DEEP DIVE: the history of hand surgery


Surgery comes from the word cheirourghìa, which means “hand work”, from cheir, hand and ergon, work.

Prehistoric findings clearly testify that rudimentary surgery was already practiced in ancient tribes, long before being witnessed in the writings and works of the great Greek, Roman, Egyptian civilizations.

The primitive study of anatomy and the absence of anesthetics helped to develop a practice that was still very risky but often effective thanks to an extraordinary level of manual ability. Obviously, the pain and the risks of bleeding or infection were very high.

We note that the figure of the surgeon was often considered separate from that of the doctor as this surgeon was not connected to the explanation of the disease but more often to the magical-religious practices.

Only Ippocrate, who lived in Greece around 450 BC, is able to show that diseases are caused by events related to the body and its functionalities and introduces the concepts of diagnosis and prognosis.

Galen of Pergamum (131-201 d.C.) was a doctor for gladiators and he studied anatomy, gaining a lot of valuable experience in the areas of traumatology and surgery, using what the Romans normally provided for baths, aqueducts and sewers: clean water.

During the Middle Ages medicine and surgery had a marked decline, becoming the prerogative of a few monastic orders using prayers and medicinal herbs. Wherever possible, the friars continued to pass on curative notions and medications for known diseases. But the Clergy discouraged the practice, which was therefore entrusted to barbers, tanners and charlatans, itinerant common people.

It is only in the fifteenth century that the prestige of the surgeon returns equal to that of the doctor thanks to the mixing of Arab, Hebrew and Byzantine cultures, the foundation of Schools and Medical Universities and the care of sovereigns and famous personalities.

During the Renaissance the dissection of bodies (also done by Leonardo da Vinci) and the study of cause / effect began to question known methods leading to the rewriting of anatomy and the treatment of diseases, sometimes even becoming fashionable. There is still no shared code so mixed practices co-exist with innovations that are not yet accepted.


It must be remembered that being insensitive to the complaints of patients and having strong assistants were indispensable skills for an apprentice surgeon.

But ideas and discoveries soon developed that highlighted the importance of anaesthesia and disinfection. In just a few years thanks to Semmelweis, Pasteur and Lister, wound cleaning developed together with tool disinfection and clean new clothing such as gowns, masks, caps and the use of closed operating rooms.

The twentieth century is the golden age of surgery: radiology, reanimation, transplantation. These are wonderful years full of successes and increasingly rare disappointments. A commitment that becomes more technical, precise, methodical. The possibility of being able to aspire to miraculous healings or unimaginable organ substitutions is obviously due to the ambition, compassion and inventiveness of these surgeons.

With technology and biotechnology there are also spaces for microsurgery and tissue reconstruction, we are studying prostheses able to reactivate the original functions, and rehabilitative techniques that lead to a regained quality of life.

Hand surgery is a specialty created to respond to the traumatic, degenerative, inflammatory and neoplastic pathologies affecting the hand, the complexity of which requires a structured treatment, i.e. requires a surgeon who has expertise in Orthopaedics and Traumatology, in Plastic Surgery and in Nerve and Vascular microsurgery.