Dr. Tosti is a fellowship trained, board certified Orthopaedic Surgeon who specializes in all conditions of the hand, wrist and elbow. He serves as Associate Professor of Orthopaedic Surgery at Thomas Jefferson University and is a consulting physician for the World Boxing Organization as well as the Ultimate Fighting Championships.
Dr. Tosti was born and raised in Bucks County, PA. After traveling the world to develop a broad perspective for surgery of the upper limb, he is happy to be settled back in Pennsylvania to serve the towns that raised him.
Dr. Tosti received his medical degree from Temple University School of Medicine and trained as Chief Resident in orthopaedic surgery and sports medicine at Temple University Hospital and Shriners Hospital for Children. Dr. Tosti completed the prestigious Hand, Wrist, Elbow, and Microvascular Surgery Fellowship at Harvard Medical School’s Massachusetts General Hospital and Boston Children’s Hospital during a year when U.S. News and World Report ranked both hospitals #1 in the nation. Under the tutelage of the world renowned Dr. Jesse Jupiter, Dr. Tosti’s fellowship was a combined program that integrated him in both the orthopaedic surgery and plastic surgery departments.
Dr. Tosti specializes in trauma and post-traumatic reconstruction of the upper extremity, which includes fractures, arthroscopy, and tendon, nerve, or ligament lacerations. He performs microsurgery procedures including limb salvage surgery, replantation of fingers, hands, and arms, toe to thumb transfer, and free tissue transfers. He cares for injuries and degenerative diseases of the hand, wrist, elbow, and some shoulder conditions. He also treats children for injuries and some congenital conditions.
Dr. Tosti is passionate about orthopaedic research and driving the field of knowledge forward. He has authored and published over 40 peer reviewed journal articles, over 50 podium presentations, 14 textbook chapters, and 11 poster presentations. He served as senior editor on two textbooks: one on complex reconstruction of the hand after severe infections and the other on adult and pediatric hand fractures. His most recent work focuses on minimally invasive surgery, endoscopic procedures, and “wide awake” hand surgery. In 2013, he won the prestigious “Julian M. Bruner Award” at the Annual Meeting of the American Society for Surgery of the Hand for his work in distal radius fractures. He has also won “Best Presentation” and “Highlighted Poster” at past Annual Meetings for the American Academy of Orthopaedic Surgery.
“I think it takes an athlete to understand an athlete.” Dr. Tosti played sports since he was “able to walk.” Over his life, he competed in baseball, golf, sailboat racing, football, Brazilian Jiu Jitsu, Muay Thai kickboxing, and freestyle and scholastic wrestling. He even lived in Thailand before medical school to compete in martial arts. While in medical school, he coached a middle school wrestling team to win the Lower Bucks Championship. He also taught mixed martial arts on the Upper East Side of New York City. He served as the team physician for Conwell-Egan Catholic High School Football and as an event doctor for various NCAA sports including football, baseball, and basketball. In 2013, he was inducted into Pennsbury High School’s Wrestling Hall of Fame for holding the all-time record for takedowns in a single season, and delivered a speech entitled “The Cultivation of Strength Through Sports and Its Application to Life’s Challenges.”
Dr. Tosti is the recipient of numerous “Top Doc” accolades, including top rankings for both Castle Connolly and Philadelphia Magazine. Furthermore, he has been featured on various news programs including Sirius XM Doctor Radio, Fox 29, and ABC.
Dr. Tosti firmly believes that one’s passion in life gives him or her strength. He understands that injuries and arthritis “challenge” people, and he says his “life’s duty” is to work through these challenges with patients. “Regardless of the goal – a sport, an event, a career, leisure, an art, or a hobby - it is important to me for the patients to know that their goals are now my goals too.”
