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Our son had an accident in shop class that cost him a fingertip and some skin, nerve, and tendon damage. We live in a medium-sized town (100,000 population) with only one hand surgeon. There's no specialty hand clinic. Is it worth the time and expense to go to a larger place with more specialized services?

This type of decision is always a judgment call. It's based on a variety of factors. First, what kind of equipment and training does the hand surgeon in your area have? Advanced techniques using microvascular methods are often needed with hand injuries. It's quite possible that your hand surgeon has received this kind of training in a larger center. Most often, hand surgeons received their training at the very place you might go for a second opinion.

Second, don't hesitate to ask for that second opinion. You may still end up having the work done by the local surgeon where family and friends can support you. But the peace of mind you get from knowing you are in good hands is very valuable.

Hand injuries can cause long-term disability. Sometimes bleeding requires immediate emergency surgery and there's no choice but to go local. You can still consider outside help with any revision surgeries. In other cases the work is staged over two, three, or more operations. Skin grafting can take quite a few operations.

If you have the time and funds, hand surgical consultation is often a good thing.

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