Trusted by over 1.2 Million Global Healthcare Seekers

Providing Multidisciplinary, Comprehensive Care- The Center for Hand and Upper Extremity Surgery


Hand and upper extremity injuries can significantly impact a person’s life. These injuries are often the result of traumatic accidents.

The Center for Hand & Upper Extremity Surgery (HUES) at The Institute for Advanced Reconstruction offers comprehensive, highly specialized treatments for hand and upper extremity injuries. A member of ARSA, this practice is distinguished by its multidisciplinary approach to upper extremity care. The center is passionate about providing hope and healing with specific, individually tailored procedures that can restore functionality, movement, and independence.

The HUES team of providers is composed of surgeons with sub-specialty expertise in hand and upper extremity surgery and microsurgery, as well as a physical medicine and rehabilitation physician specializing in pain management. This enables the team to employ a variety of different treatment methods and consult with one another about complex cases.

The knowledgeable team provides advanced treatments for injuries and disorders affecting the upper extremity, consisting of the shoulder, elbow, wrist, and hand. When left untreated, problems affecting the upper extremity may lead to impairments in function and chronic pain, significantly impacting a patient’s quality of life.

Led by Dr. Ajul Shah, this team of physicians is skilled in various areas of treatment such as tendon injuries, arthritis, hand reconstruction, nerve injuries, and amputation. Dr. Shah is board certified in plastic and reconstructive surgery by the American Board of Plastic Surgery with a subspecialty board Certification in Hand and Upper Extremity Surgery. He has advanced fellowship training in hand and upper extremity surgery and microsurgery, as well as extensive training at prestigious institutions, including Yale University and New York University.

Changing Lives of Patients with Limb Loss Using a Thorough, Team-Based Approach and Targeted Muscle Reinnervation

“One area we pride ourselves in is our advanced program for limb loss and TMR.” says Dr. Shah. Targeted muscle reinnervation (TMR) is an advanced surgical procedure that involves transferring the nerves that once controlled the lost arm or hand to functionally redundant remaining muscles. Following surgery, the nerves grow back into the new muscles, allowing for improved control of prosthetic devices. This procedure also prevents misdirected nerve growth or “neuroma” formation, which can help prevent or eliminate phantom pain within the residual limb.

“TMR has the potential to enable patients suffering from limb loss to return to their activities of daily living, improve prosthetic use and tolerance, and prevent or treat phantom limb pain,” says Dr. Shah, “It is really rewarding work to see these patients get back their quality of life and use the prosthetic to the best of their ability.”

Targeted muscle reinnervation may be performed at the time of an amputation (immediate TMR) or after an amputation (delayed TMR). TMR allows patients to achieve a new level of function with prosthetic devices and an improved quality of life. While the journey to recovery can be long and demanding, patients are often able to resume many of their pre-injury activities. For those who undergo immediate TMR, the risk of phantom limb pain is significantly decreased. In delayed TMR cases, many patients experience relief of chronic pain.

While the surgical procedure utilized to treat patients suffering from limb loss is important, the complete, team-based approach in facilitating their recovery is vital to improve their emotional and physical being.

Recovery and Therapy The HUES team has developed a program called ARMS (The Center for Amputation Rehabilitation Medicine and Surgery). An amputation is a traumatic, life-changing experience. In the aftermath, many patients struggle to get the care they deserve. The team at ARMS have made it their mission to change that by providing their patients with an all-inclusive care plan and restoring their quality of life.

The team at ARMS incorporates expert prosthetists, physical therapists, hand therapists, and behavioral health professionals to coordinate the post-operative care for patients. The team-based approach they offer is unparalleled and provides countless benefits to patients.

The Future of Upper Extremity Surgery

The team at HUES aims to provide specialized solutions for difficult and complex upper extremity injuries and remain on the forefront of research and innovation so it can be applied to patient care. They are already paving the way for a comprehensive, cutting edge program that takes advantage of the best of both specialties: hand and upper extremity and plastic and orthopedic surgery.

About The Institute for Advanced Reconstruction

The Institute for Advanced Reconstruction (IFAR) is uniquely positioned as the ‘go to’ center for revolutionary nerve procedures, as well as world-class reconstructive treatments. Our surgeons have experience in cutting-edge procedures such as nerve transplantation that may restore a significant degree of function for those who have suffered from a stroke and other forms of paralysis. For additional information on IFAR, please visit

About Advanced Reconstructive Surgery Alliance

ARSA is an alliance of likeminded practitioners with the highest clinical standards and shared resources that offer economies of scale. Our reconstructive and cosmetic surgeons benefit from an adaptive business environment with infrastructure, marketing, and the level of excellence which enables them to concentrate on providing extraordinary clinical services. They are empowered to focus unencumbered on doing their best work for what matters most: the patient. For additional information on ARSA, please visit

Learn about how you can become a Certified Medical Tourism Professional→
Disclaimer: The content provided in Medical Tourism Magazine ( is for informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. We do not endorse or recommend any specific healthcare providers, facilities, treatments, or procedures mentioned in our articles. The views and opinions expressed by authors, contributors, or advertisers within the magazine are their own and do not necessarily reflect the views of our company. While we strive to provide accurate and up-to-date information, We make no representations or warranties of any kind, express or implied, regarding the completeness, accuracy, reliability, suitability, or availability of the information contained in Medical Tourism Magazine ( or the linked websites. Any reliance you place on such information is strictly at your own risk. We strongly advise readers to conduct their own research and consult with healthcare professionals before making any decisions related to medical tourism, healthcare providers, or medical procedures.
Free Webinar: Building Trust, Driving Growth: A Success Story in Medical Travel Through Exceptional Patient Experiences