Hand & Wrist

Hand & Wrist Anatomy

The hand in the human body is made up of the wrist, palm, and fingers. The most flexible part of the human skeleton, the hand enables us to perform many of our daily activities. When our hand and wrist are not functioning properly, daily activities such as driving a car, bathing, and cooking can become impossible.

Conditions

Wrist Fracture

The wrist is comprised of two bones in the forearm (the radius and the ulna) and eight other tiny bones. The bones meet to form multiple large and small joints. A wrist fracture refers to a break in one or more bones in the wrist. Wrist fracture can be caused due to a fall on the outstretched arm or an injury due to accidents such as a car accident or workplace injuries. A wrist fracture is more common in people with osteoporosis, a condition marked by brittleness of the bones.

Hand Fracture

The hand is one of the most flexible and useful parts of our body. Because of overuse in various activities, the hands are more prone to injuries, such as sprains and strains, fractures and dislocations, lacerations and amputations while operating machinery, bracing against a fall and sports-related injuries.

Wrist Sprains

Injuries caused due to stretching or tearing of the ligaments in the wrist are called wrist sprains. These injuries are usually caused by a fall during daily activities or sports activities. Sprains can range from mild to severe based on the extent of injury to the ligament.

Flexor Tendon Injuries

Tendons are the bands of fibrous connective tissue that connect muscles to bone. Tendons aid in movement of the fingers, hand and all other body parts.

Fracture of the Finger

Fingers are fine structures of the human body which assist in daily routine activities through coordinated movements. Any abnormality affecting the fingers can have a huge impact on quality of life of the patient. A finger fracture is usually a minor injury but if left untreated it may lead to major consequences due to interference with the specialized functions such as grasping or manipulating objects in the palm. A fracture of the finger may disrupt the alignment of whole hand and cause pain and stiffness.

Mallet Finger

Mallet finger is a condition where the end of the finger is bent and does not straighten. It occurs when the extensor tendon on the back of the finger is damaged. The finger joint is a hinge-joint that allows bending and straightening of the fingers. Each finger is composed of 3 phalanges bones, joined by 2 interphalangeal joints (IP joints). The joint near the base of the finger is called the proximal IP joint or PIP joint, and the joint near the tip of the finger is called the distal IP joint or DIP joint.

Finger & Thumb sprain

Injuries that involve tearing or stretching of the ligaments of your fingers are termed as sprains. Sprains in the fingers are most often caused from a fall when you extend your arms to reduce the impact of the fall, or from overuse or repetitive activity of the thumb such as with texting.

Thumb fracture

A break or a crack in the bones of the thumb is known as a thumb fracture. Thumb fractures can occur from a direct blow, a fall, and muscle contractions or twisting during sports such as football, hockey, skiing and wrestling. Fractures may occur anywhere on the thumb, but a fracture at the base of the thumb, near the wrist, is considered the most serious. A fractured thumb is associated with severe pain, tenderness and swelling at the fracture site, little or no thumb movement, deformed appearance or coldness or numbness in the thumb.

Scaphoid Fracture

The scaphoid bone is a small, boat-shaped bone in the wrist, which, along with 7 other bones, forms the wrist joint. It is present on the thumb side of the wrist causing it to be at a high risk for fractures. A scaphoid fracture is usually seen in young men aged 20 to 30 years. They can occur at two places: near the thumb or near the forearm.

Burn Injuries in Children’s Hand

Burn injuries in children’s hands are relatively common as they use their hands to explore their environment, making them more susceptible to injury. While burns can occur with exposure to electricity, chemicals or heat, thermal burns are most common in children. The hotter the object and the longer it remains in contact with the skin, the deeper the injury.

Finger Dislocation in Children

Finger dislocation is a condition in which the bone of your finger has moved away from its normal position. Dislocation can be caused from jamming or overextending the finger during sports activities, or during a fall with an outstretched hand.

Arthritis of the Hand & Wrist

Arthritis is an inflammatory condition of joints. There are several types of arthritis and the most common type is osteoarthritis or wear-and-tear arthritis. Arthritis affects various joints in the body and the arthritis in hand affects the joint at the base of the thumb. Arthritis may also affect the joints of other digits and the symptoms include swelling, pain, stiffness, and malformation all of which interfere with use of the hand.

