Hand & Wrist Conditions and Care

Wrist Fracture

What is a wrist fracture?

The wrist is comprised of two bones in the forearm, the radius and ulna, and eight tiny carpal bones in the palm. The bones meet to form multiple large and small joints. A wrist fracture refers to a break in one or more of these bones.

Types of wrist fracture

Types of wrist fractures include:

• Simple wrist fractures are those in which the fractured pieces of bone are well aligned and stable.
• Unstable fractures are those in which fragments of the broken bone are misaligned and displaced.
• Open (compound) wrist fractures are severe fractures in which the broken bones cut through the skin. This type of fracture is more prone to infection and requires immediate medical attention.

Causes of wrist fracture

Wrist fractures may be caused due to fall on an outstretched arm, vehicular accidents or workplace injuries. Certain sports such as football, snowboarding or soccer may also be a cause of wrist fractures. Wrist fractures are more common in people with osteoporosis, a condition marked by brittleness of the bones.

Signs and symptoms of wrist fracture

Common symptoms of a wrist fracture include severe pain, swelling, and limited movement of the hand and wrist. Other symptoms include:

• Deformed or crooked wrist
• Bruising
• Numbness
• Stiffness

Diagnosis of wrist fracture

Your doctor performs a preliminary physical examination followed by imaging tests such as an X-ray of the wrist to diagnose a fracture and check the alignment of the bones. Sometimes a CT scan may be ordered to gather more detail of the fracture, such as soft tissue, nerves or blood vessel injury. MRI may be performed to identify tiny fractures and ligament injuries. Your doctor will order a bone scan to identify stress fractures due to repeated trauma. The radioactive substance injected into the blood gets collected in areas where the bone is healing and is detected with a scanner.

Treatment of wrist fracture

Your doctor may prescribe analgesics and anti-inflammatory medications to relieve pain and inflammation.
Fractures that are not displaced are treated with either a splint or a cast to hold the wrist in place.
If the wrist bones are displaced, your surgeon may perform fracture reduction to align the bones. This is performed under local anaesthesia. A splint or a cast is then placed to support the wrist and allow healing.

Surgery for wrist fracture

Surgery is recommended to treat severely displaced wrist fractures and is carried out under the effect of general anaesthesia.
External fixation, such as pins may be used to treat the fracture from the outside. These pins are fixed above and below the fracture site and are held in place by an external frame outside the wrist.
Internal fixation may be recommended to maintain the bones in proper position while they heal. Devices such as rods, plates and screws may be implanted at the fracture site.
Crushed or missing bone may be treated by using bone grafts taken from another part of your body, bone bank or using a bone graft substitute.
During the healing period, you may be asked to perform some motion exercises to keep your wrist flexible. Your doctor may recommend hand rehabilitation therapy or physical therapy to improve function, strength and reduce stiffness.

Risks and Complications

• As with any procedure, wrist fracture surgery involves certain risks and complications. They include:
• Infection
• Residual joint stiffness
• Arthritis

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.

Fractures

A fracture is a break in the bone, which occurs when force greater than the bearable limit is applied against a bone. The most common symptoms of any fracture include severe pain, swelling, bruising or bleeding, deformity, discolouration of the skin and limited mobility of the hand.

Finger fracture

Fingers are fine structures of the human body that assist in daily routine activities through coordinated movements. Any abnormality affecting the fingers can have a huge impact on the quality of life. A finger fracture is not a minor injury, and if left untreated can lead to stiffness, pain, disruption of the alignment of the whole hand and interference with specialised functions such as grasping or manipulating objects. Finger fractures commonly occur during sports activities, when you break a fall or while operating machinery.

Diagnosis

The diagnosis of a hand or finger fracture is based on history, physical examinations and X-ray imaging to determine the type and severity of the fracture. X-rays are the most widely used diagnostic tools for the evaluation of fractures.

