Randall D Alexander, MD – Orthopaedic Arm Care Specialist
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Hand & Wrist

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

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

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.

For more information about Arthroscopic Wrist Surgery click on below tabs.

Arthroscopic Wrist Surgery
Arthroscopic Wrist Surgery  

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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Arthritis of the Wrist

Arthritis affects millions of people in the United States. Simply defined, arthritis is inflammation of one or more of your joints. A joint is where the ends of bones meet. Inflammation causes swelling, pain, and stiffness in the joint.

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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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Wrist Joint Replacement (Arthroplasty)

Joint replacement surgery in the wrist is less common but can be an option if you have painful arthritis that does not respond to other treatments.

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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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