1577 Roberts Drive, Suite 225, Jacksonville Beach, FL 32250
Jacksonville Beach, FL · Jacksonville Orthopaedic Institute

Hand Surgery
in
Jacksonville, FL

From a trigger finger that locks in the morning to a cut tendon that needs repair tonight — Dr. Graham treats the full spectrum of hand conditions. Many procedures are performed in the office under local anesthesia, without sedation, without an IV, and with same-day scheduling for urgent injuries.

When to See Dr. Graham
  • Numbness or tingling in the fingers — especially at night
  • A finger that locks, catches, or won't straighten
  • Thumb or finger pain at the base — gripping, pinching, opening jars
  • A palm-side cut with altered finger motion — same day
  • Fingers curling into the palm that won't straighten
  • A hand or finger that was injured and hasn't been right since

JOI Now walk-in orthopaedic care is available on clinic days (Tue · Wed · Fri) for urgent hand injuries that don't require an emergency department.

250+
Named Google reviews from Jacksonville patients
#1
Wrist fracture volume surgeon, Northeast Florida
#1
Wrist arthroplasty volume, Northeast Florida
In-Office
WALANT procedures — no IV, no sedation, same visit

The Hand Is
Where This Practice Began

Jacksonville Hand Surgery was built around a simple principle: hand problems deserve a hand specialist. The hand is the most mechanically complex region of the upper extremity — dozens of bones, tendons, nerves, and ligaments working in precise coordination within a very small space. A millimeter of error in a flexor tendon repair matters. Zone II of the finger is still where technical skill is most visibly expressed in all of hand surgery.

Dr. Graham is fellowship-trained in hand and microvascular surgery at the Jacksonville Orthopaedic Institute. He treats routine hand problems with the same attention as complex ones — because in his experience, what looks routine on the referral form often has nuance that matters for the outcome. Carpal tunnel that doesn't improve after release. Trigger finger that isn't really a trigger finger. A "sprain" that has been hurting for four months.

The WALANT program — wide-awake local anesthesia, no tourniquet — means most common hand procedures never need a hospital at all. Carpal tunnel, trigger finger, ganglion cysts, selected tendon and nerve procedures: all done in the office or minor procedure room, with the patient awake and often watching. Faster in, faster out, faster back to what you do.

The WALANT Program

Most Hand Procedures Don't Need a Hospital

Wide-awake local anesthesia no tourniquet (WALANT) allows Dr. Graham to perform many hand procedures with only a local anesthetic injection — no IV, no sedation, no anesthesiologist, no fasting requirement.

The patient is awake, comfortable, and can participate. For tendon repairs, this means Dr. Graham can ask the patient to actively flex or extend the finger during surgery and verify the repair in real time. No other method provides this.

  • Trigger finger / trigger thumb release
  • Finger & hand ganglion cyst excision
  • Dupuytren's percutaneous fasciotomy
  • Soft tissue mass excision
  • Carpal tunnel release (OR, WALANT available)
  • De Quervain's release (OR, WALANT available)
  • Tendon repairs (OR, WALANT)

Hand Conditions

Every condition Dr. Graham treats in the hand — from the most common to the most complex. All complexity levels accepted, including revision cases.

Tendon Conditions
Arthritis & Joint Conditions
Soft Tissue Conditions
Dupuytren's Contracture
Palmar cords causing finger contracture — percutaneous fasciotomy or open fasciectomy, no Xiaflex.
🔵
Ganglion Cyst
Finger and hand ganglions excised in the procedure room under local. Wrist ganglions require the OR.
🎗️
Giant Cell Tumor of Tendon Sheath
Firm nodule on a finger or palm — excision with careful sheath preservation.
Coming soon
🩹
Hand & Finger Masses
Lipomas, epidermal inclusion cysts, mucous cysts, and other soft tissue tumors.
Coming soon
Trauma, Fractures & Urgent Care
🦴
Metacarpal Fractures
Boxer's fracture and other hand bone breaks — splinting, pinning, or ORIF depending on pattern.
🫀
Finger Fractures & Dislocations
Phalangeal fractures, PIP dislocations, and volar plate injuries — reduction and stabilization.
🦠
Hand & Finger Infections
Felon, paronychia, flexor tenosynovitis, fight bite — urgent surgical drainage when needed.
🔪
Traumatic Amputation
Fingertip to complete digit — replantation assessed case by case; revision amputation when indicated.
Coming soon

Hand Surgery the Way
It Should Be Done

Several things distinguish Dr. Graham's approach to hand surgery from the standard of care in Northeast Florida.

01

Most Procedures in the Office

The WALANT program means carpal tunnel, trigger finger, Dupuytren's fasciotomy, ganglion excision, and many other hand procedures are performed in the office without IV, sedation, or hospital scheduling. You come in, have the procedure, and go home — often the same day you call.