Treatment

The objective of early fracture management is to control bleeding, provide pain relief, prevent ischemic injury (bone death) and remove sources of infection such as foreign bodies and dead tissues. The next step in fracture management is the reduction of the fracture and its maintenance. It is important to ensure that the involved part of the body returns to its function after the fracture heals. To achieve this, maintenance of fracture reduction with immobilisation technique is done by either non-operative or surgical methods.

Non-operative Therapy

The bones can be realigned by manipulating them into place. Following this, splints, casts or braces made up of fibreglass or plaster of Paris material are used to immobilise the bones until they heal. The cast is worn for 3 to 6 weeks.

Surgical Therapy

During surgery, the fracture site is adequately exposed, the bones realigned, and reduction of the fracture is done internally using wires, plates and screws and intramedullary nails.

Rehabilitation

Fractures may take several weeks to months to heal completely. You should limit your activities even after the removal of the cast or brace so that the bone becomes solid enough to bear stress. Rehabilitation program involves exercises and gradual increase in activity levels to strengthen the muscles and improve range of motion.

Base of thumb arthritis

Arthritis is an inflammatory condition of the 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 the use of the hand.

Your doctor can usually make the diagnosis of thumb arthritis by examining the thumb. X-rays of the joint may be taken to determine the severity of the disease and the presence of any bone spurs or calcium deposits.
Nonsurgical treatment methods for relieving pain in an arthritic joint include activity modification, pain medications, use of splints and steroid injections. Surgery is usually considered if nonsurgical treatment fails to provide relief. There are different surgical procedures that can be used and may include:

Synovectomy:

This surgery is usually indicated for early cases of inflammatory arthritis where there is significant swelling (synovitis) that is causing pain or is limiting the range of motion of digits and thumb. Synovectomy is the surgical removal of the inflamed synovium (tissue lining the joint). The procedure may be performed using arthroscopy.

Arthroplasty:

In this procedure, your surgeon removes the affected joint and replaces it with an artificial implant. In patients with post-traumatic arthritis and osteoarthritis, where the bone is hard and demand on the hand is moderate, new ceramic implants are used. These are not desirable to use for severely damaged or unstable joints. In patients with inflammatory arthritis, where the bone is not strong enough and the demand on the hand is low, older silicone rubber joints are generally used. These can be used for more severe joint damage and instable joints.

Arthrodesis:

A fusion, also called an arthrodesis, involves the removal of the joints and fusing the bones of the joint together using metal wires or screws. This surgery eliminates all motion at the base of the thumb.
This surgery is usually indicated when the joints are severely damaged, there is limited mobility, damage to the surrounding ligaments and tendons, failed previous arthroplasty, and when heavy manual use is expected.
Your surgeon will discuss the options and help you decide which type of surgery is the most appropriate for you.

Carpal Tunnel Syndrome

What is carpal tunnel syndrome?

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

Symptoms of carpal tunnel syndrome

Common symptoms of carpal tunnel syndrome include numbness and tingling sensation in all the fingers except the little finger; pain and burning sensation in the hand and wrist that may radiate up the arm and elbow; and weakness in the hand, with diminished grip strength.

Causes of carpal tunnel syndrome

The exact causes of the condition are not known. However, certain factors increase the risk of developing carpal tunnel syndrome: they include congenital abnormalities, repetitive motion of hand and wrists, fractures and sprains, hormonal imbalance, and other medical conditions such as hypothyroidism, rheumatoid arthritis, diabetes, obesity, gout, overactive pituitary gland, or the presence of a cyst or tumour in the canal.

Conservative treatment options for carpal tunnel syndrome

Carpal tunnel syndrome may be treated using conservative approaches or surgery. The conservative treatments include:

• Treating the underlying medical conditions
• Immobilisation of the hand and wrist with a splint or wrist brace for 4-6 weeks
• Resting the hand for 2 weeks or more
• Application of ice packs to avoid swelling
• Avoiding activities that tend to worsen the symptoms
• Medications such as non-steroidal anti-inflammatory drugs and steroid injections
• Strengthening and stretching exercises once symptoms diminish

Surgery for carpal tunnel syndrome

If conservative treatment options fail to resolve the condition your surgeon may recommend surgical procedure.

