Common Hand and Wrist Disorders
Carpal Tunnel Syndrome – Increased pressure on the median nerve in the wrist.
| Symptoms include |
Conservative Treatment
|
Surgical Treatment
|
|
• Pain
• Numbness/Tingling
• Swelling
• Itching
• Difficulty picking up small objects
• Weakness
• Tendency to drop objects
|
(to decrease swelling around the nerve)
• Wrist brace at night
• Steroid injection |
Release the ligament over the nerve to decrease the pressure
(increase volume of the tunnel)
|
Trigger Digits – Pulley (tunnel) and/or tendon become thick and do not glide smoothly. Cause typically unknown associated with rheumatoid arthritis, gout, diabetes, carpal tunnel syndrome.
| Symptoms include |
Conservative Treatment
|
Surgical Treatment
|
|
• Pain at the base of the finger in the palm
• Nodule
• Locking/clicking of the digit
|
• Nothing
• Splint/NSAIDS
• Steroid injection - Approximately 70% cure rate may do 2 shots |
Goal is to release the first
tunnel (pulley) to allow smoth
gliding of the tendo
|
Distal Radius (Wrist) Fracture
| Symptoms include |
Conservative Treatment
|
Surgical Treatment
|
|
• Swelling
• Deformity
• Bruising
|
• Cast |
• Plate and Screws
• External Fixation
|
Arthritis of the Finger – Smooth cartilage surfaces damaged (worn out)
| Symptoms include |
Conservative Treatment
|
Surgical Treatment
|
|
• Pain
• Swelling
• Stiffness
|
• NSAIDS
• Splints
• Cremes – Capsaicin, Voltaren
• Steroid Injection |
• Arthrodesis-fusion of joint or Arthroplasty
|
Arthritis of the Thumb – Loss of cartilage at the base of the thumb
| Symptoms include |
Conservative Treatment
|
Surgical Treatment
|
|
Pain at the base of the
thumb while opening a
bottle or turning a key
|
• NSAIDS: aspirin, ibuprofen, naproxen, etc.
• Splint/brace
• Cremes - Voltaren gel, Capsaicin
• Steroid Injection |
• Arthroplasty
• Ligament reconstruction tendon interposition
|
DeQuervains – Irritation (inflammation) of thumb base tendons – Tendons to the thumb do not glide smoothly
| Symptoms include |
Conservative Treatment
|
Surgical Treatment
|
|
• Pain at thumb side of the wrist
• Swelling, catching
• Worse with movement of thumb and wrist
|
• Patience
• Rest-avoid specific motions
• Thumb/wrist brace
• NSAIDS
• Ice
• Steroid injection
• Physical Therapy |
Release the tunnel the tendons go through
to decrease the irritation/inflammation
|
Tennis Elbow – Micro tear of the wrist extensor tendon attachment to the elbow
| Symptoms include |
Conservative Treatment
|
Surgical Treatment
|
|
• Overuse
• Trauma
|
• Activity Modification
• Medication
• Brace/Force Dissipation
• Physical Therapy
• Steroid Injection |
Only after at least 6 months of conservative
treatment (Most people get better without surgery)
|
Ganglion Cyst Fingers – Called a Mucous Cyst
| Symptoms include |
Conservative Treatment
|
Surgical Treatment
|
|
• Arthritis at the distal finger joint
|
• Observation
• Excision |
|
Ganglion Cysts Wrist
| Symptoms include |
Conservative Treatment
|
Surgical Treatment
|
|
• Fluid filled benign mass
|
• Observation
• Splint/Medication
• Aspiration |
• Excision - recurrence can occur
|
 
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