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  • Basal & CMC Joint Arthritis

    Basal & CMC Joint Arthritis

    The basal joint at the base of the thumb near the wrist, also called the thumb CMC (carpometacarpal) joint, allows the thumb a wide range of motion. Basal joint arthritis is a relatively common condition, even if a person does not suffer from arthritis in any other joint.

  • Bursitis

    Untitled Bursitis

    Bursitis is the inflammation of a bursa, a thin, fluid-filled sac that lies between body tissues or structures to allow them to move against each other without friction. If the bursa is injured or inflamed it swells with excess fluid, reducing the space within which other tissues move and leading to friction, irritation, and pain.

  • Carpal Tunnel Syndrome


    Carpal Tunnel Syndrome

    Carpal tunnel syndrome is a progressive and increasingly painful condition that can result from compression of a nerve that supplies the wrist and hand. The median nerve runs from the forearm into the palm of the hand, and innervates the palm from the thumb to the third finger. It does not reach as far as the little finger. The nerve controls sensations and also supplies some of the muscles that move the fingers and thumb. As it travels to the hand it, along with nine tendons, passes through a structure in the wrist called the carpal tunnel. Carpal (wrist) bones form the sides and bottom of the narrow channel, and the transverse carpal ligament covers the top. A ligament is a band of strong connective tissue that attaches bone to bone. Surrounding the tendons is tissue called the synovium that serves to lubricate the movement of the tendons. If for some reason the synovium swells and narrows the tunnel, the median nerve is compressed and produces the painful symptoms of carpal tunnel syndrome.

  • Finger Fracture

    Finger Fracture

    A fracture is a broken bone. The bone may be only cracked, or it may be broken into two or more pieces. Each finger has three bones, the proximal (nearest the knuckle), middle, and distal (fingertip) phalanges. Joints are formed where the ends of the bones meet, to allow for finger movement. Fractures can occur at any point along the finger and may or may not involve a joint.

  • Gamekeepers Thumb


    Gamekeeper's Thumb

    Gamekeeper’s thumb, also known as skier’s thumb, is an injury to the ligament of the metacarpophalangeal (MCP) joint of the thumb. The joint is formed at the junction of the bones at the base of the thumb, that is, the head of the first metacarpal of the hand and the base of the first phalange of the thumb, in the area known as the web space. The joint is supported and held in position by ligaments on either side of the joint, plus the ulnar collateral ligament that restricts the amount of sideways movement of the thumb, away from the hand. The ulnar collateral ligament is used whenever you grip or hold an object.

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  • Ganglion Cyst


    Ganglion Cyst

    A ganglion cyst is a swelling, balloon-like in shape and on a stalk, that arises from a joint or the sheath of a tendon, and is usually found on the hand or wrist. Inside the cyst is synovial fluid, a clear, colorless substance that becomes gel-like with time. Synovial fluid is the same substance as that found within a joint capsule.

  • Hand Problems after a Stroke

    Hand Problems After a Stroke

    A stroke happens when the blood supply to the brain is temporarily cut off, depriving the brain of oxygen. Depending on the severity of the stroke, the patient may experience numbness and weakness on one side of the body. Hand coordination and strength may be affected, but with time and rehabilitation, good hand function can often be restored.

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  • Mallet Finger


    Mallet Finger

    A mallet finger, also known as a baseball finger or dropped finger, is caused by an injury to the extensor tendon on the back of a finger or thumb. The tendon attaches bone to muscle and is necessary for straightening the finger. If the tendon is damaged at the point of attachment to bone, just behind the fingernail, the ability to straighten the finger at the joint is lost and the fingertip will droop down. Often a small fragment of bone, and occasionally a large piece, will be torn off with the tendon at the time of injury.

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  • Rheumatoid Arthritis


    Rheumatoid Arthritis

    Rheumatoid arthritis is an autoimmune disease causing inflammation and damage to the joints. It is often a progressive condition that starts in the hands and feet, mostly usually in the wrist and knuckles, before spreading to other joints in the body. A joint is formed at the junction of two articulating bones. The end of each bone is covered with cartilage, a smooth, slippery coating that protects the bones as they slide across each other. Around the joint is a strong membrane that encloses the joint parts in a capsule. The capsule has a thin, membranous lining, the synovium, which secretes synovial fluid to lubricate and provide nutrients to the cartilage. Outside the capsule are ligaments and tendons that keep the bones in their proper alignment.

