Hand/Wrist

What is a distal radius fracture?
A distal radius fracture (wrist fracture) is an injury to the lower end of the radius bone, one of the major bones in your forearm. The break occurs close to the wrist joint.

Causes:

Common causes of distal radius fractures include:

• Falls: Falling onto an outstretched hand is the most frequent cause.
• Osteoporosis: This condition can weaken bones, making them more susceptible to fractures.
• Sports injuries: These fractures can happen during high-impact activities.
• Motor vehicle accidents: The force of impact in a car accident can cause this type of fracture

Treatment:

Treatment for a distal radius fracture depends on the severity of the injury. Options include:

• Non-surgical treatment:
  • Splint or cast: To immobilize the bones and keep them correctly aligned during healing.
  • Physical therapy: Helps restore range of motion and strength after the cast is removed.
• Surgical treatment:

  Surgery may be necessary if the fracture is severe, displaced, or unstable. A surgeon can use pins, wires, or plates to secure the bones in place.

Important Note:

Its crucial to seek immediate medical attention if you suspect you have a wrist fracture. Prompt diagnosis and treatment are essential for proper healing and preventing complications.

What is a flexor tendon injury?

Flexor tendons are cord-like structures located on the palm side of your hand and fingers. They are responsible for bending your fingers and thumb. A flexor tendon injury occurs when one of these tendons is partially or completely torn.

Causes:

• Cuts and lacerations: Deep cuts on the palm side of the hand or fingers are the most common cause of flexor tendon injuries.
• Sports injuries: Forceful gripping thats suddenly opened, like in sports such as rock climbing or football, can tear a flexor tendon (known as an avulsion injury).
• Crushing injuries: Accidents involving heavy machinery or other crushing forces can damage flexor tendons.
• Medical conditions: Health conditions like rheumatoid arthritis can weaken tendons, making them more likely to rupture.

Symptoms:

• Inability to bend a finger: The most obvious sign is the inability to bend one or more joints of the affected finger.
• Pain: When trying to bend the finger, especially on the palm side.
• Tenderness: Tenderness along the finger on the palm side of your hand.
• Numbness: Numbness in the fingertip may occur.
• Open wound: A visible cut on the palm or finger may be present in the case of a laceration.

Treatment:

Treatment for flexor tendon injuries usually requires surgery, though the complexity depends on the severity of the injury.

• Surgery: A hand surgeon will stitch the severed tendon ends back together. In cases of extensive damage, a tendon graft might be needed.
• Hand Therapy: Specialized therapy after surgery is crucial to regain range of motion, strength, and function in the affected finger(s).

Important Note:

• Prompt treatment is essential: The sooner a flexor tendon injury is repaired, the better your chances of regaining full function. If you suspect a flexor tendon injury, consult a hand surgeon immediately.
• Dont ignore symptoms: Delaying treatment can lead to permanent stiffness and reduced function in the affected finger(s).

Let me know if you would like any more details on flexor tendon injuries!

Finger fractures are common injuries that can range in severity. Heres a breakdown of the causes, symptoms, and potential treatments for finger fractures:

Causes:

• Trauma: The most common cause – falls on an outstretched hand, jamming fingers, crushing injuries.
• Crushing Injuries: Occur when fingers get caught in doors, machinery, or during accidents.
• Sports Injuries: Common in sports involving contact or the possibility of a ball striking fingers.
• Weakened Bones: Conditions like osteoporosis can make bones more fragile, increasing the risk of fractures even from relatively minor impacts.

Symptoms:

• Intense Pain: Usually immediate and ongoing, worsening with movement.
• Swelling: Swelling around the injury site is common.
• Bruising: Bruising or discoloration of the skin may occur around the injury.
• Deformity: In severe fractures, the finger may look twisted or out of alignment.
• Difficulty moving the finger: Moving the affected finger may be difficult or painful.
• Numbness or tingling: Nerve damage can sometimes accompany a fracture.

Treatment:

The treatment for a finger fracture depends on the type and severity of the break.

Common treatments may include:

• Immobilization (splinting): For simple, stable fractures, a splint or buddy taping might be enough to allow healing.
• Closed Reduction: To realign broken bones without surgery, a doctor may perform a closed reduction with local anesthesia.
• Surgery: More complex or unstable fractures might require surgery. Surgery might involve using pins, wires, or plates to hold the broken bones in place.
• Pain management: Over-the-counter pain relievers or prescription medication can be used to help manage pain.
• Physical therapy: Once the bone has healed sufficiently, physical therapy is often recommended to help restore range of motion and strength to the hand and injured finger.