Carpal tunnel release surgery

Carpal tunnel syndrome can be treated with carpal tunnel release surgery. Traditional surgery involves an incision in the palm and wrist area of up to 2 inches; whereas, endoscopic surgery involves one or two half-an-inch incisions and the use of an endoscope. During the surgery, the transverse carpal ligament will be dissected to release the pressure on the median nerve and enlarge the carpal tunnel. Your surgeon will decide which options are best for you based on your general and medical conditions.

Post-operative care

Your surgeon may suggest you practice certain post-operative procedures for better recovery and to avoid further complications.

• Elevate the hand above heart level to reduce swelling.
• A splint may be worn.
• Apply ice packs to the surgical area to reduce swelling.
• Keep the surgical incision clean and dry.
• Cover the area with plastic wrap when bathing or showering.
• Physical therapy may be ordered to restore wrist strength.
• Eat a healthy diet and do not smoke to promote healing.

Risks and Complications

Most patients suffer no complications following carpal tunnel release surgery. However, some patients may suffer from pain, infections, scarring, and nerve damage, causing weakness, paralysis, or loss of sensation and stiffness in the hand and wrist area.

Dupuytren’s contracture

What is a 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.

It is caused from excessive production of collagen that is deposited under the skin. It commonly occurs in the ring finger and little finger. Occasionally, the middle finger is affected, but the thumb and index finger are rarely affected. Dupuytren’s contracture is a condition that usually progresses slowly over many years and is not usually painful. However, some cases may progress rapidly and be painful to the patient.

Symptoms of Dupuytren’s contracture

The most commonly observed symptoms of Dupuytren’s contracture are lumps or nodules in the palm of the hand, difficulty in straightening the fingers, and contracture of the nodules which form tough bands under the skin.

Causes and risk factors for Dupuytren’s contracture

The cause of Dupuytren’s contracture is unknown. However, there are certain risk factors that may increase your chances of developing the condition. These can include the following:

• Age: It occurs more frequently around the age of 40.
• Social habits: Smoking and drinking alcohol may increase your risk of developing the condition.
• Medical conditions: Patients with diabetes, alcoholism, cirrhosis of the liver and seizure appear to be at increased risk of developing the condition.
• Gender: The condition is more common in males than females.
  Heredity: The condition tends to run in families.
• Ancestry: Most commonly affected are northern Europeans and people of Scandinavian descent.

Diagnosis of Dupuytren’s contracture

Dupuytren’s contracture is diagnosed based on the patient’s history and physical examination without any special tests required. The physical examination may involve pressing on different parts of your hands and fingers to assess for hardened knots or tough bands of tissue.

Treatment of Dupuytren’s contracture

You may not need treatment for Dupuytren’s contracture if the condition is not affecting your ability to perform daily activities. However, if you are experiencing pain or are having difficulty using your hands for everyday activities, your surgeon will recommend conservative treatment options to treat your condition. Treatment options will vary depending on the severity of the condition. The conservative approaches include:

• Heat: Applying heat to the palms of the hand prior to massage or exercise can help to loosen the tissues.
• Massage: Gently massage the thickened tissues of the palm.
• Exercises: Stretching exercises such as bending the fingers away from the palm may be useful.
• Injections: Steroid injections in the palm may be done to relieve local inflammation.
• Collagenase injection: An enzymatic drug that breaks down collagen can be injected into the corded tissue to soften and weaken the contracture. The physician then manipulates the area manually to break up the tissue.
• Needle aponeurotomy: This procedure involves inserting a small needle into the thickened palm tissue and manipulating it to loosen and break up the contracting tissue. Ultrasound may be used to guide the needle to avoid hitting nerves or tendons.

