You are standing at the scrub sink, thirty minutes before a Zone II flexor tendon repair in a hand that was also hit with a crush mechanism, and you need to know whether the A2 pulley can sustain what you are about to ask of it. Most operative texts tell you what to do in ideal conditions — this handbook was built for the decision that has to be made right now, in the actual case, with the anatomy you actually have. The Operative Hand Surgery Handbook 2026 delivers a structured, evidence-referenced decision framework for every major operative encounter in upper extremity surgery — so that what you do and why you do it are as defensible as how you execute it. • The Operative Decision Sequence — a five-slot pre-case tool embedded in every chapter maps indication, approach, critical anatomy, technique sequence, and evidence grade into a single coherent decision before the incision • Spiral cord anatomy made operative — learn exactly where Nataf's displaced nerve sits before you divide a Dupuytren cord, and why the position it moves to is the one you cut toward • Replantation that starts with a no — apply the three-question framework that prevents technically successful operations from producing worse outcomes than revision amputation • SL instability staged to the correct window — Garcia-Elias and Geissler combined into an indication algorithm that matches the reconstruction to what the biology can still support • Nerve transfer logic, not nerve transfer recipes — the Oberlin, the AIN-to-ulnar, the radial-to-axillary, each explained through the regeneration distance biology that determines whether the motor end plate will still be there when the axon arrives • The Master Compendium — Section 36 indexes every Operative Decision Sequence by domain and maps all nine ABOS and ABPS SOTH examination categories to the decisions most likely to appear Written for hand surgery fellows, upper extremity residents, and ABOS and ABPS Surgery of the Hand candidates who demand operative reasoning at the level the cases actually require. If your patients deserve decisions as precise as your suture technique, this is the reference you bring to every case.