Remember:

• If you think you might have fractured a finger, its important to seek medical attention for proper diagnosis and treatment of the injury.
• Delaying treatment can lead to complications and improper healing of the bone.

What is compartment syndrome of the hand?

• Compartment syndrome is a serious condition where excessive pressure builds up within a confined space in the body.
• In the hand, there are several compartments surrounded by tough tissue called fascia that doesnt stretch easily.
• When pressure inside these hand compartments rises dangerously high, it can cut off blood flow to muscles and nerves, causing tissue damage.

Causes:

Common causes include:

• Trauma: Crush injuries, fractures, severe burns, and prolonged compression of the hand.
• Bleeding: Bleeding disorders or injuries that cause bleeding into the compartments.
• Tight casts or dressings: Excessively tight bandages or casts can constrict blood flow.
• Intravenous (IV) infiltrations: Leakage of IV fluids into the tissues.
• Animal bites: Particularly snake bites that inject venom.
• Overexertion: Rare, but extreme exercise can cause swelling.

Symptoms:

The classic symptoms are often described as the "6 Ps":

• Pain: Severe, unrelenting pain that worsens with movement and seems out of proportion to the injury.
• Pressure: A feeling of tightness and fullness in the hand.
• Paresthesia’s: Numbness, tingling, or a "pins and needles" sensation.
• Pallor: Pale skin.
• Paralysis: Weakness or inability to move the fingers or thumb.
• Pulselessness: A weak or absent pulse (this is a late sign).

Treatment:

Compartment syndrome of the hand is a medical emergency. Immediate treatment is essential to prevent permanent damage.

• Fasciotomy: This surgical procedure involves making incisions in the fascia to release the pressure within the compartments.
• Addressing the Cause: Doctors will also treat the underlying cause of the compartment syndrome (e.g., repairing fractures, stopping bleeding).
• Supportive Care: This may include pain medication, wound care, and physical therapy to aid in recovery.

Important Notes:

• If you suspect compartment syndrome, seek medical attention immediately. Time is critical! Delay in treatment can lead to irreversible muscle and nerve damage, resulting in loss of function or even amputation.
• Compartment syndrome of the hand can be difficult to diagnose, especially in its early stages. Be sure to tell your doctor about any recent injuries, procedures, or symptoms you are experiencing.

What is ganglion cyst of the wrist?

• A ganglion cyst is a non-cancerous, fluid-filled lump that most often develops along the tendons or joints of your wrists or hands.
• They are the most common type of soft tissue mass in the hand.
• Ganglion cysts can range in size and may fluctuate with activity.
• Generally harmless, they can still cause discomfort or affect movement in some cases.

Causes:

The exact cause of ganglion cysts is unknown, but they are thought to develop due to:

• Joint or tendon irritation: Wear and tear or injury to the joint or tendon can lead to small tears that allow the lubricating joint fluid to leak out and form the cyst.
• Synovial fluid buildup: The synovial fluid that lubricates your joints and tendons can accumulate, creating a bulge.

Symptoms:

• Visible lump: The most obvious sign is a bump under the skin, typically on the wrist or hand.
• Discomfort or pain: Some ganglion cysts dont cause any symptoms, but others can cause pain, tingling, or weakness, especially if they press on a nerve.
• Size fluctuation: They might get bigger or smaller depending on joint activity.
• Movement limitation: If the cyst interferes with joint movement, it may cause some limitations.

Treatment:

Many ganglion cysts disappear on their own without any treatment. However, if they are causing pain or limiting your activities, here are some treatment options:

• Observation: Your doctor might recommend waiting to see if it resolves on its own.
• Immobilization: A brace or splint may be used to temporarily restrict movement in the area to allow the cyst to shrink.
• Aspiration: The doctor may drain the fluid from the cyst using a needle. This can provide immediate relief, but the cyst often recurs.
• Surgery (Excision): For cysts that return or cause significant discomfort, surgical removal (excision) of the cyst and its stalk may be considered.

Important Note:

Old home remedies like "smashing" a cyst with a hard object (like a book) are strongly discouraged. This can cause complications or rupture the cyst, making things worse.

When to see a doctor?

If you notice a lump on your wrist or hand that is causing pain, tingling, numbness, movement difficulties, or if its large, its best to consult your doctor for proper diagnosis and discussion of treatment options.

What is Trigger Finger?

Trigger finger occurs when a tendon in your finger or thumb becomes inflamed and struggles to glide smoothly through its protective sheath. This can lead to the finger or thumb getting stuck in a bent position and then "popping" or snapping straight with a painful sensation.

