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Hand surgery and rehabilitation

Adult Hand Surgery and Rehabilitation services is based at the Ä¢¹½tvÊÓƵ General Infirmary The Hand Unit ward L46 and is one of the largest and most highly respected units in the UK.

What we do

The Adult Hand Surgery and Rehabilitation service is based at the Ä¢¹½tvÊÓƵ General Infirmary. The Hand Unit ward L46 is one of the largest and most highly respected units of its kind in the UK.

The service is run by a multidisciplinary team of experienced healthcare specialists, including nationally and internationally recognised experts in their fields.

The service is run by an experienced multi-disciplinary team of healthcare specialists, including nationally and internationally recognised experts in their fields.

Here on the Hand Unit at Ä¢¹½tvÊÓƵ we treat a wide variety of patients from our local region and further afield. We see patients with hand injuries following trauma and also referred patients with hand conditions requiring elective treatment.

Planned referrals from your GP

We accept referrals for elective cases from GPs and cross specialties from our local area and the wider community.

After seeing your GP with your problem and agreeing to the referral your GP will write to us. The referral will be processed and an appointment confirmed with you for clinic.

When you arrive in the clinic reception for your appointment the reception staff will check your details and book you in to clinic. It is important that you make sure your contact details and address is correct on the hospital system, we may need to contact you with results or further appointment details.

There will often be several clinics running at the same time so please don’t be concerned if other patients are called ahead of you, they may be seeing a different consultant team.

Further investigations may be required to help make a diagnosis or plan your treatment, these will be arranged for you and the appropriate unit will contact you with details of your appointment, for example for nerve tests or scans.

Sometimes treatment will be decided or even delivered at the first appointment i.e.: Hand therapy, certain splinting, injections, etc. If surgical intervention is required this will be planned for another day. You may be asked to attend a pre-assessment clinic prior to your surgery – this is dependent on the procedure you require.

If surgery is appropriate, most surgery will be booked for you as a day case and can also be performed on The Hand Unit L46, in the day surgery theatres, with discharge to home the same day if you have suitable carers to ensure your safety and assistance with daily tasks.

Often Hand surgery does not require a general anaesthetic and you can be fully awake, with your arm ‘numbed’ by a ‘regional anaesthetic block’.

After such surgery, if appropriate you will receive follow-up care from our team of Specialist Hand Physiotherapists and Occupational therapists and nurses who are trained to help you recover from hand surgery as speedily and effectively as possible.

Unplanned / trauma referrals

If you experience an injury, or spontaneous serious problem with your hand, you will be assessed by staff in the Emergency Department. If your hand injury involves either a complex wound to the hand, complicated fracture pattern (broken bone), or a possible nerve or tendon injury to your hand, you’ll be referred for assessment and treatment by a hand surgeon in our specialist hand unit on ward L46.

You will be seen and assessed by a specialist team, and if possible treated there and then. However, many injuries require either formal surgery, or perhaps splintage / casting with regular review and therapy.

It may be necessary to monitor your progress in our hand unit as an outpatient, if so you will be invited to clinic for review appointments.

Nursing

Any necessary wound care will be undertaken by our specialist team of nursing staff in the hand dressing clinic.

Hand therapy

We have a dedicated team of specialist therapists in the unit who will work alongside the doctors to optimise your recovery.

The physiotherapy team will assess your condition and discuss with you your individual goals. Providing information on your injury, treatment and the rehabilitation process is an important part of the therapy sessions. We will use a combination of exercises to maintain your joint movement and to strengthen your muscles. We will instruct you in how to perform these exercises as part of a home exercise regimen.

You will be continually monitored either in the consultant outpatient clinics or with regular physiotherapy appointments. As you recover and we see improvements then we will develop exercise programmes to strengthen these areas.

The overall aim at all stages is to help you with your recovery and to improve the movement, strength and function of your arm based on your individual goals.

Following lessons learned from the Covid-19 pandemic some appointments will be offered as virtual consultations if appropriate.

  • Most laptops will have an integral webcam. Please locate yours and ensure that it is positioned to enable us to see you face-on.
  • Please ensure that the environment is as quiet as possible.
  • It is preferable that you ask other members of your household to refrain from streaming online during the consultation as this can affect the quality of your link.
  • Please make sure you are seated in a well lit room.
  • The Clinicians will need to see your movements to assess your progress. So it is advisable to have adequate space to move in view of the webcam.
  • If possible have a another household member available to call to assist with passive movement of your arm where necessary.

