Your upper extremity includes everything from the tips of your fingers to where your neck and arm meet, including your shoulder joint, chest muscles, and collarbone; the nerves around your neck and arm; your elbow, wrist, hand and fingers. Upper Extremity surgery runs the gamut from carpal tunnel and hand fracture surgery, to arthroscopic surgery of the shoulder and elbow, to fracture care, arthritis surgery and nerve reconstruction.

Hand Surgeons are typically either Orthopaedic or Plastic Surgeons who do a special fellowship training in Hand Surgery. Some programs only train surgeons in hand surgery and leave out the elbow and shoulder. A hand and upper extremity fellowship includes hand, wrist, elbow and shoulder. While many Orthopaedic or Plastic Surgeons perform some hand surgery procedures, complex cases are typically referred to a fellowship-trained hand and upper extremity surgeon. Dr. Raizman performed his Hand and Upper Extremity fellowship training at the Cleveland Clinic.

Dr. Raizman operates primary out of the Massachusetts Avenue Surgery Center in Bethesda, as this often provides the most benign and comfortable experience for our patients. For cases such as shoulder replacement where an overnight stay is anticipated, Dr. Raizman and colleagues operate out of Sibley Memorial Hospital in the Palisades. When Dr. Raizman performs surgery on congenital differences or pediatric patients, he often utilizes Georgetown University Hospital. He also holds privileges at George Washington University Hospital and Suburban Hospital.

This varies with the patient and the type of surgery. Most hand and wrist surgery can be performed with a nerve block performed by the anaesthesiologist along with moderate sedation. This provides long term pain relief. Longer surgery, surgery on the shoulder, and surgery where muscle relaxation is important typically requires a general anaesthetic. The options will be discussed with the anaesthesiologist at the time of surgery in order to provide the safest care. Dr. Raizman usually injects a long-acting pain medication into the area where he performs surgery to help control post-operative pain.

This is probably the most important question! Dr. Raizman will go over with you a general outline of post-operative treatment, what you can and can't do and for how long. This is highly individualized and often needs to change depending on how your recovery and rehab is progressing. A few things we can tell you, though:

1. Expect not to drive home from surgery - though some surgeries can be performed under local anaesthesia only, we still recommend that you have a ride to and from the surgery center or hospital.
2. If you have pain, it will likely be worst in the 2-3 days right after surgery - Dr. Raizman will give you pain medicine. Stay ahead of the pain (i.e. - take the medicine when you are just starting to get achy; don't wait for the pain to get worse). The best treatments for pain: ICE and ELEVATE! Especially in the first few days.
3. Start thinking early about what help you will need - imagine living with one hand or one arm while you begin your recovery. Dr. Raizman's colleague, Dr. Charles Eaton, has a great guide HERE.
4. Return to work depends on what you were doing and how strenuous your job is, relative to your hands. We recommend not working while you are taking any narcotic pain medicine. Dr. Raizman will release you for regular or light duty with specific restrictions depending on your specific case. With carpal tunnel surgery or trigger finger release, patients who perform light work or desk jobs are often able to return to work within a few days.

After surgery, you will follow up regularly with Dr. Raizman so that he can monitor your progress and answer questions. Dr. Raizman and his partners are always available for emergencies through our answering service. Additionally, Dr. Raizman is very responsive to his patients' email inquiries.