Surgical Procedure

If conservative treatment options fail to resolve the condition and symptoms persist for 6 months or more, and your quality of life is adversely affected, your surgeon may recommend a surgical procedure to open the tendon sheath and allow more room for tendon movement.
This surgery is usually performed in an operating room under local or regional anaesthesia on an outpatient basis as day surgery. Your surgeon makes a small incision to the affected palm area.
The surgeon then removes the thickened fibrous tissue, causing the contracture.
The incision is then closed with sutures and covered with a sterile dressing.

Complications

Complications can be medical (general) or specific to hand surgery. Medical complications include those of the anaesthetic and your general well-being. Some of the complications associated with hand surgery include:

• Infection
• Nerve damage, causing weakness, paralysis or loss of feeling in the hand area
• Injury to the arteries of the fingers/hand
• Recurrence of the condition

Ganglions

What are ganglion cysts of the wrist & hand?

Ganglion cysts are swellings that most commonly develop along the tendons or joints of wrists or hands. They can be found either at the top of the wrist, palm side of the wrist, end joint of a finger or at the base of a finger. A ganglion cyst is not cancerous and will not spread to the other parts of the body. It looks like a water balloon on a stalk and contains a clear fluid or jelly-like material. Ganglion cysts can be found in people of all ages.

Causes of ganglion cysts of the wrist & hand

Although the exact cause of a ganglion cyst remains unknown, some theories suggest that small cysts are formed when trauma damages the tissue of a joint. The most likely cause for these cysts may be a defect in the joint capsule or tendon sheath that permits the joint tissue to bulge outwards.

Signs & symptoms of ganglion cysts of the wrist & hand

Ganglion cysts generally appear as a mass measuring from 1 to 3 centimetres in diameter. The swelling is usually soft and immobile. It may develop suddenly or gradually over time, vary in size or even disappear or reappear. A ganglion cyst may or may not be painful. If painful, the pain may be continuous and worsen with the movement of the joint. If the cyst is attached to a tendon, one might feel weak in the affected area.

Diagnosis of ganglion cysts of the wrist & hand

Your doctor will diagnose a ganglion cyst by performing various examinations starting with physical examination. The diagnosis is confirmed by needle aspiration or ultrasound. Needle aspiration is a process where some amount of the fluid in the cyst is withdrawn using a sterile needle. An ultrasound imaging can reveal whether the lump is solid or fluid filled (cystic). It can also determine if an artery or any blood vessel is causing the lump.
Magnetic resonance imaging (MRI) of the wrist may also be employed to diagnose ganglion cysts.

Treatment of ganglion cysts of the wrist & hand

In many cases, these cysts may disappear without any treatment. Aspiration is performed to drain the fluid from the cyst using a needle. After aspiration, an anti-inflammatory steroid is injected into the empty cyst and a splint is placed to immobilise the area. If the cyst becomes painful or limits your activity, causes numbness or tingling of the hand or fingers, your doctor may recommend surgery to remove the ganglion cyst.

Hand Arthritis

Arthritis is an inflammatory condition of the 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 arthritis in the hand affects the joint at the base of the thumb. Arthritis may also affect the joints of other digits, with symptoms such as swelling, pain, stiffness, and malformation, all of which interfere with the use of the hand.

Who develops arthritis?

Arthritis is often seen in people aged over 40 years; however, it may affect people of all ages. The most common cause is wear-and-tear. As you age, you are more prone to develop arthritis. Traumatic injuries, fractures and joint dislocation make you more susceptible to arthritis. Certain types of arthritis are more common in women than men as in thumb arthritis.

What are the types of arthritis?

There are several types of arthritis. The most common are:

Osteoarthritis: Osteoarthritis is also called as degenerative joint disease; This is the most common type of arthritis, that often occurs in older people. This disease affects the cartilage, the tissue that cushions and protects the ends of bones in a joint. With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. Bones may also bulge, or stick out at the end of a joint. These are called bone spurs.