We have a specialist team of occupational therapists who may be involved in all stages of your rehabilitation. Initially working with you to maximise your function with the use of your limb following injury.

Occupational therapists will assess how you perform your daily activities and guide you in ways that you can make this easier with aids and adaptations.

The occupational therapists may also provide splints to maximise the optimum length in compromised soft tissues.

As you progress through your rehabilitation they will re-evaluate your goals and facilitate you in achieving these through functional rehabilitation. They can advise you on employment and work issues.

Our team are happy to liaise and support local teams where appropriate.

BTE PrimusRS Rehabilitation System

To meet the needs of our patients, our joint Occupational Therapy and Physiotherapy team now have the BTE PrimusRS available to support rehabilitation. The BTE PrimusRS enables us to assess and rehabilitate functional strength and range of movement, as well as simulate work-related tasks or hobbies. 

  • Enables us to establish baseline data of your strength and endurance.  
  • Allows the clinician to track your improvement and provide feedback about your progress.
  • Facilitates treatment planning and enables us to closely monitor your recovery following surgery.
  • Allows us to replicate real-life working and sporting activities such as climbing a ladder, sawing wood and throwing a cricket ball, activities which are not usually assessable in a clinical situation.
  • Provides a safe environment to create a graded return to these activities.
  • Collects objective information about your improvement over time to help build confidence and motivation.
  • Enables assessment of functional capacity which can be used to provide workplace recommendations to you and your employer, including return to work plans.
patient using BTE Primus rehabilitation system

Clinical psychology

We have a team of experienced clinical psychologists who work alongside the team in the hand unit. You are able to access this service if you are being cared for by a member of the hands and plastics surgery team. Please discuss this at your clinic appointment if you feel you would benefit from a referral to this team.

Your condition and treatment

We appreciate that having a hand injury is a major inconvenience and you will have many questions with regards to your diagnosis and the treatment that is to follow.

We have provided some information to help guide you through the process. It is important to remember however that individual cases may be managed in slightly differing ways depending on any other health issues.

Common hand conditions and injuries

  • Swellings
  • Flexor tendon injury
  • Extensor tendon injury
  • Boutonniere injury
  • Thumb extensor tendon (EPL) rupture
  • Terminal finger joint arthritis
  • Basal thumb arthritis
  • Finger dislocations

Surgery: what to expect FAQs

The thought of surgery can be worrying for many patients. An understanding of what is going to happen and why, will help reassure you.

Before any intervention, your surgeon will explain the options for treatment, the likely outcomes from surgery/treatment, and what the timescales for recovery are most likely to be.

What are the risks and benefits of having hand surgery?

Benefits include

  • The expected benefit is an improvement of your symptoms. This will vary from patient to patient. The specific implications for your injury/condition will have been explained in more detail by your consultant.

Risks are

  • Bleeding during or following surgery
  • Infection of the wound
  • Recurrence of symptoms
  • Scar Hypersensitivity (usually helped by scar massage)
  • Stiffness and swelling of the hand and fingers

This can be discussed with your surgeon. There may be alternatives such as hand therapy, splints or steroid injection, which may help with your symptoms. If surgery has been offered to you it is likely that this would give you the best clinical outcome, though other options may be available.

As with any treatment or procedure we must obtain your consent before proceeding to surgery. Your surgeon will discuss the risks and benefits of the procedure with you before they ask for your consent. If you are unsure about any aspect of the procedure, please do not hesitate to ask for more information.

Most surgery in the Hand Unit is performed under a brachial block (a procedure to numb the whole arm) or a local anaesthetic similar to a dental procedure. You will be ready to go home a short while after your procedure.

Depending upon the type of anaesthetic you have had, it may be necessary to rest for a short time after surgery. You will be taken to the recovery room initially and when you are ready you can sit in the post-operative suite.

You will be offered some light refreshment such as a cup of tea or coffee and a biscuit or toast before you go home.

You will not be able to drive immediately following your procedure therefore please plan for this in advance and arrange to be collected from the hand unit.

Your hand may be uncomfortable and you may need to take painkillers to relieve any discomfort.

You will have had local anaesthetic injected into the hand which will help with pain relief in the first few hours after your procedure.