Arthritis of the Thumb

Arthritis is an inflammatory condition of joints. There are several types of arthritis; the most common type is osteoarthritis or wear-and-tear arthritis that affects the joint at the base of the thumb. Thumb arthritis is more common in women than men, and usually occurs after the age of 40 years. Patients who have arthritis of the fingers may have swelling, pain, stiffness, and malformation all of which interfere with use of the hand.

Ganglion (Cyst) of the Wrist

Ganglion cysts are fluid-filled lumps that most commonly develop along the tendons or joints of wrists or hands. It looks like a water balloon on a stalk and contains a clear fluid or gelatinous material. Ganglion cysts are noncancerous, generally harmless and disappear without any treatment. However, if the cyst becomes painful or interferes with hand movement, they can be treated non-surgically or removed surgically.

Boutonniere Deformity

Tendons in your fingers connect the finger bones to finger muscles and help bend and straighten the finger at the joint when the muscles contract. Boutonnière deformity is a condition in which a tendon injury to the middle joint of the finger results in the inability to straighten the affected finger.

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a common, painful, progressive condition that is caused by compression of the median nerve at the wrist area.

De Quervain's Tendonosis

De Quervain’s Tenosynovitis is a hand condition affecting a patients’ ability to move their thumb. It used to be referred to as washerwoman’s sprain or mother’s wrist but with the advent of technology, is now commonly referred to as “Blackberry thumb” from typing and texting on small handheld devices.

Dupuytren's Contracture

Dupuytren’s Contracture is a hand condition where thickening of the underlying fibrous tissues of the palm cause the fingers to bend inward. Patients with this condition are unable to fully straighten the affected fingers.

Trigger Finger

Trigger Finger, also known as stenosing tenosynovitis or flexor tendonitis, is a condition where one of the fingers or thumb of the hand is caught in a bent position. The affected digit may straighten with a quick snap, similar to pulling and releasing the trigger on a gun, hence the name trigger finger.

Congenital Defects of the Hand and Wrist

The hand and wrist are formed during the 8th week of gestation. This process consists of various steps and failure in any one or more of these steps may cause congenital or birth defects. The deformities may be major (absence of a bone) or minor (disproportion of a finger).

Congenital Hand Deformities

Congenital hand deformities are abnormalities of the hand which develop at birth. About one in twenty children is born with some form of deformity, which can become a challenge as the child grows and begins to use his/her hands. The deformity may vary from a minor disproportion in the digits to a severe case of the absence of a bone.

Hand Pain

Hand pain is characterized by distress in the joints and tissues of the hand or fingers. Hand pain can be depicted as pulsating, aching, increased warmth, prickling, irritation and inflexibility. The hand is composed of nerves, bones, blood vessels, muscles, tendons and skin. Each part has its specific function, such as nerves transfer sensation, joints control movements, blood vessels maintain circulation, muscles provide motion, tendons anchor the muscles to the bones and skin receives sensations.

Hand Infections

Hands become infected more frequently as it is one of the commonly injured parts of our body. Hand infections, if left untreated or treated improperly can cause disabilities such as stiffness, contracture, weakness, and loss of tissues (skin, nerve and bone) that persist even after the infection resolves. Therefore, prompt treatment of hand infections is important.

Wrist Pain

The wrist is a commonly seen injured joint in the body. Problems include sprains and strains as well as fractures which can occur with lifting and carrying heavy objects, while operating machinery, bracing against a fall, or from sports-related injuries.

Wrist Tumours

A tumor is a lump or abnormal growth formed due to unregulated cell division. Wrist tumors can occur on or underneath the skin. They are most often benign (non-cancerous).

Gamekeeper’s Thumb

Gamekeeper's thumb, also known as skier's thumb, is a tear of the ulnar collateral ligament, a band of tissue that supports the joint at the base of the thumb. Damage to the ulnar collateral ligament may lead to chronic instability of the thumb, creating problems in its normal functioning. Gamekeeper's thumb can result from sports activities (while stopping a ball with a bare hand) or a fall on your outstretched thumb (especially while holding onto something like a ski pole).

Distal Radius Fractures

The forearm consists of two bones, the radius and ulna. The radius is the larger of the two forearm bones, and the region towards the wrist is called the distal end. Fractures in this end are most common.

Procedures

Toe to Hand Transfer

The hand is an important part of the body that helps in a multitude of actions. Each finger is an integral part of the hand and has its own function and role to play in assisting the hand in its many actions. Hence, the loss of a finger can become a challenge in performing everyday activities.