Professional Profile
Education
- Fellowship, Hand, Wrist, Elbow, and Microvascular Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA
- Residency, Orthopaedic Surgery, Temple University School of Medicine, Temple University Hospital, Philadelphia, PA
- M.D., Temple University School of Medicine, Philadelphia, PA
- B.S., General Science, Pennsylvania State University, University Park, PA
Titles & Certifications
- Board Certified, American Board of Orthopaedic Surgery
- Subspecialty Certificate in Surgery of the Hand
- Associate Professor of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University
- Consultant Physician – Ultimate Fighting Championships
- Consultant Physician – World Boxing Organization
- Consultant Physician – Ursinus College
Professional Associations
- Pennsylvania Orthopaedic Society: Board of Directors
- American Society for Surgery of the Hand: Member
- American Association for Hand Surgery: Member
- Pennsylvania Medical Society: Member, House of Delegates
- Montgomery County Medical Society: Member
- AO Trauma North America: Member
- John Lachman Society: Member
- Orthopaedic Political Action Committee (OrthoPAC): Member
Education
- Fellowship, Hand, Wrist, Elbow, and Microvascular Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA
- Residency, Orthopaedic Surgery, Temple University School of Medicine, Temple University Hospital, Philadelphia, PA
- M.D., Temple University School of Medicine, Philadelphia, PA
- B.S., General Science, Pennsylvania State University, University Park, PA
Titles & Certifications
- Board Certified, American Board of Orthopaedic Surgery
- Subspecialty Certificate in Surgery of the Hand
- Associate Professor of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University
- Consultant Physician – Ultimate Fighting Championships
- Consultant Physician – World Boxing Organization
- Consultant Physician – Ursinus College
Professional Associations
- Pennsylvania Orthopaedic Society: Board of Directors
- American Society for Surgery of the Hand: Member
- American Association for Hand Surgery: Member
- Pennsylvania Medical Society: Member, House of Delegates
- Montgomery County Medical Society: Member
- AO Trauma North America: Member
- John Lachman Society: Member
- Orthopaedic Political Action Committee (OrthoPAC): Member
SCIENTIFIC ARTICLES
• Tosti R. Rekant MS. Wide Awake Local Anesthesia Endoscopic Cubital Tunnel Release. J Hand Surg Am. 2022 Jun 3. PMID: 35667954
• Adams Aj, Miller A, Tan E, Shin EK, Tosti R. Reliability of Assessing Distal Radius Fractures on Smart Phone Versus PACS. Hand (N.Y.) 2022 Jul 6. PMID 35794854
• Tosti R. Arthroscopic Trapeziectomy. Tech Hand Up Extrem Surg. 2022 May 3.Online ahead of print. PMID: 35698313
• Folchert M. Tosti R. Ladd AL. Rizzo M. Jupiter JB. Zelouf D. Managing Challenges in Thumb CMC Arthritis. AAOS Instructional Course Lectures Volume 71. Instr Course Lect. 2022;71:147-162. PMID: 35254780
• Wang W. Osterman AL. Tosti R. Surveying the Use and Perceptions of Wrist Arthroscopy in Hand Surgery. Orthopedics. 2022 Apr 29:1-7. Online ahead of print. PMID: 35485882
• Tosti R, Hozack BA, Mudgal CS. Tension Band Wiring in Upper Extremity Surgery. J Am Acad Orthop Surg. 2020 Sep 23. Dec 15;28(24):1009-1016. PMID: 32991386
• Intravia JM, Osterman MN, Tosti R. Antibiotic Management and Antibiotic Resistance in Hand Infections. Hand Clin. 2020 Aug;36(3):301-305. PMID: 32586455
• Tosti R, Treiser MD, Eberlin KR. Contralateral Heterotopic Thumb-to-Thumb Replantation With Free Ulnar Forearm Fasciocutaneous Flap and Targeted Muscle Reinnervation. J Hand Surg Am. 2020 Jan;45(1):71.e1-71.e5. Epub 2019 May 10.PMID: 31085092
• Hozack BA, Tosti RJ. Fragment-Specific Fixation in Distal Radius Fractures. Curr Rev Musculoskelet Med. 2019 Jun;12(2):190-197. Review. PMID:30835080
• Wang W. Tosti R. A Novel Technique for Correcting Radial Length and Translation in Distal Radius Fractures. Tech Hand Up Extrem Surg. 2018 Sep;22(3):116-119.PMID:29975230
• Tosti R. Eberlin KR. Damage Control Hand Surgery. Evaluation and Emergency Management of the Mangled Hand. Hand Clin. 2018 Feb;34(1):17-26. PMID: 29169593
• Jennings JD, Zielinski E, Tosti R, Ilyas AM. Septic Arthritis of the Wrist: Incidence, Risk Factors, and Predictors of Infection. Orthopedics. 2017 May 1;40(3):e526-e531.PMID: 28399321
• Tosti, R. Ozkan S. Schainfeld R. Eberlin KR. Radial artery pseudoaneurysm. J Hand Surg Am. J Hand Surg Am. 2017 Apr;42(4):295.e1-295.e6. PMID: 28258867
• Tosti R. Shin EK. Wrist Arthroscopy for Athletic Injuries. Hand Clin. 2017 Feb;33(1):107-117. PMID: 27886828
• Tosti R. Rossy WH. Lee SG. Burners, Stingers, and Other Brachial Plexus Injuries in the Contact Athlete. Operative Techniques in Sports Medicine. 2016 Dec 24 (4): 273-277.