You may feel the need to take pain killers for the first few days following your surgery. In most cases you may use over the counter pain relief for this purpose, however if this is the case you should read the instructions provided with the tablets to ensure you do not exceed the maximum dose. If you have had problems with such medication in the past, or you are unsure you should discuss its use with a medical professional.

After your operation we will place a large bandage on your hand to protect the wound.


Your hand may be swollen so it is important to elevate your hand to help reduce any swelling and soreness. This can be done by sitting with pillows or cushions so that your hand is level with your shoulder or lie with your hand across your chest on a pillow or cushion.

You will need to keep your hand clean and dry and leave your bandage in place until you have your wound checked. Any stitches will normally remain in place for 10 to 14 days after your operation. In some circumstances your sutures will be dissolvable, you will be informed if this is the case.

Before going home the nurse will tell you when you need to have your stitches removed. This will either be done back in the hand unit or by your Practice Nurse at your GP surgery.

After you leave the unit if you experience bleeding through your dressing you should raise your hand and apply continuous pressure for about 10 minutes. If this does not stop you can either contact the hand unit directly or the out of hours number given to you on discharge.

The length of time will vary from person to person depending on your occupation and your condition. If you require a sick note please ask the nurse before discharge.

This will vary depending on your injury/operation. It is advisable to check with your surgeon and your own car insurance provider.

Not all patients who have routine surgery will need to come back after the operation. You will be advised on discharge if your GP will take over your care. In some instances you may be offered a telephone consultation to check on your progress.

If you have a problem or need advice after going home please contact the hand unit nursing staff on 0113 3923237.

Meet the Team

Surgeons

  • Professor Simon Kay – Consultant Hand, Plastic and Reconstructive Surgeon
  • Mrs Grainne Bourke – Consultant Hand, Plastic and Reconstructive Surgeon
  • Miss Catherine Hernon – Consultant Hand, Plastic and Reconstructive Surgeon
  • Mr Daniel Thornton – Consultant Hand, Plastic and Reconstructive Surgeon
  • Mr Rob Farnell – Consultant Orthopaedic Hand and Wrist Surgeon
  • Mr Rob Bains – Consultant Hand, Plastic and Reconstructive Surgeon
  • Miss Carol Chan – Consultant Hand and Wrist Surgeon
  • Mr Waseem Bhat – Consultant Plastic, Reconstructive and Hand Surgeon
  • Mr Chrishan Mariathas – Consultant Orthopaedic Hand and Wrist Surgeon

Contact us

For Adult Hand Surgery related enquiries please contact one of the following:

For Adult Plastic Surgery related enquiries please contact the following:

Secretaries

Contact details for Plastic Surgery wards

  • L22 – Jubilee wing (inpatients) 0113 3927422
  • L26 – Brotherton wing (Day case) 0113 3927426
  • L46 – Clarendon wing (Hand and Plastic day unit) 0113 3927446

Plastic, Hands and Reconstructive Therapy Services

For physiotherapy and occupational therapy enquiries contact 0113 3922720.

All other enquiries

For all other enquiries related to Plastic, Hand and Reconstructive services, please telephone the hospital switchboard on 0113 243 2799.

How to find us

Inpatients

The Plastic Surgery ward is L22, on G Floor in the Jubilee wing of Ģ¹½tvÊÓƵ General Infirmary.

Outpatient Clinics

We have various clinics in many hospitals, so please read the below locations carefully and select the one that refers to you:

Plastic Surgery Clinic

A Floor, Clarendon Wing, Ģ¹½tvÊÓƵ General Infirmary

Adult Hand Surgery Clinics Ward L46 (Hand Unit): 

D Floor, Clarendon Wing, Ģ¹½tvÊÓƵ General Infirmary

Major Nerve Injury Clinic

Ward L46 (Hand Unit), D Floor, Clarendon Wing, Ģ¹½tvÊÓƵ General Infirmary

Children’s Hand Surgery Clinic

C floor, Martin wing, Ģ¹½tvÊÓƵ General Infirmary

Head and Neck Clinic

Level 5, Bexley Wing, St James’s Hospital

Melanoma Clinic

Level 5, Bexley Wing, St James’s Hospital

Skin Cancer / Dermatology

Ward C4 on 1st Floor, Chapel Allerton Hospital, Ä¢¹½tvÊÓƵ

Combined Craniofacial Clinic

B Floor, Brotherton Wing, Ģ¹½tvÊÓƵ General Infirmary

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