ENHand surgery works on a few centimetres packed with twenty-seven bones, their joints, the flexor and extensor tendons and three major nerves, so a millimetre off target costs a grip rather than a scar. Put plainly, people fly abroad with a hand not because the first operation is difficult but because a failed hand operation is harder to redo than to do.
Below: what hand surgery in Germany covers, which conditions and injuries people travel for, how consultation and surgery are organised, how long recovery takes and what to collect before the trip.
Why the hand has its own surgeon
The hand has its own surgeon because in Germany hand surgery is not a base specialty but an additional qualification (Zusatz-Weiterbildung Handchirurgie), described by the German Society for Surgery of the Hand (DGH), earned on top of general or paediatric surgery, orthopaedics and trauma surgery, or plastic surgery. Two doctors with the same word “Handchirurg” on the door may have come from different directions, one from plastic surgery, the other as a trauma surgeon. For a complex tendon and nerve injury, ask how many such cases the surgeon treats a year.
A dedicated unit has an operating microscope, its own hand therapy service and a neighbouring specialist to call in if the damage turns out to go beyond the joint.
The conditions people come with
Planned cases include carpal tunnel syndrome, Dupuytren’s contracture, trigger finger, ganglion, thumb base arthritis and the rheumatoid hand. In carpal tunnel syndrome the median nerve is compressed under the wrist ligament: the first three fingers go numb and tingle at night, and the pinch grip weakens. The operation divides the ligament, open or endoscopically, usually as day surgery. The current German guideline (S3-Leitlinie) covers its diagnosis and treatment.
In Dupuytren’s contracture, cords in the palmar fascia, the dense layer under the palm’s skin, stop the fingers straightening. The options, needle fasciotomy through a puncture or open removal of the cord, each have their own time until the contracture returns. The disease is prone to recurrence, which no method rules out.
Other planned cases: trigger finger, where a tendon catches in a narrowed ring of ligament, a wrist ganglion, thumb base arthritis and the rheumatoid hand. For the rheumatoid hand, surgery comes after drug treatment and alongside it, and that treatment is run by rheumatology.
Hand injuries and what is done about them
Fractures are held with a cast or metal, and damaged tendons and nerves are repaired. The distal radius fracture, at the wrist, is the commonest fracture of the arm and everyday work in trauma surgery: cast or plate depends on the position of the fragments and on what the person does with that hand, not on the pain. A scaphoid fracture is often invisible on the first X-ray, and one that never unites destroys the wrist over years, so pain in the anatomical snuffbox at the thumb base after a fall is imaged again.
Flexor tendon and digital nerve injuries are repaired under the microscope, and the result depends not only on the repair but on how early the finger is moved to protocol. Replantation of an amputated finger is possible only within the first hours and not in every hospital. More on fracture treatment in Germany.
The operation itself, and what comes after
Most hand procedures are done under a regional block: only the arm is anaesthetised and the patient stays awake. Many are day cases: the patient leaves the clinic that evening. Afterwards come a splint or orthosis for an agreed period and a movement plan written out from day one.
Recovery is run not by the surgeon but by an occupational therapist and a hand therapist: separate work over weeks, sometimes months, with exercises at home between sessions. Honestly, sensation after nerve surgery returns slowly and not always completely, and grip strength comes back later than movement. See also orthopaedic rehabilitation in Germany.
Where hands are operated on in Germany
Hand surgery in Germany sits in three different places: trauma and orthopaedic departments, plastic surgery and specialised orthopaedic hospitals. Examples from the partner network: at the Diakonie-Klinikum Stuttgart, hand surgery belongs to the department of plastic and aesthetic surgery run by Professor Frank Werdin and Dr Matthias Pfau. The München Klinik Harlaching has a department of trauma surgery, orthopaedics, hand and reconstructive surgery headed by Professor Ulrich Spiegl. At the orthopaedic Schön Klinik München Harlaching, hand surgery is one of the main directions alongside joint replacement and spinal surgery.
When choosing: damaged skin and soft tissue point to plastic surgery, a broken bone to trauma surgery, chronic arthritis to orthopaedics. More under surgery in Germany.
Frequently asked questions
What is a Handchirurg?
A Handchirurg is a surgeon with an additional hand surgery qualification gained on top of a base specialty: general, paediatric or plastic surgery, or orthopaedics and trauma surgery. Before complex tendon or nerve surgery, ask how many such operations the surgeon does a year and whether the unit has its own hand therapy.
Do I need a general anaesthetic for hand surgery?
Often not: most hand procedures are done under a regional block, which numbs only the arm while the patient stays awake. The choice depends on the site and length of the operation and on the patient’s health and wishes. After day surgery the patient goes home that evening with a splint and a movement plan.
How long does recovery after hand surgery take?
Weeks to months, depending on what was operated on. First the hand rests in a splint or orthosis, then come sessions with an occupational therapist and a hand therapist, plus exercises at home. Movement returns before grip strength, and sensation after nerve surgery comes back slowly and not always completely.
How AlenMed organises treatment
It starts with documents: X-rays of the hand in two planes, any MRI or ultrasound report, a description of what exactly stopped working in daily life, and the date of the injury or first symptoms. They are translated and sent to the right department, whose reply says whether an operation is needed at all, which one, and what must still be examined on site.
AlenMed has 86 partner hospitals in 38 cities, 345 doctors and its company office in Munich. A coordinator handles the visa invitation, appointment, interpreter and accommodation if hand therapy continues locally after the operation.
This material is for information only and is not an offer. Treatment is decided by the doctor who examines the patient in person.