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Division of Hand & Upper Extremity

The Division of Hand & Upper Extremity is currently led by Dr. David Ruch (pictured left). The hand surgeons at Duke’s nationally ranked orthopaedic center in Raleigh and Durham offer advanced care for common hand pain and injuries like arthritis, fractures and cysts, as well as uncommon hand conditions and hand, finger and thumb reattachments associated with amputation. They also specialize in wrist pain and injury and sports-related injuries. Our plastic surgery hand specialists are leaders in innovative surgeries reattaching amputated hands, fingers and thumbs, as well as microsurgical techniques to repair nerves and arteries that may be damaged. 

Duke is one of only about 10 hospitals in the U.S. that has performed a hand transplant. The surgery is difficult, involving an intricate process of connecting bone, blood vessels, muscle, nerve, tendons, and skin. Matching the limb from a deceased donor is also complex, as is the control of rejection, adding to the rarity of the procedure.

Research being done by the division includes new treatments for wrist and elbow fractures, the use of new technology, such as arthroscopy and the use of microscopes, to assist in surgical management of upper extremity problems, developing advanced programs for training the next generation of leaders in orthopaedic and hand surgery, nerve repair and regeneration, tendon repair and reconstruction, wrist injuries, compartment syndrome and upper extremity anatomy. Duke Orthopedics is fortunate to have resources available to tackle many challenging questions in the field - ultimately to improve the outcomes and the experiences of our patients.

  • Our unparalleled experience enables our surgeons to treat some of the most complex cases, including hand transplant
  • We are committed to training future generations of orthopedic surgeons

Our patients benefit from our experience treating the most complex cases, including:

  • Hand Pain & Hand Injury: Normal hand function is fundamental to your quality of life. The hand specialists at Duke Orthopaedics and Duke Plastic Surgery are committed to eliminating symptoms due to all causes of hand pain and discomfort, including carpal tunnel syndrome, thumb arthritis, joint dislocations, nail-bed injuries and trigger finger. We pioneered many microsurgical techniques. These innovative procedures are done with high-powered microscopes that allow our surgeons to see vessels and nerves that are too small to be repaired without magnification, and stitches are smaller than an eyelash. As a major referral center, we have gained extensive experience using microsurgery to repair damaged nerves and blood vessels in your hands, fingers and thumbs.
  • Wrist Pain & Wrist Injury: Whether you're suffering from a wrist fracture, forearm fracture or wrist arthritis, our specialists have the expertise and skill to alleviate your wrist pain, increase your range of motion, and return you to your normal activities. Our experts have advanced training and skill in diagnosing and treating painful wrist and forearm conditions including carpal tunnel syndrome, tendonitis, wrist fractures, ganglion cysts, tendon injuries, tumors, wrist arthritis and cartilage tears.
  • Hand Transplant: Duke’s hand transplant program is led by one of the world’s leaders in vascularized composite allotransplantation (VCA), an innovative method of transplanting multiple tissues, such as a hand, as a functional unit. Our comprehensive approach guides our research on hand transplantation, which remains an investigational procedure. It is an option for people who have lost one or both hands.

When you come to us for treatment of your wrist pain, you receive care from nationally recognized medical professionals who are committed to your complete recovery. Duke is consistently ranked as one of the top orthopaedic programs in the country by U.S. News & World Report.

We invite you to learn more about our program by visiting:

Ready for an appointment? Call today at: 855-855-6484