and specialised splinting are an integral part of the plan, not an afterthought. Rehabilitation protocols differ by procedure and patient, and individual post-operative instructions are always the reference.
When is a hand problem an emergency?
Some hand conditions cannot wait: complete or partial amputation, loss of circulation in a finger or hand (cold, pale, pulseless), severe open injuries, and severe spreading infection. These require immediate attendance at an emergency department and are not managed through routine clinic booking.
What is offered routinely, and what is assessed individually
Consultation and assessment for hand conditions are offered routinely at the clinic. Complex reconstructive procedures — such as microsurgery for major injuries — are evaluated case by case, and the appropriate pathway and treating facility are determined according to the individual circumstances and facility requirements.
Medical-information notice
This information is general and does not constitute a diagnosis or individual medical advice. It does not replace consultation, discharge instructions, or patient-specific follow-up advice. Urgent medical conditions require emergency services immediately.