  • Scaphoid Fracture


    Scaphoid Fracture

    A scaphoid fracture describes an injury that breaks the scaphoid bone in the wrist.

    The wrist joint is formed by the articulation of the radius and ulna bones of the forearm with three of the eight carpal bones at the base of the hand. These carpal bones are arranged in two rows, one nearer the hand and one nearer the forearm. The boat-shaped scaphoid bone links the two rows and is particularly vulnerable to injury. It is in fact the most commonly broken carpal bone in the wrist. It is found is on the thumb side of the wrist and articulates with the distal end of the radius, helping to limit the degree of movement of the wrist.

  • Swan Neck Deformity

    Swan Neck Deformity

    Swan Neck Deformity is a condition characterized by the unusual contraction of a fingertip, caused by a hyperextended proximal (nearest the knuckle) interphalangeal joint (PIP joint) and a flexed distal (furthest from the knuckle) interphalangeal joint (DIP joint).

  • TFCC Injury


    TFCC Injury (Triangular Fibrocartilage Complex)

    A TFCC injury refers to damage sustained by the triangular fibrocartilage complex in the wrist. This structure consists of several ligaments and cartilage arranged in a triangular shape. The wrist is an intricate collection of joints. The forearm contains the radius and the ulna, the distal (furthest from the body) ends of which connect with the proximal (nearest the body) row of carpal bones of the wrist. A second row of carpal bones, the distal row, connects with the metacarpals (long bones) of the hand.

  • Trigger Finger


    Trigger Finger

    Trigger finger, medically known as stenosing tenosynovitis, describes the condition of trying to straighten a bent finger, but having it catch or lock temporarily before suddenly, and sometimes painfully, popping straight.

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  • Ulnar Deviation

    Ulnar Deviation

    Ulnar deviation, also known as ulnar drift, is a progressive deformity of the hand caused by the swelling of the metacarpophalangeal joints (knuckles), which results in the fingers bending towards the little finger side of the hand while the wrist bones deviate towards the thumb side. The primary cause of ulnar deviation is rheumatoid arthritis, although other conditions such as systemic lupus erythematosus or psoriatic arthritis may also be responsible. Very rarely, synovitis can also cause the condition.

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  • Ulnar Neuropathy


    Ulnar Neuropathy

    Ulnar neuropathy means damage to the ulnar nerve. The ulnar nerve is one of the three main nerves that travel down the arm. It originates from the spinal cord in the neck, passes down the length of the arm and provides sensation to the little finger and half of the ring finger. It also controls most muscle movement in the hand. The ulnar nerve can be damaged anywhere along its length, but the most frequent place is where it passes through the elbow. Another vulnerable area is where it passes through the wrist.

    Keeping the arm straight will help to alleviate symptoms, so please visit the elbow bracing links below for additional options.

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  • Wrist Sprain


    Wrist Sprain

    A wrist sprain is an injury to one or more of the ligaments that support the wrist joint.

    The wrist is an intricate collection of joints. The forearm contains the radius and the ulna bones, the distal (furthest from the body) ends of which connect with the proximal (nearest the body) row of carpal bones of the wrist. A second row of carpal bones, the distal row, connects with the metacarpals (long bones) of the hand.

    Ligaments, which are fibrous and elastic bands of connective tissue, join one bone or structure to another. They stabilize joints, keeping the bones in position and allowing a certain amount of movement. Some ligaments specifically restrict movement in a particular direction. Movement of a joint beyond its normal range of motion can tear some ligament fibers or, in more severe cases, completely rupture a ligament. With a severe injury the ligament may tear in its middle part, or rip away from the bone.

    Because the wrist is such a complex arrangement of joints, damage to any of the supportive ligaments is a potentially serious injury.

    A fall onto an outstretched hand is the most common cause of a wrist sprain, but any impetus strong enough to force the wrist to move beyond its normal range of motion, such as a blow or twisting, will damage the ligaments. Sporting and outdoor activities are commonly responsible for these injuries.