Causes:

While the exact cause is often unknown, trigger finger is often associated with:

• Repetitive gripping: Jobs or hobbies that involve repetitive hand motions, frequent gripping, or prolonged forceful grasping increase risk.
• Medical conditions: People with diabetes, rheumatoid arthritis, or certain other conditions are more prone to developing trigger finger.
• Unknown factors: Sometimes, theres no clear cause.

Symptoms:

• Stiffness: Especially noticeable in the morning.
• Popping / Clicking sensation: You may feel a pop or snap when bending or straightening the finger or thumb.
• Tender nodule: Sometimes you can feel a small, tender lump (nodule) on the palm side at the base of the affected finger.
• Catching or Locking: The finger or thumb gets stuck in a bent position and needs help to straighten. In severe cases, it may remain permanently locked.

Treatment:

Treatment options range from conservative measures to surgery in severe cases:

• Rest: Avoiding activities that aggravate the condition.
• Splinting: A splint helps rest the affected tendon.
• NSAIDs: Over-the-counter anti-inflammatory medications can help with pain and swelling.
• Steroid injections: One or two corticosteroid injections near the tendon sheath can offer significant relief, often resolving the issue long-term.
• Surgery: If conservative treatments fail, a small surgical procedure called "trigger finger release" is performed to widen the tendon sheath, allowing smooth movement.

Important Notes:

• Trigger finger can affect any finger, including the thumb.
• Sometimes multiple fingers are involved.
• Seeking early treatment can often prevent the condition from worsening and potentially avoid more invasive procedures later on.

When to see a doctor?

If you experience symptoms of trigger finger, consult your doctor for diagnosis and to discuss the most appropriate treatment options for your situation.

What is De Quervains disease?

De Quervains disease is a painful condition affecting the tendons at the base of your thumb. It arises from inflammation of the tendons and the sheath (tunnel) that surrounds them. This inflammation makes it difficult to move your thumb and wrist, leading to pain and other symptoms.

Causes:

While the exact cause is not always clear, De Quervains disease is commonly linked to:

• Overuse and Repetitive Motions: Activities involving repetitive thumb and wrist motions, especially those involving forceful gripping, can irritate the tendons. This is why its sometimes called "mommy thumb" or "washerwomans sprain."
• Injury to the Wrist: A direct injury or strain to the wrist can increase inflammation in the area, triggering the condition.
• Hormonal Changes: Pregnancy and hormonal fluctuations can contribute to fluid retention, which may put pressure on the tendons.
• Underlying Conditions: Inflammatory conditions like rheumatoid arthritis raise the risk of De Quervains disease.

Symptoms:

The key signs and symptoms of De Quervains disease include:

• Pain: A gradual or sudden onset of pain at the base of your thumb, on the side closest to your wrist.
• Swelling: You might notice visible swelling in the affected area.
• Tenderness: The area around the base of the thumb can be quite tender to the touch.
• Difficulty with Movement: Gripping, pinching, and twisting motions involving the thumb and wrist become painful and difficult.
• Sticking or Catching Sensation: You might feel a snapping or popping sensation when moving your thumb.
• Numbness: Some people may experience numbness along the back of the thumb and index finger.

Diagnosis:

A doctor or physical therapist can usually diagnose De Quervains disease based on:

• Medical History: Discussing your symptoms, daily activities, and any relevant health conditions.
• Physical Examination: Checking for tenderness, swelling, and range of motion in your wrist and thumb.
• Finkelsteins Test: In this test, you bend your thumb into your palm and then bend your wrist toward your little finger. A positive test indicates De Quervains if it reproduces the characteristic pain.

In some cases, imaging studies like an ultrasound or X-ray might be used to rule out other causes of pain.

Treatment:

Treatment aims to decrease inflammation, ease pain, and restore normal function. Options include:

• Conservative Treatments:
  • Rest and Activity Modification: Avoiding or limiting activities that aggravate your symptoms.
  • Splinting: Wearing a thumb splint to immobilize the thumb and wrist, promoting rest and healing.
  • Ice and Heat: Applying ice packs to reduce swelling and heat for pain relief.
  • Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen help with pain and inflammation.
  • Corticosteroid Injections: A short course of injections can provide significant relief of pain and inflammation.
  • Physical Therapy: Specific exercises and stretches can help with flexibility, strength, and reduce pain.
• Surgical Treatment:

  If conservative treatment fails to provide adequate relief, or theres severe damage, surgery may be necessary. This procedure involves releasing the sheath surrounding the tendons, creating more space and reducing friction.

Important Note:

Seek medical advice if you suspect De Quervains. Early diagnosis and treatment promote faster recovery and prevent potential complications.