Osteoarthritis causes joint pain and can limit a person’s normal range of motion (the ability to freely move and bend a joint). When severe, the joint may lose all movement, causing a person to become disabled. Disability most often happens when the disease affects the spine, knees, and hips.

Rheumatoid arthritis: This is an auto-immune disease in which the body’s immune system (the body’s way of fighting infection) attacks healthy joints, tissues and organs. Occurring most often in women of childbearing age (15-44), this disease inflames the lining (or synovium) of joints. It can cause pain, stiffness, swelling and loss of function in the joints. When severe, rheumatoid arthritis can deform or change a joint. For example, the joints in a person’s finger can become deformed, causing the finger to bend or curve.

Rheumatoid arthritis mostly affects the joints of the hands and feet and tends to be symmetrical. This means the disease affects the same joints on both sides of the body at the same time and with the same symptoms. No other form of arthritis is symmetrical. About two to three times as many women as men have this disease.

Post-traumatic arthritis:Arthritis developing following an injury to the hand, wrist or elbow is called post-traumatic arthritis. The condition may develop years after the trauma such as a fracture, severe sprain or ligament tears.

Psoriatic arthritis: This form of arthritis occurs in some persons with psoriasis, a scaling skin disorder, affecting the joints at the ends of the fingers and toes. It can also cause changes in the fingernails and toenails. Back pain may occur if the spine is involved.

How is arthritis diagnosed?

Your doctor can usually make the diagnosis of thumb arthritis by examining the thumb. X-rays of the joint may be taken to know the severity of the disease and to determine any bone spurs or calcium deposits.

What are the treatments available for arthritis of the hand?

Nonsurgical treatment methods for relieving pain in an arthritic joint include activity modification, pain medications, and use of splints, and steroid injections. Surgery is usually considered if nonsurgical treatment fails to give relief. There are different surgical procedures that can be used and may include:

Synovectomy: This surgery is usually indicated for early cases of inflammatory arthritis where there is significant swelling (synovitis) that is causing pain or is limiting the range of motion of the digits and thumb. Synovectomy is a surgical removal of the inflamed synovium (tissue lining the joint). The procedure may be performed using arthroscopy.

Arthroplasty: In this procedure, your surgeon removes the affected joint and replaces it with an artificial implant. In patients with post-traumatic arthritis and osteoarthritis where the bone is hard and demand on the hand is moderate, new ceramic implants are used. These are not desirable to use for severely damaged or unstable joints. In patients with inflammatory arthritis, where the bone is not strong enough and the demand on the hand is low, older silicone rubber joints are generally used. These can be used for more severe joint damage and instable joints.

Arthrodesis: A fusion, also called an arthrodesis, involves the removal of the joints and fusing the bones of the joint together using metal wires or screws. This surgery eliminates all motion at the base of the thumb.
This surgery is usually indicated when the joints are severely damaged, there is limited mobility, damage to the surrounding ligaments and tendons, failed previous arthroplasty, and when heavy manual use is expected.
Your surgeon will discuss the options and help you decide which type of surgery is most appropriate for you.

Rehabilitation

Following surgery, a rehabilitation program, often involving a physical therapist may help to regain hand strength and movement. You may need to use a post-operative splint for a while after surgery, which helps to protect the hand while it heals. You may need to restrict activities for a minimum of 12 weeks to let the joint reconstruction heal properly. Although recovery is slow, you should be able to resume your normal activities within few months of surgery.

Tenosynovitis

The muscles and bones of the hand are connected by thick flexible tissue called tendons. Tendons are covered by a thin soft sheath of tissue known as synovium. Extensor pollicis brevis and abductor pollicis longus are two tendons located on the thumb side of the wrist. Inflammation and swelling of the tendon sheaths puts pressure on the adjacent nerves and leads to pain and numbness in the thumb side of the wrist.

