Dr. Dennis Sagini is a hand and upper extremity surgeon who recently completed his training and joined a private practice. After receiving his Doctor of Medicine in 2002 from Temple University in Philadelphia, Pa., Dr. Sagini went on to Howard University in Washington, D.C., for his residency in orthopaedic surgery. He completed a fellowship in hand and upper extremity surgery at the University of Pittsburgh. During his training, Dr. Sagini developed a passion for providing patient care not only in his immediate community, but also in areas of Africa, where he has been an active member of medical mission teams.

What inspired you to specialize in hand and upper extremity surgery?
It started in medical school. I was fascinated by the anatomy of the hand and upper extremity and fell in love with the field of orthopaedics. When I did my orthopaedic residency, I still found the hand most fascinating. We treated patients at all stages of life, from young children, to those in mid-life, to the elderly. Patients often had problems that were correctable. Returning them to optimal function was a challenge I was eager to take on. So, it wasn’t one thing, but rather a preference for this area—for the various types of hand conditions and the broad patient population.

Please describe the medical mission work you’ve done. What drew you to those projects?
This is something I’m quite passionate about. I went on my first mission to Eritrea in October 2006. I was doing my residency, and a hand surgeon I was working with approached me about going. I found it to be exactly as it was reported. Surgeons in the area were overburdened, which left an unbelievable number of patients who still required care. When we showed up on the first day, families were lined up outside the hospital with their X-rays in hand. We had to examine them, determine the most significant deformity and schedule surgery for the next day. We had to be creative and work with what we had. It’s extremely rewarding for the physicians and beneficial for the patients. It gets physicians back to the true reasons for why we wanted to become doctors. I’ve since been on two other missions to Nigeria and would love to start a program in Kenya.

How have your experiences with medical missions changed the way you view your role as a surgeon?
I gathered from these experiences that patients want to get better, but they also want to feel comfortable about their treatment. Some patients we saw had conditions that no one had explained to them. They were grateful to be told what the problem was and what to expect, even if we couldn’t fix it. Compassionate communication about realistic expectations is important to get to a place where you’re satisfied and, more importantly, the patient is satisfied.

What has provided your greatest professional satisfaction?
This reflects back to the relationship I like to have with my patients. My goal is to be able to provide optimal care, surgical or nonsurgical, by providing the best functional outcome with high patient satisfaction.

What would you like to see as the next breakthrough in the field of hand surgery?
A lot of hand surgery procedures have good track records. However, there are some we don’t have a lot of answers for yet. One area is tissue transplantation of the digits, hand and upper extremity. Improvements in the adverse event profile of anti-rejection drugs, so the benefits outweigh the risks, would be a major advancement for patients who use prosthetics but still have suboptimal function. Further development of myoelectric prostheses will also provide improved function for many patients.

Where do you see the field of hand surgery in the next 20 or 30 years?
First, I think there will be significant improvements in nonoperative treatment options for many common hand conditions. Second, there will be advances in the variety of procedures that can be done using minimally invasive options. Further advances in arthroscopic procedures and diagnostics will allow us to reduce pain and the duration of rehabilitation after surgery. And third, there will be improvements in treatments for injuries that lead to loss of multiple digits or amputation of wrist and proximal areas, whether the treatment involves prosthetics, replants or replacement.

Dr. Sagini has joined the physicians at Joint Implant Surgeons of Florida in Fort Myers, Fla. He is a member of the American Medical Association, the American Academy of Orthopaedic Surgeons and the Florida Medical Association.