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Talk Through the Hand: Upper-Extremity Injury and Surgical Considerations in Sign Language Users.

Sarah A Uriarte¹, Jason Nguyen¹, Ali Mansour¹

¹Department of Surgery, Division of Plastic and Reconstructive Surgery, The Warren Alpert School of Medicine at Brown University, Providence, RI.

The Journal of Hand Surgery

|April 2, 2026

Summary

This summary is machine-generated.

Sign language users, particularly the deaf and hard-of-hearing, risk communication impairment from upper-extremity issues. Hand surgeons must consider this when choosing treatments to preserve daily communication abilities.

Keywords:

Biomechanics overuse injury sign language upper-extremity injury

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Area of Science:

Medicine
Orthopedics
Audiology

Background:

Sign language is a primary nonverbal communication method in the US, used by 7 million people.
One million national sign language users are deaf or hard-of-hearing and rely heavily on upper extremities.
Extensive long-term use of sign language can lead to upper-extremity impairments.

Purpose of the Study:

To highlight the vulnerability of sign language users to upper-extremity impairment.
To emphasize the importance of preserving upper-extremity mobility for communication.
To guide hand surgeons in selecting treatments that minimize communication disruption for sign language users.

Main Methods:

This article reviews clinical considerations for hand surgeons.
It synthesizes existing knowledge on sign language use and upper-extremity health.
No new clinical data was generated; this is a review and guidance piece.

Main Results:

Sign language users face unique challenges regarding upper-extremity health.
Impaired hand and arm function directly impacts communication ability.
Careful surgical planning is crucial to maintain functional communication.

Conclusions:

Hand surgeons must prioritize communication maintenance in deaf and hard-of-hearing patients undergoing treatment.
Understanding the biomechanics of sign language is essential for appropriate clinical decision-making.
This article provides a framework for managing upper-extremity conditions in sign language communicators.