Wrist Arthroscopy

Your wrist is a complex joint made up of eight small bones called carpal bones. These bones are supported by connecting ligaments. Various conditions can affect your wrist joint such as carpal tunnel syndrome, osteoarthritis and others.

Wrist Joint Replacement

Wrist joint replacement surgery, also referred to as total wrist arthroplasty, involves replacement of a severe arthritic wrist joint with an artificial joint made of metal and plastic components. It relieves pain and restores function when conservative treatment fails to provide relief.

Carpal Tunnel Release Surgery

The carpal tunnel is a narrow passageway on the palm side of your wrist. Small wrist bones known as carpals form the bottom and sides of your carpal tunnel and a strong band of connecting tissue, known as the transverse carpal ligament, covers the top of the carpal tunnel.

Hand Surgery

The hand is considered one of the most complex structures in the human body due to its intricate anatomy. Your hands are a complex system of various bones, joints, ligaments, tendons, muscles, nerves and blood vessels. Without the healthy functioning of the hand we are unable to perform activities of daily living. The hand is one part of the body that is very susceptible to injury or disease.

Intricate Hand and Microscopic Surgery

The hand is considered one of the most complex structures in the human body due to its intricate anatomy. The hand is a complex system of various bones, joints, ligaments, tendons, muscles, nerves and blood vessels. Without the healthy functioning of the hand we are unable to perform activities of daily living.

Elective Emergency Hand Surgery

Hand surgery is performed to restore the structure and functionality of the fingers, wrist and hand secondary to a traumatic injury, medical condition, severe infection, or birth defect causing pain and/or deformity of the hand. It is performed by trained and certified plastic surgeons. The surgery is done either as an emergency procedure or as an elective procedure depending on the condition and its severity.

Wrist Ligament Reconstruction

The human wrist is made up of small bones joined together by a band of tough fibrous tissue known as ligaments. Ligaments also join the bones in our wrist to the radius, ulna, and metacarpal bones, and aid in the proper functioning of our wrist. Any injury to the ligaments disturbs the normal alignment of our wrist bones causing them to wear out faster resulting in significant pain and eventually leading to arthritis.

Total Wrist Arthrodesis

Arthrodesis is the surgical immobilization of a joint by the fusion of the adjacent bones. Total wrist arthrodesis, also known as wrist fusion is a surgical procedure in which the wrist joint is stabilized or immobilized by fusing the forearm bone (radius) with the small bones of the wrist.

Sports Injury Management of Hand, Wrist and Elbow

Sports injuries are the injuries that most commonly occur during sports and exercises. These injuries may result from accidents, poor training practices, and use of improper protective gear, lack of conditioning, and insufficient warm up and stretching. The sports injuries may be either acute (sprains, fractures, tears) or chronic (tendinitis, overuse injury) injuries.

Artificial Finger Joint Replacement

Finger joints are essential for many activities, and arthritis in this area can cause significant joint damage and deformity. Artificial finger joint replacement is a surgical procedure that involves the removal of an arthritic or damaged finger joint and replacement with an artificial prosthesis.

Finger Joint Fusion

Finger joint fusion is a surgical procedure to remove the damaged bony ends of a finger joint followed by insertion of a prosthesis to fuse the bones back together. Finger joint fusion is performed to relieve arthritis pain in the fingers.

Arthritis Surgery for Thumb and Digit

Arthritis is an inflammatory condition of joints. There are several types of arthritis; the most common type is osteoarthritis or wear-and-tear arthritis that affects the joint at the base of the thumb. Thumb arthritis is more common in women than men, and usually occurs after the age of 40 years. Patients who have arthritis of the fingers may have swelling, pain, stiffness, and malformation all of which interfere with use of the hand.

Hand Rejuvenation

Cosmetic enhancement is generally focused only on the face, while the hands portray some of the most prominent signs of aging. With age, the hands lose their firmness and plumpness and can appear bony and fragile. Hand rejuvenation is a treatment that gives you visibly younger, healthy, and firmer hands.

Hand Therapy

Hand Therapy is a rehabilitation technique recommended to improve the strength and restore functional activity of hands in patients with upper extremity injuries. Hand therapy also helps in preventing the injury.

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  • American Academy of Orthopaedic Surgeons
  • American Society for Surgery of the Hand
  • St. Luke's Roosevelt
  • Texas Scottish Rite Hospital for Children
  • NYU School of Medicine
  • North Shore LIJ
  • Pro Medical Newyork