Problems with the appearance or function of the hand can be the result of injury, birth defects or degenerative conditions.
 
Re-implantation
Fingers or hands that have been accidentally cut off can be reattached by very detailed surgery that is performed under a microscope (microsurgery) and involves reconnecting blood vessels, tendons, bones and nerves.
 
Arthritis
Arthritis is a condition in which a joint and the surrounding tissue become swollen and painful and the joint surfaces can become eroded due to rheumatoid or osteo-arthritis. If surgery is necessary, it may involve replacement of the joint with an artificial joint or removal or repair of swollen or damaged synovial tissue.
 
Birth Abnormalities
Surgery may sometimes be required for hand abnormalities that are present at birth such as too many or too few fingers, webbed fingers or joints that won’t bend.
 
Carpal Tunnel Syndrome
A pinched nerve in the wrist that causes tingling, numbness and pain in your hand may require surgery to make more room for the nerve. This operation is usually performed under local anaesthetic (the area being treated is numb but you are awake).
 
Injuries
Damage to tendons, nerves, joints and bones in the hand may require surgical repair. In some cases, tissue may be transferred from a healthy part of your body to the injured site (grafting).

Fractures
These can sometimes be treated as closed injuries by manipulation and setting the position of the broken bones. Often internal fixation with K-wires or plates and screws is needed. With open reduction and internal fixation earlier and quicker mobilisation can usually be done.

Dupuytren's Contracture
This is a common condition (often of a familial inheritance pattern) usually involving the formation of dense scar-like fibrous tissue in the palm of the hand extending into the ring and little fingers and to a lesser extent the thumb and other two digits. The fibrous tissue with time contracts pulling the fingers down towards the palm. Surgery is needed to release the fibrous bands once the fingers begin to bend down. If surgery is delayed it is much harder to get the fingers out straight again and there is more risk to the arteries and nerves during surgery. Sometimes skin flaps and grafts are needed or in extreme cases (often involving the little finger) amputation is necessary as a last resort.