The extensor tendons are found on the back of the hand and wrist, and work to straighten (or extend) the fingers, thumb and wrist. Common extensor tendon injuries include a Boutonniere injury (middle joint of the finger cannot straighten) and Mallet finger (drooping of the tip of the finger). Other injuries may involve the tendons on the back of the hand, wrist or forearm. Depending on the type of injury, treatment may include splints/orthoses alone or in conjunction with a surgical procedure to repair the tendon. (See Tendon Repair.)
Fingertip injuries are very common and can include damage to skin, bone, nail, nail bed and tendon. We use our hands for a variety of tasks, and our fingertips are exposed during many activities. Fingertips can get crushed (in a door or with a hammer) or cut (knife, saw or snow blower injuries). Fingertip injuries can often be treated with dressing changes and splints/orthoses for comfort. Sometimes the nail has to be removed to examine and repair the nail bed tissue underneath the nail. Larger wounds with bone exposure may need skin grafts or flaps to cover the wound. Your doctor will carefully examine your fingertip injury to determine the most appropriate treatment.
The flexor tendons are found on the palm side of the hand and wrist, and work to bend (or flex) the fingers, thumb and wrist. Flexor tendons may be injured from a deep cut or secondary to other trauma or disease. If completely severed, you will be unable to bend the affected part. A cut flexor tendon usually requires surgery. There may also be other structures injured at the same time, including nerves and blood vessels, which need to be repaired. (See Tendon Repair.)
A fracture (or broken bone) of the hand can occur as a result of a direct blow or a fall onto an outstretched hand. Finger, hand and wrist fractures are very common. In the wrist region, the radius is frequently injured due to a fall (also commonly known as a Colles fracture). Patients with a hand or wrist fracture may experience pain, swelling, tenderness or physical deformity, depending on which bone is broken. Treatment for a fracture often involves open or closed reduction, which restores the bone back into its normal position. Fractures may be held in place with pins, screws, rods or plates, and may be removed or left in place once healing is complete. (See Fracture Care.)
A ganglion is a benign fluid-filled mass that typically forms in the soft tissues of the wrist or hand near joints or tendons. It feels like a firm lump and can be painful, especially when pressure is applied. Common locations include the back of the wrist (dorsal wrist ganglion), palm side of the wrist (volar wrist ganglion), base of the finger on the palm side (ganglion/retinacular cyst) or at the top of the end knuckle of the finger (mucoid cyst). Treatment can often be non-surgical, including observation. If cysts are symptomatic, aspiration can be attempted in the office. If non-operative treatment fails, surgical options exist. Ganglion surgery involves complete removal of the cyst and any attached tissue.
Hand infections can occur from minor trauma. They can range in severity from a small superficial cellulitis (skin infection) or abscess to a deep space infection in the hand that is a surgical emergency. Symptoms of infection include redness, swelling, pain, warmth and possibly fever, chills or drainage of pus from a wound. Many minor infections can be managed in the office and with antibiotics. More severe infections, however, may require urgent surgical attention.
Animal bites, snow blowers, lawn mowers, power saws… you name it, the doctors and therapists at the Hand Center have seen it and treated it. Treatment focuses on the repair of the injuries and restoration of function to meet the unique needs of each situation and each patient.
Any abnormal lump or bump (or mass) can be called a tumor, but this does not mean it is cancer. The vast majority of lumps and bumps in the hand are benign (non-cancerous). Tumors can occur in the skin, soft tissues under the skin or in the bone. The most common cause of tumors in the hand are ganglion cysts (See Ganglion Cyst). Treatment of hand masses can range from observation to surgical excision.
Lateral epicondylitis is a painful condition affecting the area where the extensor tendons attach to the bone on the outside of the elbow. Degeneration or tearing of the tendon origin occurs, causing localized pain that increases with activities, including lifting and gripping. This condition may be caused by overuse or trauma. Conservative treatment is often beneficial, including activity modification, splints/orthotics, exercise and injection. Surgery may be appropriate in cases that do not respond to conservative measures.