The hands and wrists are some of the most complex anatomical structures in the entire body. They are composed of numerous small bones, muscles, ligaments, tendons and nerves.
Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is a medical condition in which the median nerve is compressed as it travels through the wrist at thecarpal tunnel and causes pain, numbness and tingling, in the part of the hand that receives sensation from the median nerve. Pain may extend up the arm leading to discomfort extending to the shoulder and forearm. The mechanism of injury is compression; there are a variety of contributing factors. Some of the individual predisposing factors include: diabetes, obesity, pregnancy,hypothyroidism, and a narrow-diameter carpal tunnel. CTS may also result from an injury that causes internal scarring or mis-aligned wrist bones. Occupational causes involve use of the hand and arm, such as heavy manual work, work with vibrating tools, and highly repetitive tasks even if they involve low force motions.
The hand is made up of many bones that form its supporting framework. This frame acts as a point of attachment for the muscles that make the wrist and fingers move. A fracture occurs when enough force is applied to a bone to break it. When this happens, there is pain, swelling, and decreased use of the injured part. Many people think that a fracture is different from a break, but they are the same (see Figure 1). Fractures may be simple with the bone pieces aligned and stable. Other fractures are unstable and the bone fragments tend to displace or shift. Some fractures occur in the shaft (main body) of the bone, others break the joint surface. Comminuted fractures (bone is shattered into many pieces) usually occur from a high energy force and are often unstable. An open (compound) fracture occurs when a bone fragment breaks through the skin. There is some risk of infection with compound fractures.
Trigger finger is a painful condition that causes the fingers or thumb to catch or lock when bent. In the thumb its called trigger thumb.
Trigger finger happens when tendons in the finger or thumb become inflamed. Tendons are tough bands of tissue that connect muscles and bones. Together, the tendons and muscles in the hands and arms bend and straighten the fingers and thumbs.
A tendon usually glides easily through the tissue that covers it (called a sheath) because of a lubricating membrane surrounding the joint called the synovium. Sometimes a tendon may become inflamed and swollen. When this happens, bending the finger or thumb can pull the inflamed tendon through a narrowed tendon sheath, making it snap or pop.
Ganglion Cyst of the Hand and Wrist
Dupuytren’s (du-pwe-TRANZ) contracture is a hand deformity that usually develops slowly, over years. Dupuytren’s contracture affects a layer of tissue that lies under the skin of your palm. Knots of tissue form under the skin — eventually forming a thick cord that can pull one or more of your fingers into a bent position.
Once this occurs, the fingers affected by Dupuytren’s contracture can’t be straightened completely, which can complicate everyday activities such as placing your hands in your pockets, putting on gloves or shaking hands.
Dupuytren’s contracture most commonly affects the ring finger and pinky, and occurs most often in older men of Northern European descent. A number of treatments are available to slow the progression of Dupuytren’s contracture and relieve symptoms.
Sprains & Strains
Sprains and strains are injuries to the body, often resulting from physical activity. These injuries are common and can range from minor to severe, depending on the incident. Most sprains and strains are minor and don’t require medical attention.
Sprains occur at joints and affect ligaments, which connect bone to bone. Strains affect muscles or tendons, which connect muscle to bone. They most often occur at the calf, thigh, or groin.