Randall D Alexander, MD – Orthopaedic Arm Care Specialist
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Hand

Normal Hand Anatomy :: Trigger Finger :: Dupuytren's Contracture
De Quervain's Tenosynovitis :: Carpal Tunnel Syndrome

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.

For more information about Hand Anatomy click on below tab.

Normal Hand Anatomy  

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.

Trigger Finger Trigger Finger

Dupuytren's Contracture

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 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.

Dupuytren's Contracture Dupuytren's Contracture

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.

De Quervain's Tenosynovitis De Quervain's Tenosynovitis

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.

For more information about Carpal Tunnel Syndrome click on below tabs.

Carpal Tunnel Syndrome Carpal Tunnel Syndrome

Click on the topics below to find out more from the Orthopaedic connection website of Academy of Orthopaedic Surgeons.

Arthritis of the Hand

The hand and wrist have multiple small joints that work together to produce motion. This gives the fine motion needed to thread a needle or tie a shoelace. When the joints are affected by arthritis, activities of daily living can be difficult. Arthritis can occur in multiple areas of the hand and wrist. It can have multiple causes.

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Thumb Fractures

A broken thumb is a serious problem. It affects the ability to grasp items. A broken thumb can increase the risk of arthritis later in life.

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Sprained Thumb

A stable thumb is very important for pinch and grasp activities. A thumb sprain is an injury to the main ligament in the thumb. Ligaments are soft tissue structures that connect two bones to make a stable joint.

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Animal Bites

Each year millions of people in the United States are bitten by animals. Most bites occur on the fingers of the dominant hand, but animal bites can also occur about the head and neck area.

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Fingertip Injuries and Amputations

Injuries to the fingertips are common in accidents at home, work, and play. They can occur when a fingertip slams in a car door, while chopping vegetables, or even when clearing debris from a lawnmower or snowblower.

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Flexor Tendon Injuries

A deep cut on the palm side of your fingers, hand, wrist, or forearm can damage your flexor tendons, which are the tissues that help control movement in your hand. A flexor tendon injury can make it impossible to bend your fingers or thumb.

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Human Bites

Human bite wounds may not seem dangerous, but the risk of infection is high. These wounds contain very high levels of bacteria. Even though the wound may appear minor, an infection can lead to a severe joint infection. About one third of all hand infections are caused by human bite wounds. These infections can move quickly and cause major complications. This is why early treatment is necessary.

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Lawn Mower Injuries in Children

Many homeowners have gas or electric powered lawn mowers. Because lawn mowers are easy to use, children and adolescents are often charged with the weekly chore of mowing the lawn.

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Mallet Finger (Baseball Finger)

A mallet finger is a deformity of a finger caused when a certain tendon (the extensor tendon) is damaged. When a ball or other object strikes the tip of the finger or thumb, the force damages the thin tendon that straightens the finger. The force of the blow may even pull away a piece of bone along with the tendon. The finger or thumb is not able to be straightened. This condition is also known as baseball finger.

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Nerve Injuries

Nerves are fragile and can be damaged by pressure, stretching, or cutting. Injury to a nerve can stop signals to and from the brain, causing muscles not to work properly, and a loss of feeling in the injured area.

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Complex Regional Pain Syndrome (Reflex Sympathetic Dystrophy)

Complex regional pain syndrome (CRPS) is a condition of intense burning pain, stiffness, swelling, and discoloration that most often affects the hand. Arms, legs, and feet can also be affected by CRPS.

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Replantation

Replantation refers to the surgical reattachment of a body part (such as a finger, hand, or toe) that has been completely cut from the body. The goal of replantation surgery is to give the patient back as much use of the injured area as possible.

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Electrodiagnostic Testing

Did you know that your body is an electrical generator? Nerves and muscles create electrical signals that deliver messages to and from your brain. Sensory nerves deliver information about your surroundings to the brain. Motor nerves deliver signals from the brain to activate your muscles.

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A Patient's Experience with Restoration of a Partially Amputated Arm

Thomas Snell is a proud grandparent who enjoys hunting, fishing and working in his woodshop. In the past, he served his town of Elliot, Miss., as a volunteer firefighter and managed the local sawmill. It was at the sawmill that his left arm was severed, almost amputating it completely.

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Boutonnière Deformity

Boutonnière deformity is an injury to the tendons in your fingers that usually prevents the finger from fully straightening. The result is that the middle joint of the injured finger bends down, while the fingertip bends back. This is the characteristic shape of a boutonnière deformity. Unless this injury is treated promptly, the deformity may progress, resulting in permanent deformity and impaired functioning.

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Fracture of the finger

If you think a broken (fractured) finger is a minor injury, think again. Without proper treatment a fractured finger can cause major problems. The bones in a normal hand line up precisely. They let you perform many specialized functions, such as grasping a pen or manipulating small objects in your palm. When you fracture a finger bone, it can cause your whole hand to be out of alignment. Without treatment, your broken finger might stay stiff and painful.

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Ganglions (cysts) of the Wrist

Ganglion cysts arise from the capsule of a joint or the sheath of a tendon. They can be found at different places on the wrist. A ganglion cyst that grows on the top of the wrist is called a dorsal ganglion. Others are found on the underside of the wrist between the thumb and your pulse point, at the end joint of a finger, or at the base of a finger. Most of the time, these are harmless and will often disappear in time.

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Hand Fractures

Fractures of the hand can occur in either the small bones of the fingers (phalanges) or the long bones (metacarpals). They can result from a twisting injury, a fall, a crush injury, or direct contact in sports.

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Hand surgery

Our hands serve many purposes. Hands help us eat, dress, write, earn a living, create art, and do many other activities. To do these activities, our hands require sensation and movement, such as joint motion, tendon gliding, and muscle contraction. When a problem takes place in the hand, care must be given to all the different types of tissues that make function of the hand possible.

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Reflex sympathetic dystrophy

Complex regional pain syndrome (CRPS) is a condition of intense burning pain, stiffness, swelling, and discoloration that most often affects the hand. Arms, legs, and feet can also be affected by CRPS.

This condition was previously known as reflex sympathetic dystrophy, Sudeck's atrophy, shoulder-hand syndrome, or causalgia.

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Ulnar nerve entrapment

Ulnar nerve entrapment occurs when the ulnar nerve in the arm becomes compressed or irritated. The ulnar nerve is one of the three main nerves in your arm. It travels from your neck down into your hand, and can be constricted in several places along the way. Depending upon where it occurs, this pressure on the nerve can cause numbness or pain in your elbow, hand, wrist, or fingers.

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