London Hand and Wrist Unit: Offering advanced hand and wrist diagnostics and treatment
Lodge Road , London, NW8 7JAWelcome to the London Hand and Wrist Unit
The London Hand and Wrist Unit (LHWU) has brought together renowned surgeons and experienced hand therapists at five of London’s leading HCA UK private facilities: The Wellington Hospital, The Lister Hospital, The Portland Hospital, 120 Old Broad Street (part of London Bridge Hospital) and Chelsea Outpatient Centre (part of the Lister Hospital).
Through our treatments, we restore vital mobility, strength and function in the hand and wrist. Each one of our consultant orthopaedic and plastic surgeons are leaders in their field and are experts in the diagnosis and management of all hand and wrist conditions. Our consultants are not only highly skilled in the latest treatments and technologies – they’re the ones pioneering them.
Recognised internationally in providing expertise and an unparalleled high standard of care for all patients, for both adults and children from newborn. We can quickly facilitate onward referral to a number of specialists including rheumatologists, neurologists, specialists in peripheral nerve injury and specialist radiologists.
Specialising in every aspect of hand and wrist care
Every part of the hand and wrist is a branch of medicine in itself. To achieve the depth of understanding and experience they need, consultants need to sub-specialise. Sub-specialising means our consultants perform their specialist procedures in greater volume than they would if they were a general orthopaedic surgeon. The more they perform these procedures, the better the outcome for patients.
We sub-specialise in everything from trauma including fractures, dislocations, tendon injuries and nerve injuries — to acquired conditions of the hand. Some of our hand surgeons also sub-specialise in the treatment of congenital hand conditions, cerebral palsy and brain and spinal injury. Our hand therapists also sub-specialise, managing a range of conditions from arthritis to non-specific arm pain and wrist conditions.




World renowned hand and wrist consultants
Types of hand and wrist care
Our world-class team will help return you to a pain-free life. Whether you've fractured your wrist, injured it playing sport, or suffer from painful arthritis in your hands.
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Hand and wrist arthritis
Need to know
Arthritis is condition that causes pain and inflammation in the joint. It's very common and can affect people of all ages. The most common types are osteoarthritis (caused by wear and tear) and rheumatoid arthritis (when the immune system attacks the joints). If you’re experiencing...
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Surgery for hand arthritis
Need to know
With your fingers and thumbs are in constant use surgery can eases pain and restore mobility in an arthritic hand joint. Wear and tear can mean an increased risk of osteoarthritis in your knuckles, thumb joint and the joints at the end of your fingers. The cartilage cushioning your finger joints can...
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Carpal tunnel syndrome
Need to know
Carpal tunnel syndrome is a condition where there is increased pressure on the nerve that crosses the front of your wrist. This is called the median nerve. The nerve runs through a tight tunnel, together with the tendons that bend your fingers.
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Carpal tunnel release
Need to know
Carpal tunnel syndrome is a condition where there's pressure on the nerve that controls sensation and movement in your wrist and hand. This nerve runs through the carpal tunnel in your hand. Carpel tunnel surgery to release the pressure on the nerve is recommended when other treatments have failed to...
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Dupuytrens disease
Need to know
Dupuytren’s disease is a common, painless and benign condition affecting the hands and fingers. The disease causes a progressive deformity resulting in one or more fingers bending into the palm of the hand. It occurs when there is a build-up of thick fibrous tissue in the palm that radiates into...
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Treatments for Dupuytrens contracture
Need to know
Dupuytren's contracture is a condition affecting the hand. It can be treated with injected medicine and sometimes surgery. The first symptoms are small, fluid-filled lumps under the skin in the palm of the hand. These contain collagen, a type of protein. As the protein builds, a rope-like cord develops...
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Trigger finger and thumb
Need to know
If one or more of the tendons in your hands become swollen or inflamed, you may find it difficult to bend your fingers or thumb, or they may lock. This condition is called trigger finger (or thumb).
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Trigger finger release
Need to know
Trigger finger, which is also known as stenosing tenosynovitis, is a painful condition where your finger or thumb jams or locks. If steroid injections fail to treat the condition, a small operation can be done to stop your tendons from catching in the tunnels in your hand.
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De Quervains syndrome
Need to know
Two tendons (flexible chords) run between your wrist and thumb. If the sheath that encases these tendons becomes inflamed, you may find it difficult or painful to move your thumb. This is called De Quervain's syndrome. It's more common in women, particularly after pregnancy. Repetitive movements, when...
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Ganglion
Need to know
The clinical presentation of a ganglion is a visible bump. The exact cause of a ganglion is unknown but ultimately, a ganglion is a fluid-filled sac that arises from a tendon or joint that may be irritated.
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Ganglion removal
Need to know
A ganglion cyst is a bump that usually appears on the fingers or wrist. Its exact causes are unknown, although it is thought to be a leakage of synovial fluid from the joint or tendon. While benign, a ganglion can be unsightly, may cause pain and can even restrict movement. We can offer two main options...
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Ulnar nerve transposition
Need to know
Your ulnar nerve runs along a groove in the inside of the elbow, just behind a bony structure called the medial epicondyle. It's covered by tissue which forms a structure called the cubital tunnel. If the ulnar nerve becomes compressed, it can cause tingling and numbness in your hand and fingers. Compression...
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Small joint replacement surgery
Need to know
Small joint replacement surgery is usually carried out on the hand. It can provide pain relief when arthritis affects your knuckles or the base of your thumbs, and restore movement and function. Artificial joints tend to be made from rubber, metal or plastic and pyrocarbon (an extra-strong material)....
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Muscle strains and sprains
Need to know
Muscle strains and sprains can be a common consequence of playing sport or over exertion during activities. These may occur from physical contact or not warming your muscles up properly before playing. You will likely experience pain, swelling and tightness in the pain area. Your consultant can help...
Specialist multidisciplinary service - our expert therapy team
A hand therapist is an occupational therapist or physiotherapist who specialises in the treatment of patients with conditions affecting the hands and upper limb. A hand therapist’s high level of specialisation requires advanced post-graduate education and clinical experience.
Consultants in our unit work within a specialist multidisciplinary team of expert hand therapists, who provide a seamless pathway for our patients. For example, a patient can be seen in one of our units, have a consultation, undergo on-site diagnostic tests, therapy and be given any required custom-made splints or casts – often all in one visit. In most cases, the hand therapist will make the orthotics on-site following your consultation.