• Trionfo A, Thoder JJ, Tosti R. The effects of early antibiotic administration on bacterial cultural growth from hand abscesses. Hand (N Y). 2016 Jun;11(2):216-20. PMID: 27390566
• Tosti R, Trionfo A, Gaughan J, Ilyas, AM. Risk Factors Associated with Clindamycin Resistance in Methicillin Resistant Staphylococcus Aureus in Hand Abscesses. J Hand Surg Am. 2015 Apr;40(4):673-6. PMID: 25707549
• Tosti R, Samuelsen B, Bender S, Gaughan J, Schaffer AA, Ilyas AM. Emerging multi-drug resistance patterns of methicillin resistant staphylococcus aureus in hand infections. JJ Bone Joint Surg Am. 2014 Sep 17;96(18):1535-40. PMID:25232077
• Fowler JR, Munsch BS, Tosti R, Hagberg WC, Imbriglia JE. A comparison of ultrasound and electrodiagnostic testing for the diagnosis of carpal tunnel syndrome using a validated clinical tool as the reference standard. Journal of Bone and Joint Surgery. J Bone Joint Surg Am. 2014 Sep 3;96(17):e148. PMID:25187592
• Tosti R, Ilyas AM, Mellema J, Guitton TG, Ring D. Interobserver variability in the treatment of small finger metacarpal neck fractures. J Hand Surg Am. 2014 Sep;39(9):1722-7. PMID:25034789
• Zlotolow DA, Tosti R, Ashworth S, Kozin SH, Abzug JM. Developing a pollicization outcomes measure. Journal of Hand Surgery (Am). J Hand Surg Am. 2014 Sep;39(9):1784-91. PMID:25091337
• Tosti R, Foroohar A, Pizzutillo PD, Herman MJ. Kirschner wire infections in pediatric orthopaedic surgery. J Pediatr Orthop. 2015 Jan;35(1):69-73. PMID: 24787310
• Tosti R, Iorio J, Fowler JR, Gaughan J, Thoder JJ, Schaffer AA. Povidone-iodine soaks for hand abscesses: A prospective randomized trial. J Hand Surg Am. 2014 May;39(5):962-5. PMID: 24636027
• Tosti R. Thoder JJ. Ilyas AM. Intrinsic contracture of the hand. Journal of the American Academy of Orthopaedic Surgeons. 2013 Oct;21(10):581-591. PMID:24084432
• Tosti R. Rehman S. Surgical management of gunshot related fractures. Orthop Clin North Am. 2013 Oct;44(4):529-540. PMID: 24095069
• Tosti R. Ilyas AM. Prospective evaluation of pronator quadratus repair following volar plate fixation of distal radius fractures. J Hand Surg Am. 2013 Sep;38(9):1678-84. PMID: 23916193
• Tosti R. Jennings J. Sewards JM. Lateral epicondylitis of the elbow. American Journal of Medicine. 2013 Apr;126(4):357 e.1-6. PMID: 23398951
• Tosti R. Ilyas AM. Acute carpal tunnel syndrome. Orthopedic Clinics of North America. 2012 October; 43(4) 459-465. PMID:23026461
• Tosti R. Fowler JR. Dwyer J. Maltenfort M. Thoder JJ. Ilyas AM. Is antibiotic prophylaxis necessary in elective soft tissue hand surgery? Orthopedics. 2012 Jun 1;35(6):e829-33. PMID: 22691653
• Tosti R, Foroohar A, Park MJ, Steinberg DR, Bozentka, DJ. Distal radius fractures: a review and update. Minerva Ortopedica Traumatologica 2011 December;62(6):443-57.
• Tosti R, Kelly JD IV. Pigmented villonodular synovitis presenting as a baker cyst. Am J Orthop. 2011 Oct;40(10):528-531. PMID:22263199.
• Foroohar A, Tosti R, Richmond JM, Gaughan JP, Ilyas AM. Classification and treatment of proximal humerus fractures: inter-observer reliability and agreement across imaging modalities and experience. J Orthop Surg Res. 2011 Jul 29;6:38. PMID:21801370
• Tosti R, Ilyas AM. The role of bone grafting in distal radius fractures. J Hand Surg Am. 2010 Dec;35(12):2082-4. PMID:21134616
• Tosti R, Ilyas AM. Empiric antibiotics for acute infections of the hand. J Hand Surg Am 2010; 35A:125-128. PMID:20117314
• Tosti R, Fowler J, Chao S, Gaughan J, Kelly IV JD. Arthroscopic grafting of hill sachs lesions using osteochondral allograft transplantation. Temple University Journal of Orthopaedic Surgery and Sports Medicine 2009; 4:64-67.
