Our History

Hand Surgery as a specialty

Hand surgery has long been a part of medical practice, but it was not until World War II that it began to be a specialty. During the war, the U.S. Army established nine hand centers to treat injured soldiers. Dr. Sterling Bunnell, “the Father of Hand Surgery,” toured each center and trained surgeons, including Dr. Raymond M. Curtis, in specialized hand surgery.

The late 1960s witnessed two significant developments that introduced new techniques for hand surgery: microsurgery, which led to the first successful reattachment of a severed finger to a hand, and arthroplasty, which resulted in prosthetic finger replacements.

In 1971, the Hand Center at Union Memorial Hospital acquired its first surgical microscope and became a pioneer in applying vascular surgery and nerve regeneration to surgical procedures of the arms, hands, and fingers.

In 1976, John Engalitcheff developed a work simulator for the hand and upper extremity, pioneering hand therapy and vocational rehabilitation techniques for workers with upper extremity injuries.

Hand Center Concept and Early Years

Following medical school, Dr. Curtis performed his surgical training at MedStar Union Memorial Hospital in Baltimore, Maryland. After World War II, he returned to Union Memorial to practice hand surgery and ultimately pioneer the concept of the Hand Center. Dr. Curtis’s surgical skills, his patient management, and his teaching abilities stimulated the interest of many young surgeons, including Dr. E.F. Shaw Wilgis, Dr. Frederik Hansen, and Dr. Gaylord Clark.

For many years, the four surgeons — Curtis, Wilgis, Hansen, and Clark — practiced hand surgery in Baltimore in separate locations, often cooperating with or covering for one another. Their goal was to return patients to a near-as-normal lifestyle as possible after management of their hand injuries or disease.

To that end, they asked Janice Maynard, an occupational therapist who was skilled with patients who had hand problems related to injury and arthritis, to come to Union Memorial to start a therapy unit modeled after the Hand House at Chapel Hill, North Carolina.

Janice’s philosophy was to develop equipment and activities to allow upper-limb handicapped individuals to return to their day-to-day work and life activities. Thus, the beginnings of the Hand Center at Union Memorial Hospital were based on restorative hand therapy started by Janice Maynard.

In the early 1970s, Dr. R. Adams Cowley, a professor at the University of Maryland School of Medicine and a military surgeon in the Korean War, implemented the concept of a trauma center at the University of Maryland Hospital. Soon thereafter, the Maryland Institute of Emergency Medical Systems (MIEMS) was created. Dr. Cowley enlisted Dr. Curtis to organize and run the Upper Extremity Trauma Unit of MIEMS, and Union Memorial Hospital was designated as a hand trauma center, the only such center in the United States to be so recognized under a state emergency system.

In 1975, the Raymond M. Curtis Hand Center formally opened. Under Dr. Curtis’ guidance, surgeons, occupational and physical therapists provided a multi-disciplinary approach to the treatment of hand and upper extremity disorders. Dr. Curtis served as Chief of Hand Surgery until 1983, when he stepped down and was replaced by Dr. E.F. Shaw Wilgis.

Hand Fellowship

In 1960, Dr. Curtis was asked by the U.S. Army Surgeon General to take on the training of an Army surgeon from Walter Reed Army Hospital. After Union Memorial was designated a hand trauma center, the hospital began to receive referrals from the entire state of Maryland and adjacent areas of Virginia, West Virginia, Pennsylvania, and Delaware. This concentration of patients with upper extremity injuries provided a unique teaching opportunity, and in 1977, a one-year fellowship in hand surgery was established. The founders of the Hand Center believed it was essential to pass on experience and knowledge to the next generation of hand surgeons and that their combined knowledge was unequaled in scope anywhere else in the country.

Research History

Research is a critical component of the Curtis National Hand Center. From the onset, it was the desire of the founders to educate and inform other surgeons interested in the field of hand surgery. Every hand fellow was required to conduct a research project that would be presented at the end of their year of study to a visiting professor of national stature.

