Wrist & Hand
Hand Arthritis | Trigger Finger Release | Wrist Fractures
About Carpal Tunnel
This condition is a result of median nerve compression at the wrist. The median nerve is an important nerve that supplies sensory and motor function to the hand. Often, as a result of repetitive overuse, trauma, pregnancy, diabetes, thyroid disease and other medical conditions, the nerve can become compressed within the carpal canal. When the nerve is compressed, symptoms will result and include pain in the wrist, hand and forearm which can be aggravated with use, numbness or tingling in the hand and weakness or clumsiness of the hand. Initial treatment for this condition is a wrist splint, anti-inflammatory medications, steroid injection and activity modification. In cases that do not respond to medical treatment or in cases where the nerve compression is severe, the recommended treatment is a surgical procedure to decompress the median nerve.
At Regional Orthopedics, this can be done as an ambulatory procedure with local anesthesia through a small 1-inch incision over the volar aspect of the wrist. The recovery time is typically a few weeks, during which time routine activities to remain independent can be performed.
About Dequervains Disease
This condition is related to tendonitis of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB). These tendons are located over the radial aspect of the wrist and control function of the thumb. These tendons pass through a fibro-osseous tunnel where they can become entrapped, damaged and chronically inflamed. This is typically encountered as an overuse injury. Initial treatment is oral anti-inflammatory medications, steroid injections, bracing, activity avoidance and exercises. In cases that do not resolve with medical treatment surgery is recommended.
At Regional Orthopedics, this condition can be surgically treated on an ambulatory basis, with local anesthetic, through a small 1-inch incision over the radial aspect of the wrist. The ligament overlying the fibrosseous tunnel is released, inflammatory tissue is removed from the surface of the tendons, and any tendon tearing can be repaired. Recovery time is rapid and routine activities can be performed within a few days.
About Ganglion Cyst Excision
This condition typically presents as a ‘mass’ or ‘lump’ in the vicinity of the wrist or hand. It may be painful or painless in nature. In some cases where the cyst is small and simple in nature, it can be aspirated in the office to remove the fluid, causing the cyst to collapse. In cases where the cyst is large, complex and/or located adjacent to vital structures such as the radial artery, recommended treatment is surgical excision.
At Regional Orthopedics, this procedure can be performed on an ambulatory basis, utilizing local anesthetic in many cases. The size of the incision is dictated by the size of the mass and is typically the length of the diameter of the lesion. Recovery time is typically short and routine activities can be restored within a few days of the procedure.
Arthritis can affect the hand in the same way that it can affect the weight bearing joints such as the hip and knee. The type of arthritis may be inflammatory or degenerative. Arthritis is a condition whereby the cartilage surfaces of the joint become damaged and deteriorate over time, resulting in the loss of the cushioning material between the bones.
Symptoms associated with this condition are pain in the small joints of the hand or wrist, stiffness and weakness. The most commonly affected joints are the base of the thumb and the distal interphalangeal joints of the fingers. Treatment for this condition if it is mild or moderate typically involves activity modifications and oral medications for inflammation. Sometimes temporary bracing is also employed to relieve stress on the joints. If these methods fail, a steroid injection can be administered into the joint under fluoroscopic navigation. In many cases, this can help alleviate symptoms substantially. If the pain is resistant to nonsurgical treatment and the arthritis is advanced, surgical correction is recommended.
Surgical treatment of this condition is varied depending on the location of the problem. Joint replacement or interpositional arthroplasty or fusion are typically employed. This procedure typically requires an overnight hospital stay followed by 8 weeks of physical therapy.
About Trigger Finger Release
This condition is caused by chronic inflammation of the flexor tendons of the fingers. A single finger or multiple fingers can be affected. As a result of the inflammation, the tendon and tendon sheath can become scarred, resulting in an impediment for the tendon to glide through the sheath.
The symptoms that result are pain in the palm and fingers and/or ‘locking’ or ‘triggering’ of the digits. Initial treatment is typically an oral anti-inflammatory medication, steroid injection and splinting. In cases that persist, surgical correction is recommended.
At Regional Orthopedics, this condition can be treated on an ambulatory basis, with local anesthetic, through a small 0.5-inch incision over the palm. Recovery time is rapid and the hand can be used for routine activities almost immediately. The condition, once surgically corrected, typically does not recur.
The wrist and hand is a common area of the body to sustain a fracture. This is often related to the protective mechanisms of our body to use our hands to shield us from injury. Typical fractures of the wrist and hand include the distal radius, metacarpals and phalanges. The most common is fracture of the distal radius. This is often the result of a fall onto the outstretched hand. The symptoms associated with this type of injury are pain and swelling. Treatment of this injury is cast immobilization for a nondisplaced fracture or a displaced fracture that does not exceed the limits of what is considered to be acceptable for restoration of normal function to the hand. Displaced fractures are treated surgically.
At Regional Orthopedics, surgical treatment of a displaced distal radius fracture involves the placement of a fracture implant on the volar surface of the bone deep to the muscle and tendons. The implant holds the fracture rigidly reduced in the absence of a cast and allows for use of the hand during the bone healing phase, which is over a period of 6- 8 weeks.