The hand and wrist work together to allow you to perform activities of daily living, as well as participating in athletic and artistic endeavors. Working with your hands is not only functionally important, but can enhance our humanity. The goal of hand surgery is to treat pathology caused by overuse trauma, inflammatory or degenerative processes. Restoration of function and resolution of symptoms, such as pain, are critical goals of our discipline. Most conditions are amenable to initial non-operative management. However, in cases in which surgery is required, we strive to preserve anatomy and utilize minimally invasive, and the most up-to-date procedures.
Below is a list of a select hand pathologies and treatments including basic information regarding each condition. We would be happy to evaluate your problem and consult with you regarding any of these topics in order to educate you about your condition and develop an appropriate treatment plan.
Normal Hand Anatomy
The human hand is an intricate instrument that is both tough and delicate. Its functions of sensations 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 eventually becomes irritated and swells. Pain, catching and eventually locking of the finger will occur. Early treatment consists of anti-inflammatory medication or Cortisone injection. 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, resulting in nodules on the ligament which, if severe enough, can cause an inability to fully straighten the fingers. The ring and small fingers are the fingers most commonly involved.
The cause of this disorder is unknown. It is seen more commonly in men and is usually found in individuals of northern European extraction.
If this deformity and contracture interferes with use of the hand, or if it is progressing, evaluation of a hand surgeon is appropriate. Traditionally, surgical removal of a portion of the ligament has been the treatment of choice to improve function and to prevent further deformity; however, our hand surgeon at SDOA can discuss other less invasive procedures that can be appropriate for you.
De Quervain’s Tenosynovitis
Tendonitis on the thumb side of the wrist can be a very painful and disabling condition. Simple pinching and twisting activities can be almost impossible. The tendons to the thumb become inflamed as they pass under a ligament and the slightest motion of the wrist can cause pain.
Treatment consists of rest, medication and occasionally the use of 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 is 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 suggested.
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Arthroscopic Wrist Surgery
Wrist is also called as carpus, a complex joint comprised of bones and joints, ligaments and tendons, nerves, blood vessels, and muscles that hold the bones together.
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