Hand surgery syllabus for the FRCS (Tr & Orth) examination

“The hand” covers the hand and forearm and the structures anatomically contained within. Knowledge of the structural anatomy and the biomechanics of joint and tendon function is required.

Pathology

A working knowledge of the acute conditions and trauma of the hand is required, i.e. injury to the bones, joints, tendons, nerves, skin and vessels of the hand and infective processes.

Knowledge of the non-acute congenital, degenerative, inflammatory (rheumatoid) and neoplastic conditions as well as benign tumours, e.g. ganglions, is also required.

Training in operative hand surgery

For the purpose of the examinations, the trainee should have gained experience in the operative management of:

• The acutely injured hand

• Fractures, including scaphoid non-union

• Dislocations

• Nerve injuries

• Tendon injuries and common tendon transfers

• Skin grafts

• Infections

In elective surgery, the candidate must have sound knowledge of the procedures appropriate for carpal tunnel syndrome, trigger finger, Dupuytren's contracture, benign tumours, degenerative conditions of the carpometacarpal joint and wrist joints and surgery of the rheumatoid hand.

Long cases

• Brachial plexus injuries

• Peripheral nerve injuries

• Rheumatoid shoulder/hand and wrist

Short cases

• Brachial plexus lesions

• Carpal instability

• Carpal tunnel syndrome

• Basal thumb osteoarthritis

• Duplicated thumb

• Dupuytren's disease

• Kienböck's disease

• Median nerve injury

• Ulnar nerve injury (high and low)

• Perilunate dislocation

• Radial nerve palsy

• Rheumatoid hand and wrist

• Ulnar collateral ligament injuries

Basic science

• APB wasting

• Flexor tendon sheath/vinculae

• Brachial plexus

• […]