Over the ensuing years, the Hand Center added research facilities, a microsurgical laboratory, and collaborated on various inventions used in the delivery of care and therapy to the upper extremities.

Through pioneering efforts, the Hand Center has been the site of many breakthroughs in the treatment of the hand and arm and has gained recognition as one of the most important innovators of new surgical techniques and technologies:

• Developed a prototype Baltimore Therapeutic Equipment (BTE) device
• Performed pioneering work in microsurgery, especially complex vascular and nerve surgery
• Performed nerve regeneration to improve post-operative feeling and function in the upper extremities
• Developed artificial joints for the treatment of arthritis and the care of congenital differences
• Developed a method of fixation of battlefield elbow injuries
• Improved the long-term effectiveness of carpal tunnel syndrome treatments
• The Research Unit occupies 1,500 square feet on the sixth floor of MedStar Union Memorial’s Baurenschmidt Building. The AAALAC-accredited Microsurgical Lab Operating Room is equipped with two double-headed operating microscopes for teaching and a third research operating microscope.

Support facilities include:

• Facilities for biomechanical research studies on the forearm, wrist, and hand
• Clinical research and clinical trials in cooperation with pharmaceutical companies and equipment manufacturers
• Surgical Technique and Technology lab (STAT lab) for surgeons to enhance their skills using the latest tools and materials
• In 1994, Congress designated appropriations for the purposes of creating a National Hand Center for the treatment of the hand and upper extremity at the Curtis Hand Center in Union Memorial Hospital, recognizing the Hand Center’s singular experience and expertise.

Our Military Hospital Connection

We have a long and distinguished connection to the U.S. military.

In 1947, Dr. Raymond M. Curtis returned to his native Baltimore from World War II and pioneered the concept of the Hand Center at Union Memorial Hospital. General Eisenhower and Surgeon General Norman Kirk charged a selected group of surgeons from our armed forces, including Dr. Curtis, with developing a specialty that brought orthopedic, plastic, vascular, general, and neurosurgeons together to address the functional complexity unique to the hand.

In 1960, Dr. Curtis was once again called upon by the U.S. Army Surgeon General, this time to take on the training of an Army surgeon from Walter Reed Army Hospital. As advances in surgical science blossomed, the hand surgery unit at Union Memorial Hospital grew to attract luminaries like Drs. Gaylord Clark, Frederik Hansen and E.F. Shaw Wilgis.

In 1975, Dr. R. Adams Cowley enlisted Dr. Curtis to organize and run the Upper Extremity Trauma Unit for the Maryland Institute for Emergency Medical Services Systems. Union Memorial then began receiving referrals from the entire state of Maryland and adjacent areas of Virginia, West Virginia, Pennsylvania, and Delaware. This concentration of patients with upper extremity injuries provided a unique teaching opportunity and led to the establishment of a one-year fellowship training program in hand surgery. Since the formal inception of the hand fellowship program in 1977,the Curtis National Hand Center has honored its humble beginnings by seeking applicants from Walter Reed Army Hospital. The Hand Center accepts two military-trained surgeons into the fellowship program each year.

The Hand Center Today

As Chief of Hand Surgery from 1983 to 2000, Dr. E.F. Shaw Wilgis oversaw the construction of a new state-of-the-art Hand Center at Union Memorial Hospital in 1998. The 23,000 square-foot facility occupies two floors of the Johnston Professional Building at Union Memorial Hospital. The Center houses facilities for diagnosis, treatment, hand therapy, vocational evaluation and work hardening, and research.

Today, the Curtis National Hand Center (CNHC) is the regional leader in the repair and rehabilitation of injuries and other disabling conditions of the hand and upper extremity. In addition, CNHC has the largest concentration of hand surgeons and fellows in the country. After Dr. Wilgis stepped down as Chief of Hand Surgery in 2000, he was replaced by Dr. Thomas J. Graham, who served the position for ten years. In 2010, a new chapter began with Dr. James P. Higgins at the helm.