The field of hand surgery deals with both surgical and non-surgical treatment of conditions and problems that may take place in the hand or upper extremity (commonly from the tip of the hand to the shoulder) including injury and infection. Hand surgery may be practiced by graduates of general surgery, orthopedic surgery and plastic surgery. Plastic surgeons and orthopedic surgeons receive significant training in hand surgery during their residency training, with some graduates going on to do an additional one-year hand fellowship. Board certified general, plastic, or orthopedic surgeons who have completed approved fellowship training in hand surgery and have met a number of other practice requirements are qualified to take the "Certificate of Added Qualifications in Surgery of the Hand" examination, formerly known as the CAQSH, it is now known as the SOTH.
Regardless of their original field of training, once candidates have completed an approved fellowship in hand surgery, all hand surgeons have received training in treating all injuries both to the bones and soft tissues of the hand and upper extremity. Among those without additional hand training, Plastic surgeons have usually received training to handle traumatic hand and digit amputations that require a "replant" operation. Orthopedic surgeons are trained to reconstruct all aspects to salvage the appendage: tendons, muscle, bone. Orthopedic surgeons are trained to handle complex fractures of the hand and injuries to the carpal bones that alter the mechanics of the wrist.