Hand and Wrist
Normal Hand Anatomy
The human hand is an intricate instrument that is both tough and delicate. Its functions of sensation and motion allow us to experience and control the world around us.
The tendons of the thumb and each of the fingers pass through a sheath on the palm side of the hand. Certain diseases and overuse activities can cause a thickening of this sheath. As the tendon passes through a thickened sheath, the tendon may eventually become irritated and swollen. Pain, catching and eventually locking of the finger may occur. Early treatment consists of anti-inflammatory medication or cortisone injections. If these fail to provide relief, the sheath is opened surgically through a small incision at the base of the finger.
This disorder is a thickening of a ligament in the palm. Dupuytren’s Contracture produces nodules on the ligament which, if severe, can cause an inability to fully straighten the fingers. The ring and small fingers are most commonly involved.
If the deformity is mild, and there is no functional loss, no surgery is needed. If, however, there is significant contracture that interferes with full use of the hand, surgical removal of a portion of the ligament is the treatment of choice to improve function and to prevent further deformity.
De Quervain’s Tenosynovitis
Tendinitis on the thumb side of the wrist can be a very painful and disabling condition. Simple pinching and twisting activities can become almost impossible. The tendons to the thumb become inflamed as they pass under a ligament, and the motion of the wrist can cause pain.
Treatment consists of rest, medication, and occasionally, a steroid injection. If these treatments do not provide relief over time, the tendons can be surgically released.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common hand problem resulting from pressure on the median nerve at the wrist. Symptoms, which are often worse at night, consist of numbness and/or pain in the wrist and fingers. Eventually there may be loss of strength, fine motor control, and sensation.
Early treatment consists of splinting and anti-inflammatory medication. If symptoms do not improve, an outpatient surgical procedure to relieve the pressure on the nerve is recommended.
For more information about Carpal Tunnel Syndrome, click on the link below.
Arthroscopic Wrist Surgery
The structure of the wrist is complex, composed of bones and joints, ligaments and tendons, nerves, blood vessels, and muscles that hold the bones together.
For more information about Arthroscopic Wrist Surgery, click on the link below.
Click on the topics below to find out more from the Orthopedic connection website of American Academy of Orthopaedic Surgeons.
- Adult Forearm Fractures
- Erb’s Palsy (Brachial Plexus Birth Palsy)
- Forearm Fractures in Children
- Distal Radius Fractures (Broken Wrist)
- Finger Fractures
- Fingertip Injuries and Amputations
- Flexor Tendon Injuries
- Hand Fractures
- Mallet Finger (Baseball Finger)
- Nerve Injuries
- Scaphoid Fracture of the Wrist
- Sprained Thumb
- Thumb Fractures
- Wrist Sprains
- Arthritis of the Hand
- Arthritis of the Thumb
- Arthritis of the Wrist
- Boutonnière Deformity
- Carpal Tunnel Syndrome
- De Quervain’s Tendinosis
- Dupuytren’s Contracture
- Ganglion Cyst of the Wrist and Hand
- Kienböck’s Disease
- Trigger Finger
- Ulnar Tunnel Syndrome of the Wrist
- Electrodiagnostic Testing
- Wrist Arthroscopy
- Getting the Most Out of Your Doctor’s Visit
- Orthopaedic Evidence-Based Medicine
- Questions to Ask Your Doctor Before Surgery
- The Physician-Patient Relationship: The Importance of Good Communication