Hand Surgery
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.
- 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 Monday–Friday for urgent hand injuries that don't require an emergency department.
Hand Surgery in Jacksonville Beach
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 many of the most common hand procedures never need a hospital at all. Trigger finger release, hand and finger ganglion cyst excision, Dupuytren's percutaneous fasciotomy, mucous cyst excision, and hand mass excision are done in the office or minor procedure room, with the patient awake and often watching. Carpal tunnel release, De Quervain's release, and tendon repairs are done in the operating room, using the same wide-awake anesthesia. Faster in, faster out, faster back to what you do.
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)
Conditions Treated
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.
Why This Practice
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.
Most Procedures in the Office
The WALANT program means trigger finger release, hand and finger ganglion cyst excision, Dupuytren's percutaneous fasciotomy, mucous cyst excision, and hand mass excision 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. Carpal tunnel release and De Quervain's release are done in the operating room, also under wide-awake local anesthesia.
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.
Dupuytren's: Fasciotomy First
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 offered, but not recommended first — cost matters and outcomes don't justify the difference.
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.
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 Monday–Friday for injuries that don't require an ED.
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.
Patient Experiences
In Their Own Words
“Dr. Graham performed a bilateral carpal tunnel surgery on my hands and I immediately had relief. Great bedside manner and I could not be more pleased. I highly recommend.”
“I have arthritis in my thumbs and Dr. Graham did surgery on my right hand. Surgery was a couple of months ago and I am pain free now! I have to workon building the strength back up, but the constant aching is gone!”
“Dr. Graham did an excellent job removing a plate in my wrist and doing a Carpal tunnel release. His bedside humor and surgical skills are just what I needed!!”
“The surgery was a very successful and, on the evening after the procedure, Dr. Graham took the time to call me to see how I was doing. In all our meetings Dr. Graham answered my questions and was very polite. I would highly recommend Dr. Graham!”
Common Questions