    The amount of pain in the wrist after a trauma, or the degree of flexibility, may not accurately reflect the level of injury, so you should seek medical attention for any symptoms that do not go away after a day or two. You should immediately seek attention for extreme pain, numbness or deformity.

    Symptoms may include:
    • Pain at the moment of injury
    • Swelling
    • Bruising
    • Heat or warmth in the skin at the wrist
    • Sensation of popping or ripping inside the wrist
    • Diminished ability to move the wrist due to pain
    • Deformity of the wrist
    After asking for your medical history and the details of any previous injury to your wrist, your doctor will ask you about the circumstances of your current injury, and the onset, duration, and severity of your symptoms. He or she will then physically examine the wrist, touching and moving it in particular ways to determine the location and severity of the injury. Your entire arm will be assessed for other damage, and the nerve and blood circulation checked.

    X-rays will be taken to look for any bone fracture or bone dislocation. Sometimes an occult (hidden) fracture may be present. An MRI (magnetic resonance imaging) scan or CT (computed tomography) scan may be performed as these show the soft tissues of the body and will clearly show damage to any ligaments. An arthrogram is another diagnostic test that shows the joint and ligaments clearly through the injection of a dye into the joint.

    Wrist sprains are graded according to severity, with Grade I being a relatively mild injury with some partial tearing of ligament fibers, but a stable joint. Grade II are moderate sprains with more extensive damage to the ligament and a degree of instability in the joint. Grade II sprains refer to a completely ruptured ligament, where the ligament has been torn and the wrist joint is unstable.

    Unless there is an obvious deformity of the wrist, numbness or extreme pain, you can try some self-help measures at home before you decide if you need to see your doctor.

    You must rest the wrist completely. Avoid any activity that may cause further damage. Apply crushed ice, in a bag and wrapped in a towel, to your wrist for as long as is comfortable, several times a day. This will help reduce swelling and so will ease pain. Applying an elastic bandage will compress the wrist and make you feel more comfortable. Elevating the wrist above the level of your heart will also help reduce swelling. You can take acetaminophen (Tylenol) or NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil), naproxen (Aleve) or similar for pain and inflammation relief.

    If your symptoms have not gone away after a day or two, see your doctor for a proper diagnosis and treatment.

    Based on your particular injury, your doctor may place your wrist in a wrist splint or cast for at least a week. A splint will allow you to take it off when necessary. Splinting or placing the wrist in a cast will effectively immobilize the joint and give the ligaments time to heal. Stiffness after immobilization is common, so you are likely to be given some exercises to do to regain mobility and strength in the wrist.

    A more severe injury may need surgical repair. The exact procedure would depend on the type and location of your sprain, but the goal of any surgery would be to restore stability and range of motion to the wrist. The various options would be discussed with you to help you reach the best decision. Following surgery your wrist would be immobilized for a period of time, dependent on the type of procedure, following which you would need to undertake a program of stretching and strengthening exercises to rehabilitate the wrist.

    An untreated wrist sprain may lead to chronic joint instability that, in time, can cause degeneration of the cartilage in the wrist. The result could be the development of arthritis, and surgery to try to alleviate painful symptoms could become necessary.

    With proper diagnosis, treatment, and rehabilitation a wrist sprain should heal well.

    Follow medical advice as to when to begin doing exercises. Repeat each exercise 10 times for 1 set. Do 3 sets.
    Flex, extend, and side-to-side:
    Simply bend the wrist forwards and hold the stretch for 5 seconds. Then bend the wrist backwards and hold the stretch for 5 seconds. Move the wrist from side to side (as in a handshake) and hold at the furthest point at each side for 5 seconds.
    Ball grip:
    Gently squeeze a rubber ball, hold the squeeze for 10 seconds, then release. As strength in the hands builds, you will be able to squeeze harder.
  • Wrist, Hand, Finger Contracture


    Wrist, Hand, or Finger Contractures

    A contracture is the shortening of certain tendons, muscles or other connective tissues causing loss of full extension of the affected joints. A wrist contracture can be caused by scar tissue forming adhesions in and around the joint, which can lead to restricted movement and limited extension of the wrist.

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