Hand specialists few, JJ turns to alumnus for complex surgery

Mumbai: After a staffer sustained a hand injury in a fall, JJ Hospital reached out to one of its alumni—a prominent private orthopaedic surgeon and hand specialist—to perform the surgery at no charge.
"In most cases, the bone breaks into two pieces, but in some, it shatters into multiple pieces: we call this a comminuted fracture," said Dr Nadir Shah, head of orthopaedics at JJ Hospital.In such instances, doctors opt for ‘distal end of radius volar plating', an advanced technique that involves attaching a metal plate to the bone to ensure proper healing and added stability.
While the hospital routinely performs this procedure with available staff, it marked the first time that a hand specialist like Dr Sudhir Warrier, who has worked at hospitals such as Breach Candy, PD Hinduja and HN Reliance, was brought in. According to the Indian Society for Surgery of the Hand, there are only around 700 such specialists in the country, mostly practising in private setups.
"Hand surgery is a highly specialised field that very few doctors choose to pursue," Dr Shah said. Of every 100 orthopaedic surgeons, about 20 specialise in spine surgery, another 20 in joint procedures and an additional 20 in trauma care. "Then, about 5-7% focus on deformities, another 5-7% on paediatrics, and only about 1% choose hand surgery as their specialty."
Dr Manish Jain, who passed from JJ Hospital just a few months ago and is now pursuing a fellowship in arthroplasty (joint replacement) at PD Hinduja Hospital, said hand surgery specialists are few because it's not a lucrative career path. Most orthopaedic surgeons are trained to handle complex procedures, but specialists offer patients a better chance at precision and improved outcomes. "Even then, hand specialists cater to a small, elite population. In tier-1 cities, that base is limited. In tier-2 or tier-3 cities, it would be nearly impossible for these specialists to practise sustainably," Dr Jain said.
Dr Pallavi Saple, dean of JJ Group of Hospitals, said the choice of specialisation in medicine often shifts with societal needs. "We appointed Dr Warrier as an honorary professor a few months ago. We're considering introducing a hand surgery fellowship for our students, and hopefully, more will be drawn to this field in the future."
A 2020 paper published in the journal of Clinical Orthopaedics and Trauma has highlighted "a huge burden of traumatic injuries of the hand in India". "These accidental injuries not only lead to dysfunction and permanent hand deformities but also cause severe financial losses due to absence from the work... Hence, not only the management of these complex injuries should be undertaken promptly by a hand specialist, but also an emphasis needs to be put in place about the prevention of these injuries at the workplace," it said.