Hand & Wrist Procedures
Please scroll through this page to view the various hand & wrist treatment options available at Spine & Sports Medical Group.
Arthroscopy is a surgical procedure used by orthopaedic surgeons to diagnose and treat problems inside a joint. The wrist is a complex joint with eight small bones and many connecting ligaments.
Arthroscopy enables the surgeon to see the anatomic parts and their movements without making large incisions into the muscle and tissue. An arthroscope is used for two reasons: to make more accurate diagnoses (diagnostic arthroscopy) and to correct any problems with the joint.
Arthroscopic surgery is a valuable diagnostic and treatment tool. Because it needs fewer and smaller incisions (ie, it is minimally invasive), patients generally have fewer problems and a more rapid recovery than with regular surgery. Because it is usually an outpatient procedure, most patients return home several hours after surgery.
For detailed information about this procedure please visit: AAOS Online Services Fact Sheet - Wrist Arthroscopy
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common source of hand numbness and pain. The tendons in the wrist swell and put pressure on the median nerve, one of three major nerves responsible for supplying feeling in the hand. It is more common in women than men and affects up to 10 percent of the entire population.
Carpal tunnel is caused by increased pressure on a nerve entering the hand through the confined space of the carpal tunnel. There are many causes of carpal tunnel.
- Heredity is the most important factor
- Hand use over time can play a role.
- Repetitive motions of the hands or wrist; that is, when the same motion is repeated over and over again over a very long period of time
- Hormonal changes related to pregnancy and menopause
- Medical conditions, including diabetes, rheumatoid arthritis, and thyroid gland imbalance.
If diagnosed and treated early, carpal tunnel syndrome can be relieved without surgery.
Treatment often begins with a brace or splint worn at night to keep the wrist in a natural position. Splints can also be worn during activities that aggravate symptoms.
Simple medications can help decrease pain. These medications include anti-inflammatory drugs (NSAIDs), such as ibuprofen.
Changing patterns of hand use to avoid positions and activities that aggravate the symptoms may be helpful.
A corticosteroid injection will often provide temporary relief, but symptoms may come back.
Surgery may be considered if carpal tunnel syndrome continues to bother you and you do not gain relief from nonsurgical treatments. The decision whether to have surgery is based mostly on the severity of the symptoms.
- If the symptoms are severe and won't go away, your doctor may consider surgery.
- In more-severe cases, surgery is considered sooner because other treatment options are less helpful.
- In very severe cases, surgery may be recommended to prevent irreversible damage.
For detailed information about this procedure please visit: AAOS Online Services Fact Sheet - Carpal Tunnel Syndrome
A trigger finger occurs when the motion of the tendon that opens and closes the finger is limited, causing the finger to lock or catch as the finger is extended.
Tendons that control the movements of the fingers and thumb slide through a snug tunnel of tissue created by a series of pulleys that keeps the tendon in place. The tendon can become irritated as it slips through the tunnel. As it becomes more and more irritated, the tendon may thicken, making its passage through the tunnel more difficult. The tissues that hold the tendon in place may thicken, causing the opening of the tunnel to become smaller. As a result, the tendon becomes momentarily stuck at the mouth of the tunnel as the finger is extended. A pop may be felt as the tendon slips past the tight area. This why pain and catching may be felt as the finger is moved.
The cause is not always known. Trigger fingers are more common in women than men. They occur most frequently in people who are between the ages of 40 and 60 years of age. Trigger fingers are more common in people with certain medical problems, such as diabetes and rheumatoid arthritis.
There are both nonsurgical and surgical treatments for trigger finger.
For detailed information about this condition and treatments please visit: AAOS Online Services Fact Sheet - Trigger Finger
Wrist Tendonitis (DeQuervains)
De Quervain's tendinitis occurs when the tendons around the base of the thumb are irritated or constricted. The word "tendinitis" refers to a swelling of the tendons. Thickening of the tendons can cause pain and tenderness along the thumb side of the wrist. This is particularly noticeable when forming a fist, grasping or gripping things, or when turning the wrist.
De Quervain's tendinitis is caused when tendons on the thumb side of the wrist are swollen or irritated. The irritation causes the lining (synovium) around the tendon to swell, which changes the shape of the compartment. This makes it difficult for the tendons to move as they should.
Tendinitis may be caused by overuse. It can be seen in association with pregnancy. It may be found in inflammatory arthritis, such as rheumatoid disease. De Quervain's tendinitis is usually most common in middle-aged women
There are both nonsurgical and surgical treatments for wrist tendonitis.
For detailed information about this condition and treatments please visit: AAOS Online Services Fact Sheet - De Quervain's Tendinitis (De Quervain's Tendinosis)
If nonsurgical treatment of arthritis fails to give relief, surgery is usually discussed. There are many surgical options. The option chosen should be one that has a reasonable chance of providing long-term pain relief and return to function. It should be tailored to your individual needs. It is important that the treating physician is well versed in current surgical techniques.
If there is any way the joint can be preserved or reconstructed, this option is usually chosen.
When the damage has progressed to a point that the surfaces will no longer work, a joint replacement or a fusion (arthrodesis) is performed.
Joint fusions provide pain relief but stop joint motion. The fused joint no longer moves; the damaged joint surfaces are gone, so they cannot cause symptoms
Joint replacement attempt to provide pain relief and functional joint motion. As with hip and knee replacements, there have been significant improvements in joint replacements in the hand and wrist. The replacement joints are made of materials similar to those used in weightbearing joints, such as ceramics or long-wearing metal and plastic parts. The goal is to improve the function and longevity of the replaced joint.
For detailed information about this procedure please visit: AAOS Online Services Fact Sheet - Arthritis of the Hand
Fractures (Radius, Scaphoid, Carpal, Metacarpal)
The radius is the larger of the two bones of the forearm. The end toward the wrist is called the distal end. A fracture of the distal radius occurs when the area of the radius near the wrist breaks.
For detailed information about this procedure please visit: AAOS Online Services Fact Sheet - Distal Radius Fracture
The scaphoid is one of the small bones in the wrist. It is the wrist bone that is most likely to break.
For detailed information about this procedure please visit: AAOS Online Services Fact Sheet - Scaphoid Fracture
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. For detailed information about this procedure please visit: AAOS Online Services Fact Sheet - Hand Fractures