Introduction
The hand is made up of the wrist, palm, and fingers and consists of bones, joints, muscles, ligaments, tendons, and many blood vessels and nerves. It is one of the most flexible and useful parts of our body and can suffer injury due to overuse or trauma. The hand can also be affected by certain chronic medical conditions.
Common Hand Injuries and Conditions
Common hand injuries and conditions include:
- Broken finger/fractured hand: A fracture is a break in the bone that occurs when more force than the bearable limit is applied against a bone. A hand fracture can occur in the fingers, thumb, or bones within the palm of the hand.
- Carpal tunnel syndrome: Carpal tunnel syndrome is a condition characterized by numbness or pain in the thumb and first two fingers due to compression of the median nerve at the wrist.
- Osteoarthritis: This is most common type of arthritis (joint inflammation due to cartilage loss). It is caused by wear and tear of the joints usually seen with aging.
- Rheumatoid arthritis: This is an autoimmune condition which can lead to arthritis in the hands as well as other joints.
- Ganglion cysts: Ganglion cysts are noncancerous lumps that usually form around the tendons or joints of the wrists or hands.
- Hand nerve injuries: Nerve injuries in the hands may be caused by excessive strain, stretching, or a cut.
- Tendinitis: Tendinitis is a condition in which the tendons in the hands become irritated and inflamed due to overuse.
- Trigger finger: This is a common condition in which the sheath through which tendons move becomes irritated or swollen.
- Dupuytren's contracture: A disorder caused by the thickening of the tissues of the palm.
Symptoms
Signs and symptoms of hand injuries include:
- Pain
- Bruising
- Swelling
- Deformity
- Inability to move the fingers
- Warmth around the area of injury
- Tenderness
- Loss of motion
- Weakness
- Numbness
Diagnosis of Hand Injuries and Conditions
Your doctor will review your symptoms and medical history and perform a thorough physical examination to check for range of motion and stability, and any ligament or tendon damage. Blood flow and skin color are evaluated. The following diagnostic tests may be performed for further evaluation:
- X-rays: During this study, high-energy electromagnetic beams are used to produce images of the bones.
- CT scan: Multiple x-rays are used to produce detailed cross-section images of the hand.
- Electromyography (EMG) and nerve conduction studies to measure nerve impulses and nerve damage.
Treatment for Hand Injuries
Hand injuries may be treated by resting the hand, medications, bracing, heat or ice application, compression, stretching, and strengthening exercises, and by treating the underlying cause or condition.
Some of the most common procedures used for the treatment of hand conditions and injuries include:
- Skin grafts: This involves the use of healthy skin from an area of the patient's body to cover or resurface the injured area. This is most commonly used for burn reconstruction and amputation of fingers.
- Tendon repair: This is performed with special sutures for the management of ruptured tendons caused by trauma or sports injury. Surgery performed within 24 hours of the injury is associated with better outcomes.
- Nerve repair: This is a complex surgery performed immediately after a nerve injury, as damage to any of the three main nerves of the hand may lead to limited use or compromised range of motion of the hand, fingers, and wrist.
- Open reduction and internal fixation (ORIF): This is treatment for fractures with completely displaced and/or crushed bones. It involves the realignment of the bones of the hand with the help of rods, wires, splints, and casts.
- Joint replacement: This involves the replacement of the joints in the fingers and the wrist with a new joint made of silicone rubber, a portion of the patient's own tendon, or a plastic or metal implant. This is usually performed in patients with osteoarthritis or traumatic arthritis of the hand to relieve pain and restore function.