• Knickelbein JE, de Souza AJ, Tosti R, Narayan P, Kane LP. Cutting edge: inhibition of T cell activation by TIM-2. J Immunol. 2006 Oct 15;177(8):4966-70. PMID:17015678
• Narayan P, Holt B, Tosti R, Kane LP. Carma 1 is required for Akt mediated NF-kB activation in T cells. Mol Cell Biol. 2006 Mar;26(6):2327-36. PMID:16508008
BOOK EDITOR
• Hand Infections. Tosti R, Fowler JR Editors. Elsevier. Philadelphia PA. 2020.
• Pediatric and Adult Hand Fractures: A Clinical Guide to Management. Osterman AL, Abzug J, Gaston G, Tosti R. Springer.New York, NY. Expected Publication 2023.
BOOK CHAPTERS
• Osterman AL, Tosti R, Tarr R. Essex Lopresti Interosseous Membrane Reconstruction. In Garrigues G, Richard MJ, Gage MJ. Skeletal Trauma of the Upper Extremity. Elsevier Philadelphia PA. 2022. Pp. 434-435.
• Tosti. Acute Instability of the Distal Radioulnar Joint. In Jupiter JB Chammas M Buijze GA (eds) Distal Radius Fractures Evidence Based Management. Elsevier Cambridge MA. 2021 Pp. 217-223.
• Tosti R. Jacoby S. Intra Articular Hand Fractures and Joint Injuries. In Osterman AL, Shin E (eds) Rehabilitation of the Hand. 7th Ed. Elsevier. Philadelphia PA 2021. Pp. 310-322.
• Rogalski B. Tosti R. First Metacarpal Base Fractures. In Beredjiklian, PK. Vosbickian, M (eds) Hand Surgery: Tricks of the Trade. Thieme. New York NY 2020. Pp.
• Lawrence C. Tosti R. Anatomy of the Ulnar Nerve. In Fowler JR (eds). Cubital Tunnel Syndrome: Diagnosis, Management, and Rehabilitation. Springer. 2019. Pp 3-13.
• Tosti R. Jupiter JB. Open Reduction Internal Fixation of Acute Midshaft Clavicle Fractures. In Nevasier R, Lee DH (eds). Operative Techniques in Shoulder and Elbow Surgery. 2nd Ed. Philadelphia PA. Elsevier. 2019. Pp. 276-281.
• Tosti R. Jupiter JB. Metacarpal Fracture Malunion. In Neumeister M, Sauerbier M (eds). Problems in Hand Surgery. 1st ed. Boca Raton, FL: CRC Press. 2019. Pp 351-354
• Tosti R. Jupiter JB. Distal Radius Nonunion. In Neumeister M, Sauerbier M (eds). Problems in Hand Surgery. 1st ed. Boca Raton, FL: CRC Press. 2019. Pp170-173.
• Tosti R. Machol JM IV. Chen N. Tenolysis In Chung K (ed): Operative Techniques in Plastic Surgery. 2nd ed. Philadelphia, PA: Lippincott Williams, and Wilkins. 2019. Pp. 321-325.
• Tosti R. Machol JM IV. Chen N. Flexor Tendon and Pulley Reconstruction. In Chung K (ed): Operative Techniques in Plastic Surgery. 2nd ed. Philadelphia, PA: Lippincott Williams, and Wilkins. 2019. Pp313-320.
• Tosti R. Infections of the Hand. In Chapman MW, James MA (eds): Chapman’s Comprehensive Orthopaedic Surgery. 4th ed. New Delhi, India: Jaypee Medical Publishers. 2019. Pp. 2084-2105
• Tosti R, Thoder JJ. Operative treatment of lesser and greater arc injuries. In Hunt TR, Wiesel SW (eds): Operative Techniques in Orthopaedic Surgery. 2nd ed. Philadelphia, PA: Lippincott Williams, and Wilkins. 2016. Pp. 2982-2989.
• Jennings J, Tosti R, Sewards JM. Arthroscopic treatment of lateral epicondylitis. In Young-Park, J (ed): Sports Injuries to the Shoulder and Elbow. 1st ed. New York, NY: Springer. 2015. Pp. 303-312.
• Tosti R, Ilyas AM:. Humeral shaft fractures. In Ilyas AM, Rehman S (eds): Contemporary Surgical Management of Fractures and Complications, 1st ed. New Delhi, India: Jaypee Medical Publishers, 2012, vol 1 pp. 655-702.
