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.

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Trigger Finger

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.

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Dupuytren’s Contracture

This is a disorder of thickened 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 most commonly affected.

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 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.

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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 almost be 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.

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Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common hand problem resulting from pressure on the median nerve at the wrist. Symptoms, which often get 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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Click on the topics below to find out more from the Orthopaedic connection website ofAmerican Academy of Orthopaedic Surgeons.

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