Strain on these tendons can cause swelling and irritation, and lead to a condition called De Quervain’s tenosynovitis, which is characterised by inflammation. The condition is also referred to as De Quervain’s tendinitis, De Quervain’s tendinosis, De Quervain syndrome, or De Quervain’s disease.

Causes

The exact cause of De Quervain’s tenosynovitis is unknown, but is usually seen in individuals with repetitive hand or wrist movements, injury to the wrist or tendon, and inflammatory conditions such as rheumatoid arthritis and inflammatory arthritis. De Quervain’s tenosynovitis is most common in pregnant and middle-aged women.

Signs and Symptoms

The symptoms of De Quervain’s tenosynovitis include pain and tenderness on the side of the wrist at the base of the thumb. You may also have a little swelling and redness in the area. Your symptoms may get worse while making a fist, grasping or gripping things, or turning the wrist. You may experience a “catching” or “snapping” sensation while moving your thumb.

Diagnosis

Your physician diagnoses De Quervain’s tenosynovitis by observing your symptoms, medical history and performing a physical examination of the wrist. De Quervain’s tenosynovitis can be confirmed through the Finkelstein test. For this test, your doctor will ask you to make a fist with your fingers covering the thumb and bend the wrist towards the little finger. Pain during this movement will confirm the condition.

Treatment

Treatment of De Quervain’s syndrome consists of both non-surgical and surgical therapy.
Non-surgical therapy includes avoiding activities that increase pain and swelling, applying ice, using a splint to support and immobilise the hand, and physical therapy. Anti-inflammatory drugs are helpful in relieving pain and swelling. Your physician may also recommend a corticosteroid injection to reduce the swelling of the tendon sheath.

Surgical therapy: Your physician will recommend surgery based on the severity of your pain symptoms and response to non-surgical treatment methods. The outpatient surgical procedure involves opening or cutting the inflamed part of the tendon sheath to relieve the pressure on the tendon and allow free movement of the wrist. After the surgical procedure, a wrist splint with your thumb and fingers free and mobile is applied for a month. Your surgeon will also instruct you on exercises to strengthen your wrist.

Trigger Finger

What is a trigger finger?

The ability to bend the fingers is governed by supportive tendons that connect muscles to the bones of the fingers. The tendons run along the length of the bone and are kept in place at intervals by tunnels of ligaments called pulleys. When the fingers bend, or are straightened, a slippery coating called tenosynovium helps the tendons smoothly glide through the ligaments with reduced friction.

Inflammation in the tenosynovium leads to a condition called trigger finger, also known as stenosing tenosynovitis or flexor tendonitis, 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, like pulling and releasing the trigger on a gun, hence the name trigger finger.

Causes of trigger finger

Trigger finger is caused by inflammation of the tenosynovium. Inflammation forms a nodule and makes it difficult for the tendon to glide smoothly within its sheath causing “catching” of the finger in a bent position and then suddenly releasing the finger straight.

Other causes of trigger finger can include the following:

Repetitive motion: Individuals who perform heavy, repetitive hand and wrist movements with prolonged gripping at work or play are believed to be at high risk for developing trigger finger.
Medical conditions: Conditions associated with developing trigger finger include hypothyroidism, rheumatoid arthritis, diabetes, and certain infections such as tuberculosis.
Gender: Trigger finger is more common in females than males.

Signs and Symptoms of trigger finger

Commonly reported symptoms associated with trigger finger include the following:

• Pain and tenderness over the inflamed tendon nodule
• Bent finger suddenly pops out and straightens.
• “Popping” or “clicking” sound or sensation when the nodule moves through the pulley
• Finger feels stiff and sore.
• Finger gets locked and is unable to straighten when the nodule grows large and gets stuck in the pulley
• Symptoms are worse in the morning

Complications of untreated trigger finger

Long-term complications of untreated trigger finger can include permanent digit swelling and contracture, as well as tearing of the tendon or rupture.

