Hand and Wrist

Wrist Fractures

The bones of wrist consist of eight small bones located at the base of the hand (carpal bones) where they join the two large bones in the arm − the radius and the ulna. When a break is sustained in the area of the wrist, this is referred to as a wrist fracture. Wrist fractures are most frequently caused by falling on an outstretched arm, but a wrist fracture can also be the result of direct trauma to the wrist, such as being hit by a baseball or a collision with a football helmet. Individuals suffering from osteoporosis, a condition where bones become thinner and more fragile, wrist fractures can occur from an even lesser degree of force applied to the area.

The most common wrist fracture is called a distal radius fracture. The radius is the arm bone that connects to the wrist near the thumb side of the hand, and the end of the radius that meets at the wrist is called the distal end, thus a fracture to this area of the bone is known as a distal radius fracture. A wrist fracture involving the other large bone in the arm is called a distal ulna fracture.

X-rays are typically required to properly diagnose wrist fractures. Treatment of wrist fractures may include use of a cast or splint to stabilize the area, allowing for the fracture to heal on its own. When necessary, minimally invasive use of an arthroscope is employed to diagnose complex wrist fractures. Arthroscopic wrist surgery may be warranted for fractures that result in small fragments of bone requiring removal, or fractured bones in need of alignment and stabilization to enable proper healing.

Tendonitis of the Wrist

Tendonitis of the wrist occurs when a series of small tears to the tendons results in inflammation. Individuals coping with tendonitis of the wrist may feel soreness or swelling in the wrist and find it more challenging to move fingers or grasp objects. Tendonitis of the wrist may also trigger pain in the fingers, but it’s a “referred” pain from the wrist. A popping “trigger finger” is evidence of a tendon problem.

Ganglion Cysts

Ganglion cysts are benign (non-cancerous) lumps that develop along the tendons or joints of the wrist or hand. This condition is more common among young women than other demographic groups; the cyst is well known in particular to female gymnasts, who apply hard stress to their wrists. With their soft, lumpy feel and the possibility of soreness or numbness when the cyst presses on a nerve, this can be a bothersome condition. In many cases, a healthy immune system will eventually take care of the cyst, but a particularly painful occurrence may require examination and treatment by an orthopedic physician.

Arthritis

Arthritis attacks the cartilage in joints, and the wrist can be a prime target, particularly if there is a history of fracture or other a bone there in the past. Hand and wrist pain is the key symptom, which can become more acute when the weather changes from sunny to rainy. An arthritic wrist can make a “cracking” noise as the cartilage deteriorates.

Carpal Tunnel Syndrome

Carpal tunnel syndrome has received much attention, yet it occurs less frequently than arthritis, tendonitis, and conditions that cause hand pain or wrist pain. Carpel tunnel syndrome is an injury to the median nerve, which runs from the forearm to the palm of the hand. The carpal tunnel itself is a tight space that sits between the wrist bone and a band of fibrous tissue that normally supports the wrist joint. When pressure is put on the tissue, the resulting tingling, numbness and radiating hand and wrist pain can range from inconvenient to incapacitating.

Finger Fractures

There are fourteen bones in the hand that make up the fingers called phalanges. There are three phalanges in each finger except for the thumb, which contains two. In the case of athletic injuries, finger fractures may be the result of trauma sustained by being “jammed” by a ball or landing awkwardly from a fall. Non-athletic finger fractures can result from fingers caught in a door or other such accidents.

X-rays may be necessary to diagnose finger fractures. Treatment is most often non-surgical, though severe cases may require surgery to implement screws, pins or wire to hold fractured bones together for optimal healing to occur.

Treatment for Wrist and Hand Injuries

Unlike injuries to the lower extremities, where an individual can still function more or less normally while staying off their feet, a condition of the hand or wrist can compromise every aspect of your daily life. Tasks such as driving a car or tying one’s shoes can become challenging or even “off-limits.”

Getting fast, effective relief from pain begins with a complete evaluation, followed by a course of treatment that may include minimally invasive arthroscopic surgery. During arthroscopic surgery, the orthopedic surgeon creates small incisions in the wrist or hand, inserts a miniature camera, called an arthroscope, to get a close look at the source of the problem. With the interior of the wrist or hand displayed on a monitor, the surgeon uses tiny instruments mounted on the arthroscope to remove or repair tissues, fractures, and other disorders.

Most Common Orthopedic Treatment

  • Arthroscopic surgery
  • Evaluation and treatment of hand and wrist conditions, including tendonitis, ganglion cyst, sprain, carpal tunnel syndrome, arthritis, tendon injuries, and nerve injuries