The wrist is the most mechanically intricate joint in the upper extremity — 15 bones, a network of ligaments, and a narrow canal that carries every nerve and tendon to the hand. Dr. Graham is the #1 volume wrist fracture and wrist arthroplasty surgeon in Northeast Florida, treating everything from acute fractures to complex ligament reconstruction and end-stage arthritis.
Wrist injuries after a fall should be evaluated the same day if there is deformity, inability to use the hand, or severe pain. JOI Now walk-in is available on clinic days.
Wrist Surgery in Jacksonville Beach
No joint rewards surgical experience more reliably than the wrist. The distal radius fracture — the most common fracture in adults — looks straightforward until it isn't: a highly comminuted intra-articular pattern, an osteoporotic bone that doesn't hold fixation, or a malunion from inadequate initial treatment. Managing these cases well requires having seen them before, many times, in all their variations.
Dr. Graham is the highest-volume wrist fracture surgeon in Northeast Florida. That volume isn't incidental — it reflects a deliberate focus on wrist surgery and a referral base that sends the hard cases specifically because of what that experience represents. He uses arthroscopic assistance for select intra-articular fractures to directly visualize articular reduction that fluoroscopy alone misses, and he accepts revision and malunion cases from across the region.
The same philosophy applies to wrist arthritis. Wrist arthroplasty — proximal row carpectomy, capitolunate fusion, wrist replacement, total fusion — requires precise matching of procedure to pattern. The wrong operation for a given arthritis pattern produces a poor result regardless of technical execution. Dr. Graham is the #1 volume wrist arthroplasty surgeon in Northeast Florida and performs the full spectrum of these procedures, including revision cases.
Volume in surgical subspecialties correlates directly with outcomes. Surgeons who perform a procedure regularly encounter its full complexity, develop pattern recognition for the unusual cases, and maintain the technical fluency that infrequent operators cannot.
Conditions Treated
Every condition Dr. Graham treats at the wrist — from the most common to the most complex. All complexity levels accepted.
Why This Practice for Your Wrist
The wrist's complexity rewards volume. Here's what distinguishes Dr. Graham's approach to wrist surgery specifically.
For select intra-articular distal radius fractures, Dr. Graham uses the wrist arthroscope to directly visualize articular reduction — confirming surface congruence that fluoroscopy alone cannot reliably demonstrate. A 1mm articular step-off that looks acceptable on X-ray is visible under the scope. This matters for long-term outcomes.
Wrist fractures that healed in a poor position — malunion — and prior surgeries that did not achieve the intended result are accepted cases here. Corrective osteotomy for distal radius malunion, revision wrist arthroplasty, and re-exploration after failed ligament repair are all within scope. These are not the cases to send to a surgeon who sees them rarely.
Not every wrist arthritis patient needs the same operation. PRC is right for some, capitolunate fusion for others, wrist arthroplasty for many, and total fusion for a specific subset. Dr. Graham performs all four and selects among them based on where the arthritis is and what the patient needs from their wrist — not a default procedure applied uniformly.
Scapholunate ligament tears have a narrow repair window. Caught early enough, direct repair with suture anchors is possible. Missed too long, ECRB reconstruction is the next option. In advanced SLAC arthritis, salvage is the only path. Dr. Graham stages these injuries accurately — including arthroscopic gold-standard assessment — and matches the treatment to the stage, not to what's easiest.
The EPB subcompartment — the most common reason De Quervain's release fails or symptoms persist — is always released alongside the first dorsal compartment. Dr. Graham does not consider the procedure complete without addressing both. Patients with persistent pain after a previous De Quervain's release are seen and re-evaluated, and revision release is performed when the subcompartment was missed.
Wrist fracture fixation with the smallest exposure that achieves stable anatomic reduction. No unnecessary soft tissue stripping, no larger incision than the hardware requires. In Dr. Graham's experience, patients notice the difference in recovery — less swelling, faster return of motion, and scars that often disappear.
"Pauline Hartje — a complex 4-part wrist fracture. Dr. Graham called the next morning to check in, and the scar was essentially invisible."
Pauline Hartje · Wrist Fracture Patient · Verified Google Review ★ 5/5
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