Some of our most common therapies
Thermoplastic splinting
Neoprene splints
Oedema management
Exercise therapy and mobilisation techniques
Activities of daily living
Work and leisure rehabilitation
Wound and Scar management
Meet our therapists

Juliette Bray, Clinical Specialist
Juliette is one of our Clinical Specialists in hand therapy. Having gained her BSc (Hons) in Physiotherapy from King’s College London, she has worked in the NHS as well as privately, and in France, gaining experience in managing a range of different hand and upper limb related conditions and injuries.
Juliette developed her interest and enthusiasm for hand therapy early on in her career and has been a specialist in this field for over 10 years. She has extensive experience in the management of hand trauma in both adults and paediatrics, elective surgery and acquired conditions such as work-related upper limb disorders, arthritis and neurological conditions. Juliette has a special interest in sporting injuries and has experience of working with athletes, rehabilitating from the acute phase all the way through to returning to sport.
Juliette regularly organises and lectures on Post Graduate training courses, and is currently working towards her British Association of Hand Therapists accreditation. She has also had the opportunity to volunteer her hand therapy expertise in Sierra Leone.

Roberta Brincat, Clinical Specialist
Bertie trained as an Occupational Therapist in 1993 and then continued training as a Hand Therapist at the University of Derby where she achieved a Masters Degree in 2002. She became accredited by the British Association of Hand Therapists in 2005, and has maintained accreditation since. Bertie has special interest in wrist conditions particularly wrist instabilities and post op rehabilitation following wrist surgery, however she treats all types of hand and wrist trauma and conditions.
Bertie also works as an Advanced Practitioner in Hand and Wrist with the MATT team which is part of Sussex Community NHS Foundation Trust. Other professional interests include service development in hand therapy and hand management services in primary care and the private sector, improving outcome for patients with hand and wrist conditions and disorders and training of junior hand therapists. She also provides continuous professional development of clinicians in primary care.
Outstanding facilities, teams and equipment
From the latest imaging equipment to advanced therapy techniques, we have everything we need to care for our patients. In our unit at The Wellington Hospital, we use the latest diagnostic equipment that includes MRI and X-ray to help us deliver the most accurate diagnosis. We offer same-day appointments and same-day reporting, six days a week.




How to contact The Hand Unit
We offer hand and wrist surgery and hand therapy across our network if you have any questions please don't hesitate to get in touch. We can book appointments at any of our locations.