Hand and Wrist

Specialist care for hand and wrist conditions

The Hand and Wrist Unit at Publio Cordón Memorial Hospital is dedicated to the diagnosis and treatment of traumatic injuries, complex sequelae and degenerative conditions that impair the function of the hand and wrist.

It intervenes when pain, loss of strength, stiffness or changes in sensation limit a patient’s ability to carry out daily activities or work.

The Unit treats both recent injuries and complex sequelae, as well as previously treated cases requiring specialist reassessment to restore function.

The anatomical and neurological complexity of these structures requires a precise assessment and a treatment plan aimed at restoring mobility, dexterity and function.

Specialist assessment of hand conditions

The unit deals with a wide range of injuries affecting hand function, from recent traumatic injuries to complex sequelae that compromise mobility, strength or sensation.

The clinical assessment enables us to accurately identify the affected structure — whether bone, tendon, joint or nerve — and to determine the functional impact of the injury, particularly in cases where the prognosis has not been favourable or the diagnosis is not clearly defined.

The most common conditions include:

• Fractures, malunions and
pseudoarthrosis• Poorly healed fractures with deformity or loss of function•
Joint stiffness, contractures and scar tissue•
Injuries to flexor and
extensor tendons• Osteoarthritis and arthritis of the finger joints•
Persistent pain or functional limitation without a clearly identified cause

In more complex cases, the Unit performs advanced reconstructive procedures such as:

• Digital reimplantation•

Toe-to-hand transfers• Reconstructions using vascular and nerve microsurgery

The need for these techniques is determined following an individualised assessment that analyses tissue viability, the duration of the condition and the realistic prospects for functional recovery.

Malunions may require surgical correction to restore the alignment, mobility and function of the hand.

In cases of pain or limited function without a clear diagnosis, a detailed assessment is carried out to identify the source of the problem and determine the most appropriate treatment.

Treatment of wrist conditions

The wrist is a complex joint in which even minor structural changes can cause persistent pain, loss of strength or significant functional impairment. Proper assessment is essential, particularly in cases where symptoms persist or have not responded to previous treatments.

The Unit treats traumatic and degenerative injuries that affect joint mobility and stability, including:

• Distal radius fractures•
Scaphoid fractures and pseudoarthrosis•

Radiocarpal osteoarthritis•
Complex ligament injuries•
Persistent ulnar pain•
Tendinopathies• Compression syndromes such as carpal tunnel syndrome

The use of diagnostic and therapeutic arthroscopy techniques enables intra-articular injuries to be identified and treated with a high degree of precision, particularly in situations where other tests have failed to clearly pinpoint the source of the problem.

Where indicated, arthroscopy promotes a faster return to function and helps to preserve joint stability.

Nerve injuries and functional reconstruction

The Unit treats peripheral nerve injuries affecting sensation and motor function:

•
Brachial plexus injuries•
Traumatic paralysis• Volkmann’s syndrome

Nerve microsurgical techniques aimed at anatomical reconstruction and progressive functional recovery are applied, following an individualised assessment of each case.

In complex cases, tendon transfers or functional reconstructions may be required to restore mobility when the original function cannot be recovered.

Structured diagnosis and treatment planning

The diagnostic process begins with a detailed clinical examination that assesses mobility, strength, stability and sensation.

Where indicated, this is supplemented by imaging tests and neurophysiological studies, which enable the lesion to be precisely characterised.

Treatment planning is tailored to the patient’s individual characteristics, their level of activity and the anatomical complexity of the condition, with surgery being indicated where there is a clear functional benefit.

Rehabilitation and monitoring of progress

Following surgery or during conservative treatment, a progressive plan is drawn up aimed at safely restoring mobility, strength and manual dexterity.

Regular clinical follow-up allows splints, exercises and weight-bearing levels to be adjusted in line with each patient’s progress. In complex reconstructive procedures, ongoing monitoring is essential to assess bone union, neurological recovery and the functional adaptation of the hand.

Surgical expertise and ongoing support

The Unit comprises specialists with specific expertise in reconstructive hand and wrist surgery and experience in advanced microsurgery.

During consultations, we take the time needed to clearly explain the injury, the treatment options and the expected functional outcome. We detail the risks, recovery times and possible limitations before any procedure, enabling an informed and shared decision-making process.

Clinical support is provided from the initial assessment through to functional recovery, with scheduled follow-up appointments to allow treatment to be adjusted according to the patient’s progress.

Coordination between surgery, microsurgery, rehabilitation and other relevant specialities ensures continuity of care and coherent functional planning.