The fingers are where hand surgery is most visible — and most consequential. A trigger finger that locks every morning, a drooping fingertip after a sports injury, or a tendon cut by a kitchen knife all have well-defined treatments. Many finger procedures are performed right in the office or procedure room, under local anesthesia, without an operating room visit.
Flexor tendon lacerations and finger infections are time-sensitive. Call the same day or go to the ED for initial care.
Finger Surgery in Jacksonville Beach
The fingers contain some of the most precisely arranged anatomy in the body — two tendons, two nerves, and two arteries all running through a tunnel barely wide enough for the structures themselves. Surgical problems in the fingers don't forgive imprecision the way larger joints might. A flexor tendon repair that is a millimeter too bulky will catch on the pulley above it. A trigger finger release that misses the A1 pulley will not work. A mallet finger splint that comes off for even a few minutes can restart the healing process entirely.
Dr. Graham treats finger problems with the same attention to detail that defines his hand and wrist practice. Most common finger conditions — trigger finger, Dupuytren's, ganglion cysts, soft tissue masses — are managed in the procedure room under local anesthesia with no operating room scheduling, no IV, and often same-day or next-day availability. Complex cases — flexor tendon lacerations, nerve injuries, fractures requiring fixation — are managed in the operating room with the same precision.
The hand therapists who manage post-operative finger rehabilitation are a critical part of every outcome. In Dr. Graham's experience, a surgeon is only as good as their hand therapists — and Jacksonville has exceptional therapists with years of experience treating complex finger and hand problems. Patients who invest in their therapy do measurably better.
Many of the most common finger conditions are treated in the office or procedure room under local anesthesia — no fasting, no IV, no OR wait time. You come in, have the procedure, and go home.
Conditions Treated
Every finger condition Dr. Graham treats — from the most common to the most complex. Green badges indicate procedures typically done in the office or procedure room.
Why This Practice for Your Finger
The principles that define the rest of this practice apply in miniature to the fingers — with less room for error and a higher premium on precision.
Trigger finger, trigger thumb, Dupuytren's percutaneous fasciotomy, ganglion cyst excision, mucous cyst removal, and soft tissue mass excision are all performed in the procedure room under local anesthesia. No hospital, no OR scheduling delay, no IV. Many patients are seen and treated in a single visit.
Zone 2 of the finger — "no man's land" — remains the most technically demanding area of flexor tendon surgery. Dr. Graham uses a 6-strand non-absorbable core repair with an epitendinous suture under WALANT, testing the repair with active patient flexion before the wound is closed. The FDS decision is made intraoperatively based on what he sees, not a predetermined protocol.
Mallet finger almost always heals with splinting — but only if the splint is worn continuously. The DIP joint cannot flex, even briefly, for the entire treatment period. Dr. Graham fits the splint himself, explains exactly what continuous wear means, and follows up to confirm compliance. The patients who fail splinting almost always have a compliance issue, not a treatment failure.
Percutaneous fasciotomy with a 15-blade in the procedure room achieves comparable outcomes to Xiaflex collagenase at a fraction of the cost — without the $6,500–7,000 drug price. Patients who need more extensive release choose open fasciectomy. Xiaflex is not offered because cost matters and the outcomes don't justify the difference.
Flexor tenosynovitis — infection inside the tendon sheath — is a surgical emergency. The Kanavel signs are recognizable and the window for irrigation washout before permanent tendon damage is narrow. Paronychia and felon can often be drained in the office. Deep space infections and tenosynovitis require the OR. Dr. Graham's office accommodates urgent finger infection referrals on clinic days.
Finger surgery outcomes depend heavily on rehabilitation. Flexor tendon repairs that aren't mobilized early develop adhesions. Dupuytren's releases that aren't splinted at night re-contract. Mallet fingers that aren't splinted correctly don't heal. Dr. Graham works with hand therapists who have years of experience with complex finger and hand problems — and the outcomes reflect it.
"Jean Ward described her experience as receiving an injection of humor alongside expert surgical care — and Dr. Graham called the day after surgery to check on her."
Jean Ward · Finger Surgery Patient · Verified Google Review ★ 5/5
Common Questions