Hand

Normal Hand Anatomy

The human hand is an intricate instrument that is both tough and delicate. Its functions of sensation and motion allow us to experience and control the world around us.

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Carpal tunnel syndrome

Carpal tunnel syndrome is a common hand problem resulting from pressure on the median nerve at the wrist. Symptoms, which often get worse at night, consist of numbness and/or pain in the wrist and fingers. Eventually there is loss of strength, fine motor control, and sensation.

Early treatment consists of splinting and anti-inflammatory medication. If symptoms do not improve, an outpatient surgical procedure to relieve the pressure on the nerve is suggested.

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Trigger finger

The tendons of the thumb and each of the fingers pass through a sheath on the palm side of the hand. Certain diseases and overuse activities can cause a thickening of this sheath. As the tendon passes through a thickened sheath, the tendon eventually becomes irritated and swells. Pain, catching and eventually locking of the finger will occur. Early treatment consists of anti-inflammatory medication or Cortisone injection. If these fail to provide relief, the sheath is opened surgically through a small incision at the base of the finger.

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Arthritis and joint replacement

The hands are made up of 27 bones, which are grouped into carpals, metacarpals and phalanges. Each bone is separated by the articular cartilage, which helps in a smooth gliding movement of the fingers. Arthritis develops when the cartilage wears-out, resulting in pain, stiffness and inflammation in the joints. Arthritis can affect any joint in the body, but the most commonly affected joints are the small joints of the fingers.

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Dupuytren’s Disease

This is a disorder of thickened ligament in the palm, resulting in nodules on the ligament; which if severe enough can cause an inability to fully straighten the fingers. The ring and small fingers are most commonly affected.

The cause of this disorder is unknown. It is seen more commonly in men and is usually found in individuals of Northern European extraction.

If the deformity is mild and there is no functional loss, no surgery is needed. If, however, there is significant contracture that interferes with the full use of the hand, surgical removal of a portion of the ligament is the treatment of choice to improve function and to prevent further deformity.

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Fractures

Fractures of the Hand and Fingers

The hand is one of the most flexible and useful parts of our body. In the wrist, many small bones are connected to each other and help you perform various activities. Because of the overuse of the hand in various activities, hands are more prone to injuries and may suffer from sprains and strains, fractures when lifting and carrying heavy objects, injuries while operating machinery, bracing against a fall, or sports-related injuries. Any injury to bones or the attached ligaments may cause pain and strain, thereby limiting the activities of the hands and wrists.

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Tendon injuries

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

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Microvascular surgery

Microvascular surgery or microsurgery is a surgical technique for joining or repairing the damaged blood vessels and nerves during reconstructive surgery of body parts. Reconstructive surgery restores the functioning of the body parts by improving the circulation.

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Minimally Invasive Treatments

Endoscopic Carpal Tunnel Release

Carpal tunnel syndrome can be treated with carpal tunnel release surgery. Traditional surgery involves up to a 2-inch incision in the palm and wrist area, whereas endoscopic surgery involves one or two half-an-inch incisions and the use of an endoscope.

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