The RNSH Department of Hand Surgery and Peripheral Nerve Surgery is a tertiary referral centre in NSW for injuries to and diseases of the hand, as well as nerve injuries affecting the upper limb.  The Department provides care for both emergency and elective hand and upper limb conditions, with a 24 hour on-call service staffed at Consultant and Fellow/Registrar level.

The Department consists of six Hand Surgery consultants (of orthopaedic, plastic and general surgical backgrounds, with further training specifcally in hand surgery), three Hand Surgery Fellows, two Orthopaedic Surgery Registrars, one Plastic Surgery Registrar and a Resident Medical Officer, along with a Research Officer and Department Secretary. Hand Therapists, Plaster Physiotherapists and nursing staff work in conjunction with the Department of Hand Surgery to provide a full range of services to patients.

Special areas of expertise within the department include:

- mutilating hand injuries and replantations

- congenital hand anomalies, including transition to adult care

- spasticity and tetraplegic hand and upper limb surgery

- brachial plexus injuries

- free tissue transfer and flap coverage for upper limb injuries

- Dupuytren's contracture management, including collagenase injections

- complex wrist injuries

- rheumatoid hand surgery