Wrist & Hand – Joint Clinic Paarl

Carpal Tunnel Syndrome

Daan Botes — Sun, 20 Sep 2020 14:47:03 +0000

Carpal Tunnel Syndrome is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms are pain, numbness and tingling in the thumb, index finger, middle finger and the thumb side of the ring finger. Symptoms typically start gradually and during the night. Pain may extend up the arm. Weak grip strength may occur, and after a long period of time the muscles at the base of the thumb may waste away. In most cases, both hands are affected.

Risk factors include obesity, repetitive wrist work, pregnancy, genetics, and rheumatoid arthritis. There is tentative evidence that hypothyroidism increases the risk. Diabetes mellitus is weakly associated with CTS. The use of birth control pills does not affect the risk. Types of work that are associated include computer work, work with vibrating tools and work that requires a strong grip.

Diagnosis is suspected based on signs, symptoms and specific physical tests and may be confirmed with electrodiagnostic tests. If muscle wasting at the base of the thumb is present, the diagnosis is likely.

Wrist Tendonitis

Saltlicker — Thu, 23 Jul 2020 13:18:44 +0000

Wrist tendonitis, is a type of tendon disorder that results in pain, swelling, and impaired function. The pain is typically worse with movement. Causes may include an injury or repetitive activities. Groups at risk include people who do manual labor, musicians, and athletes. Less common causes include infection, arthritis, gout, thyroid disease, and diabetes.

Diagnosis is typically based on symptoms, examination, and occasionally medical imaging. A few weeks following an injury little inflammation remains, with the underlying problem related to weak or disrupted tendon fibrils.

Scaphoid Fracture of the Wrist

Saltlicker — Thu, 23 Jul 2020 13:18:29 +0000

A scaphoid fracture is a break of the scaphoid bone in the wrist. Symptoms generally includes pain at the base of the thumb which is worse with use of the hand. The anatomic snuffbox is generally tender and swelling may occur. Complications may include nonunion of the fracture, avascular necrosis, and arthritis.

Scaphoid fractures are most commonly caused by a fall on an outstretched hand. Diagnosis is generally based on examination and medical imaging. Some fractures may not be visible on plain X-rays. In such cases a person may be casted with repeat X-rays in two weeks or an MRI or bone scan may be done.

Mallet Finger

Saltlicker — Thu, 23 Jul 2020 13:17:40 +0000

A mallet finger, also known as hammer finger or PLF finger, is an extensor tendon injury at the farthest away finger joint. This results in the inability to extend the finger tip without pushing it. There is generally pain and bruising at the back side of the farthest away finger joint.

A mallet finger usually results from over bending of the finger tip. Typically this occurs when a ball hits an outstretched finger and jams it. This results in either a tear of the tendon or the tendon pulling off a bit of bone. The diagnosis is generally based on symptoms and supported by X-rays.

Ganglion Cyst of the Wrist

Saltlicker — Thu, 23 Jul 2020 13:17:26 +0000

A ganglion cyst is a fluid-filled bump associated with a joint or tendon sheath. They most often occur at the back of the wrist followed by the front of the wrist. Onset is often over months. Typically there are no further symptoms. Occasionally pain or numbness may occur. Complications may include carpal tunnel syndrome.

The cause is unknown. The underlying mechanism is believed to involve an outpouching of the synovial membrane. Risk factors include gymnastics. Diagnosis is typically based on examination with light shining through the lesion being supportive. Medical imaging may be done to rule out other potential causes.

Hand Fractures

Saltlicker — Thu, 23 Jul 2020 13:17:08 +0000

Hand fractures are breaks of the bones in the hand. This includes the small bones of the fingers (phalanges) and the long bones within the palm (metacarpals). A broken hand can be caused by a fall, crush injury, twisting injury, or through direct contact in sports.

In most cases, a hand fracture will heal well with nonsurgical treatment. Depending on the type and location of the fracture, this may include wearing a cast, splint or buddy straps for a period of time. For more serious fractures or for fractures that do not line up properly, however, surgery may be required to realign the broken pieces of bone.

Hand Injuries

Saltlicker — Thu, 23 Jul 2020 13:16:50 +0000

The goal with hand injuries are rapid and accurate initial evaluation and treatment. In other words, once an injury occurs, the doctor strives to begin medical treatment quickly so the short- and long-term effects on the hand can be minimized. The hand consists of 27 bones (including the 8 bones of the wrist). When the other associated structures (nerves, arteries, veins, muscles, tendons, ligaments, joint cartilage, and fingernails) are considered, the potential for a variety of injuries exists when trauma involves the hand. The most common cause of the injuries is blunt trauma, followed by injury from a sharp object.

Hand injuries can be divided into six general categories:

lacerations (cuts),
fractures and dislocations,
soft tissue injuries and amputations,
infections,
burns, and
high pressure injuries (grease and paint guns).

Other common hand injuries include

nail injuries,
finger injuries,
finger infection,
wrist injuries, and

Dupuytrens Contracture

Saltlicker — Thu, 23 Jul 2020 13:16:33 +0000

Dupuytrens Contracture is a disease with gradual bending of the fingers due to scar tissue build up within the palms. Dupuytrens contracture is a condition in which one or more fingers become permanently bent in a flexed position.

Distal Radius Fracture

Saltlicker — Thu, 23 Jul 2020 13:16:18 +0000

A distal radius fracture, also known as wrist fracture, is a break of the part of the radius bone which is close to the wrist. Symptoms include pain, bruising, and rapid-onset swelling. The wrist may be deformed. The ulna bone may also be broken.

In younger people, these fractures typically occur during sports or a motor vehicle collision. In older people, the most common cause is falling on an outstretched hand. Specific types include Colles, Smith, Barton, and Chauffeur’s fractures. The diagnosis is generally suspected based on symptoms and confirmed with X-rays.

Cubital Tunnel Syndrome

Saltlicker — Thu, 23 Jul 2020 13:16:00 +0000

Cubital tunnel syndrome is a nerve compression disorder of the ulnar nerve at the level of the elbow. Ulnar nerve entrapment is a condition where the ulnar nerve becomes physically trapped or pinched, resulting in pain, numbness, or weakness, primarily affecting the little finger and ring finger of the hand.

Entrapment may occur at any point from the spine at cervical vertebra C7 to the wrist; the most common point of entrapment is in the elbow (Cubital tunnel syndrome). Prevention is mostly through correct posture and avoiding repetitive or constant strain (e.g. “cell phone elbow”[citation needed]).

Treatment is usually conservative, including medication, activity modification and exercise, but may sometimes include surgery. Prognosis is generally good, with mild to moderate symptoms often resolving spontaneously.