hi-q keto An estimated 16 million people in the U.S. seek out care for fist-related injuries each year. These hand surgeons are required to obtain an additional year of specialized training beyond their board certifications for orthopedic surgery, plastic surgery, and general surgery. The need for this exclusive medical training dates back to World War II, when many soldiers sustained hand-related injuries and required military surgeons to obtain additional training. Up until this point, injuries and wounds rarely healed properly due to a lack of appropriate care.