Stony Brook’s First Hand Surgeon Performs His Last Operation

In 1980, Larry Hurst performed the very first hand surgery done on the premises of Stony Brook University Hospital, a case of trigger finger release on a university staff member when he was an acting intern. That was just a year after he joined the faculty and shortly after the hospital — then known as Stony Brook University Medical Center — opened its doors.

Since then, Hurst has built a department that last year saw more than 72,000 patients and accomplished more than 6,000 surgeries; he performed his last hand surgery, trigger finger release and carpal tunnel release, on October 15, 2020. Hurst stepped down on June 30, ending 41 years of clinical work and relinquishing his 27-year Department of Orthopaedics chair position.

“My first job was sorting out equipment,” he recalled. “The hospital opened in 1980. Now we have seven full-time hand surgeons.” Back then it was “11 hours a day, full-blast,” when he was one of only three hand surgeons.

It’s been a career of firsts for Hurst: assisting in the first microsurgery performed at University of North Carolina at Chapel Hill in 1977 and the first vascularized fibular bone graft at Columbia University at 1979.

Arguably his biggest legacy was co-developing the injectable collagenase clostridium histolyticum (CCH) for the treatment of joint contractures caused by Dupuytren disease. This work was done with his colleague, Marie Badalamente, professor of orthopaedics, in the early 1980s.

Dupuytren disease, which results in bent fingers, can be traced back to the 12^th century. “People died with their hands in a contracted, locked position because there was no treatment available,” Hurst noted.

Hurst traveled to Japan, Australia and much of Europe lecturing and setting up clinical trials, and the treatment was finally approved by the Food and Drug Administration in 2010. Hurst received the Albion D. Bernstein, MD Award from the Medical Society of the State of New York, given to the physician or scientist who has made the most widely beneficial discovery or developed the most useful method in medicine, surgery, or disease prevention during a calendar year.

The surgery involving the most traumatic set of circumstances happened in the early 2000s when he was called upon, along with four hand surgeons doing two to three shifts for nearly 14 hours, to reattach a patient’s hands that had been severed. The operation’s successful outcome resulted in a New Yorker article. “That’s the nature of working with an emergency component,” Hurst said. “You see it as a sort of a puzzle to put back together.”

Hurst grew up in Lennox, Massachusetts, the son of a cabinet maker, and graduated from the University of Vermont College of Medicine. He interned in Utah, did his residency at UNC at Chapel Hill and fellowship training at Columbia University. As a young man he had worked as a lifeguard and with ski patrols, to prepare him for “dealing with people who experienced injuries and other problems.”

Accomplishments of which he is most proud include: building a world-class orthopaedic department; starting a hand surgery fellowship in 1987; guiding the Department of Orthopaedics as its chairman from eight to 27 faculty by 2020; being cited for twice (2019 and 2020) by US News and World Report for being in the top 50 orthopaedic departments in the United States and keeping the department fiscally in the black.

Hurst also started a non-profit Hand Surgery Resource at the Stony Brook incubator in 2015, oversaw development of a website that is available to the public at no cost and accessed by hand surgery providers and students in more than 100 countries, established a newsletter with a circulation of 20,000 and a YouTube channel viewed by more than 85,000 people.

Hurst is not ready to end his storied career with Stony Brook just yet; he will remain on campus to teach and do research and continue assisting with administrative duties. “I’m not one of those people who can stop cold turkey. I’m looking to build in a step-by-step plan of not being bored. I’ll see my grandson more, play more golf and be home more with my wife,” Hurst said.

“Years ago when I would return to New England by ferry I felt as if was heading home. Today, I feel the same way when I take the ferry back to Port Jefferson,” he added.

More than anything, it is the pleasure Hurst gets from eliminating or lessening both physical and mental pain through his treatment for patients with hand problems.

“Among the most rewarding aspect is correcting a deformity of a child ridiculed by his peers, helping someone to return to work as a carpenter or simply alleviating carpal tunnel syndrome that is making enjoyment of life more difficult for a patient,” he said. “Like the golfer trying to enjoy the game but who can’t because of the arthritic pain we can correct.”

— Glenn Jochum