Hand Injuries
Need a Specialist,
Not a Waiting Room.
Fractures, tendon injuries, dislocations, lacerations, infections — the hand is unforgiving of delay. Dr. Graham sees acute upper extremity injuries through JOI Now, often the same day, with access to definitive surgical care when it matters most.
- Wrist & hand fractures
- Finger dislocations & fractures
- Tendon lacerations & ruptures
- Hand & finger infections
- Ligament & soft-tissue injuries
- Post-ER follow-up & second opinions
Walk in on clinic days (Tue · Wed · Fri) or call ahead. For amputations, uncontrolled bleeding, or vascular injuries — go directly to the ER.
Why Timing Matters
The Hand Is Unforgiving
of Delay.
The hand contains 27 bones, over 30 muscles acting through an intricate network of tendons, three major nerves, and a vascular supply that can fail quickly after injury. When any part of that system is disrupted, the window for optimal treatment is often measured in hours — not days.
Tendons that are cut or ruptured retract into the palm within hours, making repair progressively more difficult. Infections in the flexor tendon sheath — one of the most dangerous hand emergencies — can destroy a tendon in a matter of days. Fractures that heal in poor alignment may require complex corrective surgery that a simple early intervention would have avoided. Nerve injuries repaired early recover far better than those addressed after weeks of delay.
In Dr. Graham's experience, the single greatest predictor of outcome after a hand injury is how quickly the right specialist is involved. The ER is essential for life-threatening emergencies — but for most hand injuries, a hand surgeon seeing the problem directly, with the ability to move to surgery the same day if necessary, is the most efficient path to a good result.
Uncontrolled bleeding · Partial or complete amputation · Cold, pale, or pulseless hand · High-pressure injection injuries (grease gun, paint sprayer) · Rapidly spreading redness with fever · Open fracture with exposed bone
Tendons, bones, nerves, and blood vessels run in close proximity throughout the hand. An injury to one structure rarely occurs in isolation — a laceration that appears superficial may sever a flexor tendon or digital nerve just millimeters beneath the skin.
This is why hand injuries require evaluation by someone trained to look for — and treat — the full picture. A missed tendon injury identified weeks later is a very different surgery than one addressed on the day of the injury.
Getting the Right Care
ER or Hand Surgeon?
Matching your injury to the right level of care is the first decision. Most hand injuries don't need an emergency room — they need a specialist who can see and treat them definitively.
- Uncontrolled or arterial bleeding
- Partial or complete finger / hand amputation
- Cold, pale, or pulseless hand after injury
- High-pressure injection injury (grease gun, paint sprayer)
- Rapidly spreading redness with fever or rigors
- Open fracture with visible bone
- Crush injury with suspected vascular compromise
High-pressure injection injuries look deceptively minor — a small entry wound — but cause massive internal destruction. These are surgical emergencies, regardless of how the hand feels at first.
- Closed fractures — wrist, hand, or finger
- Finger dislocations (even if already reduced)
- Deep lacerations — especially over joints or tendons
- Suspected tendon rupture or laceration
- Hand or finger infections — felon, paronychia, fight bite
- Mallet finger, jersey finger, boutonnière injury
- Ligament injuries, including skier's / gamekeeper's thumb
- Post-ER follow-up — splinted elsewhere, needs evaluation
Most hand injuries are better served by a fellowship-trained hand surgeon than an ER. Dr. Graham can evaluate, image, and treat — including proceeding to surgery that same day if needed.
Conditions Treated Urgently
Acute Injuries & Infections
Dr. Graham evaluates and treats the full spectrum of acute upper extremity injuries — from finger fractures to complex wrist trauma requiring reconstruction.
Why It Matters Who You Call
Subspecialty Care
From the First Visit
When you call a hand surgeon instead of waiting in an ER, you don't just get faster care — you get better care. Here's what that means in practice.
Dr. Graham is a fellowship-trained hand and upper extremity surgeon at Jacksonville Orthopaedic Institute, Jacksonville Beach. He is the highest-volume wrist fracture surgeon in Northeast Florida — and available for acute cases through JOI Now on clinic days.
Diagnosis & Surgery in One Visit
Dr. Graham can evaluate your injury, obtain imaging, and proceed to surgery the same day if needed — at Baptist Beaches Hospital, Jacksonville Beach Surgery Center, or the JOI surgical center. There is no referral chain to navigate. Eliminating that gap is often the difference between a straightforward repair and a complex reconstruction.
Nothing Gets Missed
The most dangerous hand injuries are the ones that are initially underestimated. A deep laceration with tendon involvement. An infection that looks like a simple finger swelling. A wrist fracture with an unstable carpal ligament injury behind it. Fellowship-trained hand surgeons are trained specifically to find these — and treat them definitively.
In-Office Local Anesthesia, When Needed
For select acute injuries, Dr. Graham's office offers WALANT (Wide-Awake Local Anesthesia No Tourniquet) procedures performed in-office by John Tierney, PA-C. Simple lacerations, minor fracture reductions, and certain soft-tissue procedures can be addressed without IV sedation, OR scheduling, or general anesthesia delays.
Post-ER Coordination
Were you seen in the ER, splinted, and told to follow up? Dr. Graham's office accommodates these patients promptly. Bring any X-rays or imaging provided. In many cases, a more definitive treatment plan — conservative or surgical — can be established at the first follow-up visit rather than waiting weeks for a routine appointment.
Highest Surgical Volume in Northeast Florida
Volume matters when it comes to outcomes. Dr. Graham is the highest-volume wrist fracture surgeon in Northeast Florida — the single most common acute hand and wrist injury. That volume translates into pattern recognition, surgical efficiency, and outcomes that less-experienced surgeons simply can't match.
Hand Therapists Who Know Complex Cases
Recovery from acute hand injuries requires skilled therapy. Dr. Graham's hand therapists have years of experience managing complex post-operative and post-injury rehabilitation. A surgeon is only as good as their hand therapists — and we have the best in Jacksonville.
Walk In on
Clinic Days.
JOI Now accepts walk-in patients for acute hand and upper extremity injuries on Dr. Graham's clinic days — no appointment required. Calling ahead is always welcome and can help us prepare for your evaluation.
What Patients Say
"Complex forearm fracture requiring bone graft. Dr. Graham is beyond exceptional — I would give 10 stars if available."
Roy Williams · Complex Forearm Fracture & Bone Graft · Verified Google Review ★ 5/5
"Dr. Graham is the go-to guy for hand surgery — I wouldn't trust anyone else."
Fred Alvarez · Hand Surgery · Verified Google Review ★ 5/5
Common Questions