Hand surgery - an introduction

Since having shadowed a hand surgeon in Derby, which got me excited about the profession, I thought I'd review how hand surgery is organised, and just what hand surgeons do.

Hand surgery governing body - the BSSH
The British Society for Surgery of the Hand (BSSH), est 1952, formally 1968.  Its first president was Irish-born 'Guy Pulvertaft' (1907-1986).  The Pulvertaft Hand Centre at the Royal Derby Hospital of the Royal College of Surgeons (internationally recognised) is named after him.

Commonest hand surgeries
I was informed during shadowing at the Pulvertaft that there are 250 hand surgeries that can be mastered.  BSSH list the commonest as (2006 UK figures):
- Carpal tunnel decompression (38,000)
- Palmar fasciotomy for Dupuytrens disease (11,000)
- Surgical removal of Ganglion cysts (6,400)

Carpal Tunnel Release

Ganglion cyst

Dupuytrens

Further surgeries
These include the following - it would be good to find a resource with a list including statistics
- Trigger finger release
- Post-traumatic reconstructive surgery of the hand, including scaphoid (wrist bone) fracture
- Ruptured tendon repair, often secondary to rheumatoid arthritis - plus tendon transfer
- Trapeziectomy (removal of a bone in the wrist) at the base of the thumb
- Joint fusions (PIP, DIP, carpal fusion in the wrist)
- Arthroplasty (e.g. resurfacing joints - commonly MCP, PIP)
- Treatment for ligament injuries in the wrist
- Wrist replacement, nerve ablation, very specialised centres conduct hand transplants, etc. unclear how common all these are

Referrals to hand units
Referrals to hand units don't all require surgical intervention - common referrals are below:

Links:
BSSH Hand surgery report: http://www.bssh.ac.uk/members/documents/ukhandsurgreport.pdf
Introduction to common hand surgeries for junior doctors: http://bit.ly/1m7pTNJ