02

Tendon Repair Under Local Anesthesia

Flexor tendon repairs are performed in the OR under local anesthesia with the patient awake. Dr. Graham can ask the patient to actively flex the finger during surgery — verifying the repair glides cleanly, the pulleys are appropriately managed, and the FDS decision is made based on what he sees, not a protocol. In his experience, this produces a superior repair.

03

Dupuytren's Without Xiaflex

Dr. Graham treats Dupuytren's contracture with percutaneous fasciotomy using a 15-blade — the same functional outcomes as Xiaflex collagenase injection, without the $6,500–7,000 drug cost. Patients choose between percutaneous fasciotomy and open fasciectomy based on their anatomy and goals. Xiaflex is not offered because cost matters and outcomes don't justify the difference.

04

De Quervain's Done Right

Every De Quervain's release includes release of both the first dorsal compartment and the EPB subcompartment — the most common reason for failed release elsewhere. Dr. Graham always addresses both. Patients with persistent pain after a previous release are seen and re-evaluated.

05

Urgent Cases Seen Promptly

Flexor tendon lacerations, fight bites, hand infections, and traumatic injuries are time-sensitive. Dr. Graham's office accommodates urgent referrals and coordinates with the emergency department when same-day surgery is needed. JOI Now walk-in is available on clinic days for injuries that don't require an ED.

06

Revision Cases Accepted

Persistent symptoms after carpal tunnel release, trigger finger that has recurred, De Quervain's that didn't resolve — revision hand surgery requires both technical skill and an honest re-evaluation of what was done and what was missed. Dr. Graham accepts these cases and treats them as a different clinical problem than the primary procedure.

Verified Google Reviews

What Jacksonville Patients Say

"Jean Ward described her experience as receiving an injection of humor along with expert surgical care — and Dr. Graham called the day after surgery to check on her."

Jean Ward  ·  Finger Surgery Patient  ·  Verified Google Review

"Tammy Davis said Dr. Graham's positive outlook made all the difference — she came in nervous about Dupuytren's surgery and left with a plan she actually felt good about."

Tammy Davis  ·  Dupuytren's Patient  ·  Verified Google Review

Frequently Asked Questions

Dr. Graham treats the full spectrum of hand conditions — carpal tunnel syndrome, trigger finger and thumb, Dupuytren's contracture, De Quervain's tenosynovitis, basilar joint (thumb) arthritis, flexor and extensor tendon lacerations, digital nerve injuries, hand fractures and dislocations, ganglion cysts, hand infections, and more. All complexity levels are accepted, including revision cases and patients who have been told they are difficult to treat.
WALANT stands for wide-awake local anesthesia no tourniquet. Many hand procedures are performed in the office using only local anesthetic — no IV, no sedation, no anesthesiologist. Procedures performed under local anesthesia include trigger finger and trigger thumb release, finger and hand ganglion cyst excision, and Dupuytren's percutaneous fasciotomy. Carpal tunnel release and De Quervain's release are currently performed in the OR but are available under WALANT. For tendon repairs performed in the operating room, Dr. Graham also uses local anesthesia so the patient can actively flex or extend the finger during surgery — providing intraoperative feedback no other method can offer.
Yes. Flexor tendon lacerations, digital nerve injuries, hand infections, and complex fractures are seen urgently. Patients should go to the nearest emergency department for initial wound care and stabilization, then contact Dr. Graham's office for definitive surgical management. JOI Now walk-in orthopaedic care is also available on clinic days (Tuesday, Wednesday, Friday) for hand injuries that don't require an emergency department.
See a hand surgeon promptly for: any laceration on the palm side of the hand where you cannot fully bend a finger, numbness in a finger after a cut, a bite wound over a knuckle, any deep hand infection with spreading redness, or a hand injury where you cannot grip normally. For more gradual symptoms — numbness, a trigger locking, a bump on the wrist, pain at the thumb base — a scheduled appointment is appropriate. When in doubt, call. The nurses at Dr. Graham's office can help determine the right level of urgency.
Yes — revision cases are accepted and welcome. Persistent symptoms after carpal tunnel release, recurrent trigger finger, De Quervain's that didn't fully resolve, or a tendon repair that didn't heal correctly are all conditions Dr. Graham evaluates. Revision hand surgery is a distinct clinical problem from the primary procedure, and it requires re-examining what was done, what was missed, and what the anatomy looks like now. These cases are treated with the same thoroughness as any other.

Hand problem?
You're in the right place.

Whether it's a common condition you've been managing for months or an acute injury that happened today, Dr. Graham's office in Jacksonville Beach serves patients from across Northeast Florida. New patients are welcome. Referrals are welcome. Urgent cases are prioritized.

Call (904) 241-1204 Referring Physicians →
Contact & Location
1577 Roberts Drive, Suite 225
Jacksonville Beach, FL 32250
Clinic days: Tue · Wed · Fri
Surgery days: Mon · Thu
JOI Now Walk-In · Clinic days
No appointment needed for urgent injuries

Serving Jacksonville Beach, Jacksonville, Neptune Beach, Atlantic Beach, Ponte Vedra, and surrounding Northeast Florida communities.