Hand & Wrist Common Injuries

Hand & Wrist Common Injuries

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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome involves compression of the median nerve as it passes through the carpal tunnel at the wrist. This most commonly occurs from overuse. The median nerve controls muscle strength and skin sensation over specific parts of the hand and wrist.

Symptoms include numbness, tingling, pain and/or weakness of the hand, particularly movements of the thumb. These may occur anytime but are most common during or shortly after activity and at night.

Treatment often includes a period of activity modification, night splints, with possible oral medications. Dr. Sampson performs ultrasound diagnostics to confirm diagnosis and guided injections for refractory cases prior to consideration of surgical release.

Carpometacarpal (CMC) Arthritis

Carpometacarpal (CMC) joint arthritis is arthritis at the base of the thumb. Over time the cartilage wears down and causes the bones to rub together causing pain.

Symptoms include pain, weakness, and limited motion at the base of the thumb.

Treatment often includes a period of rest, activity modification, and bracing. Dr. Sampson performs ultrasound guided injections for refractory cases.

De Quervain’s

De Quervain’s tenosynovitis is an overuse injury of the tendons that run from the base of the thumb into the wrist and forearm. It affects mostly patients in their 30s – 50s, and occurs in women more than men. It is most common in athletes who participate in sports with repetitive hand and wrist movements, such as racket sports and golf. The repeated wrist and thumb motions in these activities can increase the tension and stress on the tendons around the thumb, and cause symptoms.

Symptoms include pain in the wrist or thumb aggravated by movement. This may cause pain while gripping or hitting, such as while playing golf, tennis, weightlifting or rowing. There may also be swelling at the base of the thumb, decreased movement of the wrist and thumb, and a sensation that the thumb is sticking or locking with movement.

Treatment often includes a period of rest, activity modification, and bracing. Dr. Sampson performs ultrasound guided injections for refractory cases.

Dupuytren’s Disease

Dupuytren’s Disease or Contracture is a gradual thickening and tightening of tissue under the skin in the hand. The condition most often affects the ring and pinky fingers. Over time, contracture can cause one or more fingers to stay bent toward the palm.

Symptoms include thickening of the skin and gradual contracture of one or more fingers.

Treatment may include using a needle to break up the thickened tissue, enzyme injection, or surgery. Dr. Sampson performs a procedure under ultrasound guidance to break up the tissue for refractory cases.

Ganglion Cyst

A ganglion cyst is a small sac of fluid that forms over a joint or tendon. Commonly found on the back of the hand.

Symptoms include a painless or painful swelling, commonly on the back of the hand or wrist.

Treatment often includes ultrasound confirmation of cyst diagnosis followed by aspiration and injection under ultrasound.

Intersection Syndrome

Intersection syndrome is an overuse injury characterized by irritation and swelling of the wrist and forearm above the thumb. It is also called “oarsmen’s wrist” because it is most common in sports like rowing, with repetitive wrist movements. It also affects racquet sport athletes and people who participate in weight training.

Symptoms include pain and swelling on the back of the wrist and forearm above their thumb that is worse with movement. There may also be swelling at the site of tendon irritation.

Treatment often includes a period of rest, activity modification, and bracing. Dr. Sampson performs ultrasound guided injections for refractory cases.

Jersey Finger

Jersey Finger occurs when the tendon responsible for flexing the tip of the finger is torn. The most commonly injured finger is the ring finger. Commonly occurs in athletes participating in sports requiring frequent grasping.

Symptoms include pain and swelling on the palm side at the end of the affected finger with inability to flex the tip of the finger.

Correct diagnosis is paramount as most of these cases will require surgical intervention.

Mallet Finger

Mallet finger occurs when the tendon responsible for extension the tip of the finger is torn. This commonly occurs when an object strikes the tip of a finger or thumb and forces it to bend further than it is intended to go.

Symptoms include pain and swelling on the fingernail side at the end of the affected finger with inability to extend the tip of the finger.

Treatment often includes a strict period of finger bracing to allow the bone and tendons to heal, avoiding surgery.

Skier’s thumb

The ulnar collateral ligament is a strong band of tissue that resists separation of the thumb from the index finger. An ulnar collateral ligament sprain is a stretch or tearing of the ulnar collateral ligament. Acute sprains of the ulnar collateral ligament can occur when the thumb is pulled away from the index finger. This is a common injury in skiing, due to gripping the ski pole during a fall, so it may be referred to as a “skier’s thumb”. It may also occur after falling on an outstretched thumb or hooking a thumb into a jersey or facemask.

Symptoms include pain over the inside of the thumb and pain with movement of the thumb. There may also be swelling. There can be decreased pinch strength, making holding objects between the thumb and index finger difficult.

Treatment often includes a period of rest, activity modification, and bracing. Dr. Sampson performs ultrasound evaluation to determine the extent of ligament injury.

Trigger Finger

Trigger finger most commonly presents as a sensation of locking or catching when attempting to bend and straighten the finger. The ring finger and thumb are most often affected by trigger finger, but it can occur in the other fingers, as well.

Symptoms include a sensation of locking or catching of the finger(s). Patients may have to manually unlock the finger(s)

Treatment often includes injections, which are very effective.

Wrist Arthritis

Wrist joint arthritis is arthritis at the articulation of the radius/ulna with the carpal bones. Over time the cartilage wears down and causes the bones to rub together causing pain.

Symptoms include pain, weakness, and limited motion at the wrist.

Treatment often includes a period of rest, activity modification, and bracing. Dr. Sampson performs ultrasound guided injections for refractory cases.

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