Sustainable Surgery: A Hand Surgeon's Guide to Ergonomics

Hand surgeons face unique ergonomic challenges because of prolonged seated positions, precise motor demands, postural strain from magnification equipment, and repetitive micromovements. Ergonomic interventions specific to hand surgery remain grossly understudied. This nonsystematic review addresses the musculoskeletal burden in hand surgery and provides evidence-based ergonomic recommendations. For microsurgery, maintaining neutral head positioning with properly aligned microscopes and incorporating microbreaks reduced strain. In open hand surgery, optimal table height positioning and strategic instrument placement enhanced comfort and precision. Endoscopic approaches benefited from monitor positioning at eye level with 15° to 25° downward tilt, while arthroscopic procedures required joint-specific positioning adaptations. Across all subtypes of hand surgery, workstation configuration, equipment selection, and environmental modifications can considerably improve ergonomic outcomes. Implementation of these ergonomic principles may considerably reduce work-related musculoskeletal disorders while maintaining surgical excellence. Our findings highlight the need for a cultural shift that prioritizes ergonomic health as an essential component of surgical practice and training, ultimately extending career longevity and improving patient outcomes.