Diagnosis of trigger finger

Hand and wrist conditions should be evaluated by an orthopaedic hand surgeon for proper diagnosis and treatment. Trigger finger is diagnosed based on the medical history and physical examination and without any special testing required.

Treatment of trigger finger

Your surgeon will recommend conservative treatment options to treat trigger finger symptoms. Treatment options will vary depending on the severity of the condition.
Conservative treatment options may include the following:

• Get the underlying medical condition, such as diabetes or arthritis, that may be causing the problem treated.
• Rest the hand for 2-4 weeks or more by avoiding repetitive gripping actions.
  Avoid activities that tend to bring on the symptoms.
• Strengthening and stretching exercises with the affected finger may be suggested.
• Occupational therapy may be recommended for massage, heat, ice and exercises to improve the finger.
• Ice over the affected finger may help symptoms. Apply ice over a towel for 5-15 min, 3-4 x daily.
• Non-steroidal anti-inflammatory drugs (NSAIDs) may help to relieve pain and inflammation.
• Steroid injections into the affected finger may help reduce the inflammation.
• If conservative treatment options fail to resolve the condition and symptoms persist for 6 months or more, and your quality of life is adversely affected, your surgeon may recommend you undergo a surgical procedure to release the tendon.
• Percutaneous trigger finger release surgery is a minimally invasive procedure performed under local anaesthesia. Your surgeon makes one small incision to the affected finger area, about an inch long, and releases the tight portion of the flexor tendon sheath.

Wrist arthritis

Arthritis is an inflammatory condition of the 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 arthritis in the hand affects the joint at the base of the thumb. Arthritis may also affect the joints of other digits, with symptoms such as swelling, pain, stiffness, and malformation, all of which interfere with the use of the hand.

Who develops arthritis?

Arthritis is often seen in people aged over 40 years; however, it may affect people of all ages. The most common cause is wear-and-tear. As you age, you are more prone to develop arthritis. Traumatic injuries, fractures and joint dislocation make you more susceptible to arthritis. Certain types of arthritis are more common in women than men as in thumb arthritis.

What are the types of arthritis?

There are several types of arthritis. The most common are:

Osteoarthritis: Osteoarthritis is also called as degenerative joint disease; This is the most common type of arthritis, that often occurs in older people. This disease affects the cartilage, the tissue that cushions and protects the ends of bones in a joint. With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. Bones may also bulge, or stick out at the end of a joint. These are called bone spurs.

Osteoarthritis causes joint pain and can limit a person’s normal range of motion (the ability to freely move and bend a joint). When severe, the joint may lose all movement, causing a person to become disabled. Disability most often happens when the disease affects the spine, knees, and hips.

Rheumatoid arthritis: This is an auto-immune disease in which the body’s immune system (the body’s way of fighting infection) attacks healthy joints, tissues and organs. Occurring most often in women of childbearing age (15-44), this disease inflames the lining (or synovium) of joints. It can cause pain, stiffness, swelling and loss of function in the joints. When severe, rheumatoid arthritis can deform or change a joint. For example, the joints in a person’s finger can become deformed, causing the finger to bend or curve.

Rheumatoid arthritis mostly affects the joints of the hands and feet and tends to be symmetrical. This means the disease affects the same joints on both sides of the body at the same time and with the same symptoms. No other form of arthritis is symmetrical. About two to three times as many women as men have this disease.

Post-traumatic arthritis :Arthritis developing following an injury to the hand, wrist or elbow is called post-traumatic arthritis. The condition may develop years after the trauma such as a fracture, severe sprain or ligament tears.

Psoriatic arthritis: This form of arthritis occurs in some persons with psoriasis, a scaling skin disorder, affecting the joints at the ends of the fingers and toes. It can also cause changes in the fingernails and toenails. Back pain may occur if the spine is involved.

How is arthritis diagnosed?

Your doctor can usually make the diagnosis of thumb arthritis by examining the thumb. X-rays of the joint may be taken to know the severity of the disease and to determine any bone spurs or calcium deposits.