Hand surgery / Top clinic in Germany, Friedrichshafen

Hand surgery

The hand, like the foot, is a highly complex structure made up of numerous individual parts: 27 bones, 36 joints and 39 muscles, as well as various tendons and ligaments combine to form a versatile tool that has become our most important gripping and sensing organ in the course of evolution.

What is the hand?

The most important organ of the body is divided into the carpal, metacarpal and fingers. The carpal root is formed by eight small, squat bones, four of which are distributed on two transverse rows and are named after their shape: navicular, lunar, triangular and pea are arranged towards the forearm, large and small polygonal leg, and head bone and hook leg in direction metacarpal. A donkey bridge helps to remember the names: "A boat in the moonlight in the triangle around the pea, polygon big and polygon small, on the head there must be a hook."

These small bones are held together tightly by ligaments and form a vault with the bulge upwards. On the inside of a strong, transversely extending band is a passage for tendons and nerves that pull from the forearm into the palm of the hand, allowing movements and sensory perceptions. The carpal bones as a whole are an articulated connection to the forearm (ulna, spine) as well as to the metacarpal bones.

The metacarpal consists of five bones (Metacarpalia), which are numbered Roman from I to V, and forms the palm of the hand. Between the first metacarpal bone (which leads to the thumb) and the large polygonal leg is a well-articulated joint. Thanks to this, the thumb can be the only finger to face all other fingers - irreplaceable for gripping and holding objects. The remaining four metacarpal bones are articulated to the carpal bones via tight ligaments and, like these, form a vault. When you make a fist, you can clearly see the heads of the metacarpals, because they project as spherical protrusions under the skin.

The fingers are composed of 14 individual elongated bones, which - like the 14 toe bones on the foot - are divided as follows: The thumb (like the big toe) consists of only two bones, the base and the end or nail member. The remaining fingers (or toes) are composed of three bones each: basic, middle and end or nail member.

What is the function of the hand?

Main function is grasping. Here, the thumb plays a crucial role, as he can form the only finger with all other fingers a pair of pliers. However, it is not just the gripping function that makes the hand special. Thanks to its numerous palpates, many of which are located in the finger berries, it is also an important sensory organ, which can even develop very highly through special training - such as, for example for the blind is needed for orientation and reading the braille.

What problems can the hand cause?

The carpal bones are particularly susceptible to injury: If you fall on the outstretched hand in a bicycle accident, for example, a break is often the consequence, which affects the scaphoid in 70 percent of the cases. Frequent injuries include finger dislocations (finger dislocations) and finger fractures (finger fractures). The carpal tunnel syndrome is narrowed the middle arm nerve in the bony-connective tissue passage at the wrist. The consequences are sensory disorders in the fingers, ranging from mild discomfort to paralysis. Joint wear (osteoarthritis), joint inflammation (as in rheumatoid arthritis), bone inflammation (osteomyelitis) and gout are other possible diseases that may affect the hand, among other things.

The hand surgery deals with the treatment of diseases and injuries of the forearm and the hand. In Germany, this is done by specially trained surgeons. Hand surgery has developed from orthopedics and surgery. As an independent specialist area, it is interwoven with plastic surgery.

Tasks of hand surgery

Hand Surgery is concerned with the diagnosis and treatment of acute or chronic upper extremity injuries or injuries (shoulder, upper arm, forearm, hand, fingers, thumb). The field of hand surgery includes the prevention, detection, surgical and conservative treatment of diseases, injuries, malformations and tumors of the hand and forearm, as well as the reconstruction of diseases or injuries.

The essential specific tasks of hand surgery include the treatment of:

  • Injuries of the finger bones, tendons, ligaments, wrist (eg, scaphoid fracture), forearm bones (eg distal radius fracture), ulnar-spine joint (distal radioulnar joint) as well as on blood vessels and nerves (brachial plexus) including amputations of fingers, the hand or the arm.
  • Burns of the upper limb
  • Chronic diseases of the joints (osteoarthritis, arthritis, rheumatoid arthritis), circulatory disorders of the soft tissues and bones (eg lunatemalacia), constriction of nerve or tendon sheaths (eg carpal tunnel syndrome, Loge-de-Guyon syndrome, sulcus ulnaris syndrome), tendovaginitis stenosans, connective tissue (Dupuytren's contracture)
  • Soft tissue infections (panaritium, flexor divisional infection) and bone (osteitis)
  • Tumors (benign or malignant tumors) and cysts (ganglia) of hand and arm
  • congenital (childish) malformations (polydactyly, thumb aplasia)
  • complex regional pain syndromes (CRPS)
  • Functional limitations / losses of the upper extremity as a result of a disease (eg spastic paresis, paralysis) or injuries (eg after nerve injuries) with restoration of function (motor replacement surgery)
Hand surgery

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Medical Staff

DM M. Ruggaber

DM M. Ruggaber
Head of the Plastic and Aesthetic Surgery Department


Aesthetic Surgery


Facts and Figures

  • 2153 outpatient
  • 250 inpatients
  • 600 cosmetic surgeries

+49 163 59-51-511


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