J. Grant Thomson, MD: Plastic surgeon’s interest in the hand is more than skin deep

A founding father of hand surgery, Sterling Bunnell, once said: “Without sensation, the hand is blind.” J. Grant Thomson, MD, couldn’t agree more.

Thomson, recruited to Yale in 1993, has devoted his career to hand surgery and microsurgery, concentrating on the repair of the hand and other extremities damaged by trauma. He mends tiny bones and blood vessels and reconnects nerves using microscopic techniques he acquired as a fellow in St. Louis. To make a broken hand whole again is a complex undertaking that encompasses several disciplines and is focused on restoring function.

“Not only does the skeleton have to be stable but there are soft tissue parts that have to glide against other structures, and nerves that need to be functioning so that the hand can feel its way through the world,” says Thomson.

One of four plastic surgeons and three hand specialists at YMG (the two others, Carrie Swigart, MD, and Joseph Slade, MD, are colleagues in orthopaedics), Thomson is in the operating room for 15 to 20 cases a week and sees about 100 patients weekly in his practice on the fourth floor of the Yale Physicians Building. Seventy percent of his work involves the hand and upper extremities. The rest is treatment of lower extremity trauma, breast reduction, the occasional cosmetic case and a growing number of post-bariatric procedures to remove excess abdominal skin in patients who have lost 100 pounds or more after surgery. “It interferes with their mobility, their ability to exercise, and causes skin rashes and infections, so I look at that as a functional problem as well.”

Thomson, who is broadly trained as a plastic surgeon, contrasts his work with extremities and that other very popular aspect of plastic surgery: “Cosmetic surgery can be rewarding because you’re improving someone’s appearance, you see the results immediately and the patients are very grateful for it,” he says. “But for me there is more involved in making something functional. There are so many fine structures that you have to think about in order to get them working right, that it is really challenging.”

- Originally published in the July/August 2006 issue of Yale Practice.