Hand and wrist problems can affect sensation, grip, work and daily activities. MPGCARE coordinates specialist reviews with Medical Park and Liv Hospital. The receiving clinic confirms accepted conditions, patient ages, the surgeon’s hand and microsurgery expertise, available methods and rehabilitation support. An operation is not appropriate for every problem; treatment follows an examination and review of relevant records.

Condition	Symptoms and points to notice	Tests the specialist may select
Carpal tunnel syndrome	Tingling in the thumb, index and middle fingers, nighttime symptoms or grip weakness. Progressive weakness needs timely review.	Examination; selected nerve conduction studies/EMG or ultrasound. Splinting, activity changes or injection may be considered; release surgery depends on severity and response.
Cubital tunnel syndrome	Tingling in the little and ring fingers or hand weakness, sometimes worse with a bent elbow.	Examination and selected nerve conduction/EMG or imaging. Position changes and splinting may help; decompression or nerve transposition is chosen for appropriate cases.
Trigger finger	Painful catching or locking of a finger. Do not repeatedly force a locked finger straight.	Usually clinical diagnosis; ultrasound for an unclear case. Activity adjustment, splint or injection may precede selected pulley-release surgery.
De Quervain’s tenosynovitis	Pain on the thumb side of the wrist with gripping or lifting.	Clinical examination; selected ultrasound or X-ray to clarify another cause. Splint, activity modification, therapy or injection; release surgery only when indicated.
Dupuytren’s contracture	Palmar nodules and cords can progressively bend fingers and limit extension.	Examination of the skin and degree of contracture. Observation or selected needle/surgical treatment; availability must be confirmed and recurrence is possible.
Ganglion cyst	A lump near the wrist or hand, sometimes painful or fluctuating in size. Do not puncture or strike it yourself.	Examination; ultrasound or MRI if the diagnosis is uncertain. Observation, aspiration or excision may be considered; recurrence can occur.
Hand and wrist fractures, including scaphoid fracture	Pain, swelling or deformity after injury. Persistent thumb-side wrist pain may reflect a scaphoid injury even if the first X-ray is normal.	X-rays; selected repeat imaging, CT or MRI. Stable injuries may use a splint/cast; displacement or instability may require fixation. Open fractures need urgent local care.
Wrist ligament and TFCC injuries	Pain, clicking or instability, often after a fall or twisting injury.	Examination and X-rays; MRI and, in selected cases, diagnostic arthroscopy. Splinting and therapy may help; repair or reconstruction depends on the lesion and stability.
Flexor tendon injury	After a cut, inability to bend a finger can indicate tendon damage; a small wound may hide a deep injury.	Movement and wound examination, with selected ultrasound. Complete cuts often need repair; delayed injuries may require grafting or staged reconstruction and protected therapy.
Extensor tendon injury and mallet finger	Difficulty straightening a finger or a drooping fingertip after injury.	Examination, X-ray for associated fracture and selected ultrasound. Some closed injuries can use a supervised splint plan; open or unstable injuries may need repair.
Peripheral nerve injury	Numbness, loss of protective sensation or weakness after injury. Protect numb skin from burns and cuts.	Sensation and strength examination; nerve conduction/EMG timed by the specialist, and selected ultrasound/MRI. Observation, repair, grafting or transfer depends on the damage.
Syndactyly	Joined fingers may affect growth and use of the hand. Pediatric assessment is distinct from adult care.	Clinical assessment and selected X-rays. Separation and skin reconstruction are planned according to the anatomy and age, not a universal timetable.
Polydactyly	An extra finger may involve bone, tendons and joints. Avoid home attempts to remove or tie off a digit.	Examination and selected X-rays. Removal with reconstruction of supporting structures is considered individually by a pediatric hand specialist.

