Adult Hand and Upper Extremity Care

Exceptional Care for Adults

If you have an injury or problem affecting your hand, wrist, forearm, or elbow, let our expert physicians help you. Our fellowship-trained, board-certified orthopedic surgeons are known throughout Georgia and the Southeast for providing the highest level of hand and upper extremity care to patients of all ages. We provide the entire spectrum of care, including surgical and nonsurgical care. As a patient, you will receive the best care by being evaluated by a hand surgeon who is specially trained to develop the best treatment plan for you.

At each visit, our patients are seen by a physician—not a nurse practitioner or physician’s assistant. Therefore every decision about your care is made directly by your physician. And if you require surgery, that same physician will be the one performing your surgery and guiding your care from start to finish.


Arthritis pain can affect your hands, wrists, and elbows. Thumb basal joint (CMC joint) arthritis is the most common site of arthritis in the hand, but other finger joints and the wrist joint can also be affected. Our physicians specialize in treating osteoarthritis, arthritis due to injury, and rheumatoid arthritis. Treatment can include therapy, injections, and surgeries to reconstruct, replace, or fuse joints.

Tendon Problems

Inflammation of, or injury to, tendons can cause pain and limited function in the hand and upper extremity. Common causes of elbow pain include tennis elbow (lateral epicondylitis), golfer’s elbow (medial epicondylitis), and distal biceps tendon injuries. Tendonitis in the wrist and hand can cause trigger fingers or De Quervain’s tenosynovitis. Our physicians can help you recover from tendon problems, whether it requires surgery or not.

Sports Medicine/Traumatic Injuries

Our physicians treat athletes of all ages with hand, wrist, and elbow problems. Our sports medicine expertise is reflected in Dr. Lourie serving as a team physician for Georgia Tech Athletics and the Atlanta Braves. We understand the unique demands that athletes place on their hands, wrists, and elbows. From ulnar collateral ligament injuries in the elbow (Tommy John), to triangular fibrocartilage complex (TFCC) tears in the wrist, to ligament sprains in the hands, we provide comprehensive sports medicine care. When possible, we employ minimally invasive treatments to help athletes return to competition as quickly as possible.

Accidents or recreational activities can also cause traumatic injuries to the hand and upper extremity. Fractures (broken bones) and ligament, tendon, or nerve injuries are quite common. Our fellowship-trained hand surgeons are equipped to handle all of these injuries and help maximize your recovery.


Lumps and bumps frequently occur in the hands and wrists. Many are benign, fluid-filled masses like mucous cysts, retinacular cysts, and ganglion cysts. Others are benign, solid masses such as lipomas, fibromas, and giant cell tumors of tendon sheath or bone tumors like enchondromas. Our physicians can guide your treatment from possible needle aspiration and biopsy to removal and reconstruction.

Dupuytren’s disease can cause contractures in the hands and fingers. Dr. Costas was one of the hand surgeons involved in the original research trials for Xiaflex, an injectable medication for treating Dupuytren’s disease. All of our surgeons can provide a Dupuytren’s disease treatment program tailored to you from Xiaflex to surgery.

Peripheral Nerve Problems

Carpal tunnel syndrome and cubital tunnel syndrome are due to nerve compression and are the most common nerve-related issues we treat. Our physicians specialize in treating all conditions affecting nerves in the hand and upper extremity. Nerve injuries can sometimes only require close observation and therapy, but others can require decompression surgery or microsurgical repair/reconstruction.

Brachial Plexus and Spinal Cord Injuries

In addition to common peripheral nerve problems, we provide expertise and treat the most complex brachial plexus injuries as well as reconstructive surgery for spinal cord injury patients. When surgery is required, we perform nerve repair, nerve grafting, nerve transfers, or tendon transfers.

Dr. Peljovich and Dr. Gillespie are the hand and upper extremity surgery consultants to Shepherd Center, one of the largest rehabilitation hospitals in the U.S. They provide specialty surgical and nonsurgical care to Shepherd Center patients who have sustained traumatic injuries to their hands, wrists, and arms. This includes fractures, tendon lacerations, and nerve injuries. They also work closely with the physical and occupational therapists to diagnose and treat conditions related to the initial traumatic injury or late effects of these injuries, including heterotopic ossification of the elbow/forearm, and hand/wrist/elbow contractures and spasticity.

Dr. Peljovich and Dr. Gillespie also provide highly specialized care for patients with upper extremity weakness due to spinal cord injuries (tetraplegia). These reconstructive surgeries typically involve tendon transfers to restore elbow extension, thumb pinch, and possibly hand grasp. Nerve transfer surgery is now also being used for selected patients with spinal cord injury to help improve crucial hand and upper extremity function.