Operation	What the procedure does	When it may be considered and its limits
Finger, hand or arm replantation	Reattaches a completely separated part, repairing bone/tendons and reconnecting small vessels and nerves when feasible.	Time-critical trauma care. Suitability depends on injury mechanism, tissue condition, ischemia and overall health; survival or normal function is not guaranteed. Seek local emergency care immediately.
Revascularization	Restores blood flow to a part that remains attached but has lost its circulation.	Urgent specialist assessment for a cold, pale or poorly perfused digit/hand. Not all tissues can be salvaged; the team assesses repair options.
Microvascular repair and vessel grafting	Repairs a small artery or vein, or bridges a damaged segment with a graft.	Selected traumatic or reconstructive defects; clotting, loss of circulation and repeat surgery are possible.
Direct microsurgical nerve repair	Joins suitable cut nerve ends under magnification without excessive tension.	Selected nerve cuts with appropriate tissue conditions. Sensation and strength may recover incompletely; recovery is gradual and rehabilitation matters.
Nerve graft reconstruction	Bridges a nerve gap when direct repair is unsuitable.	The surgeon considers gap length, timing and donor options; donor-site effects and incomplete recovery must be discussed.
Nerve transfer	Redirects a suitable functioning nerve or branch to another target to support lost function.	Selected complex nerve injuries; timing and muscle viability matter. Retraining is required, and benefit is not assured.
Free flap reconstruction	Moves living tissue from another body area and reconnects its blood vessels to cover a defect.	Selected major tissue loss, including exposed tendons or bone. Discuss donor-site effects, flap circulation monitoring and possible revision.
Toe-to-hand transfer	Transfers selected toe tissue to reconstruct a missing thumb or finger with vascular and other repairs.	Specialized reconstruction for carefully selected patients. The team weighs hand goals, foot donor-site effects and rehabilitation; center availability must be explicitly confirmed.

A hand surgeon evaluates bone, joint, tendon, nerve and soft-tissue problems and coordinates care with a hand therapist. Microsurgery is a technique for small structures, not a synonym for every hand operation. Carpal tunnel release, fracture fixation, tendon repair, tendon transfer or wrist arthroscopy may be relevant without being microvascular surgery. The clinic must confirm which procedures it actually provides.

Depending on the diagnosis, observation, activity modification, splints, prescribed medicines, hand therapy or selected injections may be appropriate. A complete tendon cut, impaired circulation or another serious injury may require prompt surgical assessment instead. The specialist weighs alternatives against the risk of waiting; an online review cannot decide the operation.

Send dated clinical and discharge reports, previous operation notes, X-ray/CT/MRI reports and original DICOM images when available, nerve conduction/EMG reports, and therapy records. Include the affected side, dominant hand, injury date and mechanism, symptom duration, work demands, medicines, allergies, diabetes and nicotine use. Ask MPGCARE for the agreed secure channel and translation requirements; imaging screenshots alone may be insufficient. New tests are chosen by the specialist.

Consultation and tests are separate from an injection, arthroscopy or operation. Proposed procedures require discussion of indication, alternatives, anesthesia and consent. Risks may include infection, bleeding, stiffness, tendon rupture/adhesions, nerve symptoms, vascular clotting, donor-site problems and further surgery, depending on the method. Full movement, normal sensation or a permanent result cannot be promised.

Fasting, medicine changes and preparation are provided only after the receiving clinic confirms the patient-specific plan. Do not stop blood thinners or other medicines yourself. Clarify the written clinical scope, expected visits and arrangements for an accompanying person before travel.

The surgeon and hand therapist set a plan specific to the injury, repair and healing stage. It may include a custom orthosis, protected motion, swelling/scar care, sensory retraining and later strengthening. Starting too early or too late can harm recovery; do not copy exercise schedules from another patient.

Ask who provides therapy, when it starts, which movements are allowed, how progress is measured and what equipment is needed. Return to work, driving and sport depends on safety and function. Before departure, agree on local therapist/surgeon handover, reports, review dates and a route for urgent concerns. A remote check cannot always replace an in-person circulation or wound examination.

Amputation, a cold/pale/blue hand or finger, uncontrolled bleeding, severe crush or injection injury, an open fracture, rapidly increasing pain/swelling, or an infected wound with fever needs immediate local emergency assessment. Follow emergency-service instructions; do not wait for an international appointment or transfer. Stable long-standing symptoms can follow a routine specialist pathway.

Contact MPGCARE for a planned hand and wrist record review. The clinic confirms the accepted condition, surgeon, available treatment and rehabilitation/follow-up scope.

ASSH: HandCare · ASSH: Replantation · ASSH: Nerve injury · AAOS: Scaphoid · BSSH