Hand Injuries and Disorders

Carpal Tunnel Syndrome

The carpal tunnel is a passageway of bones and ligament found at the base of the hand that is sometimes narrowed if swelling occurs. Specifically, carpal tunnel syndrome is caused by compression in the median nerve in the wrist. This may result in pain or a numbness that can extend all the way up the entire length of the arm. Initial symptoms include sensations of itching, burning, and numbness in the fingers and palm of the hand. If untreated, the patient may loose ability to strongly grasp objects or even distinguish between hot and cold by touch. Females are more at risk for developing carpal tunnel syndrome than males. Carpal tunnel syndrome is diagnosed with a physical examination for swelling in the wrists and atrophy of the muscles at the base of the hand. Ultrasound and different electrodiagnostic tests can also be used to diagnose carpal tunnel syndrome. Nonsurgical treatments of carpal tunnel syndrome include prescription medication, exercise, and acupuncture. Surgical treatments include open release surgery and endoscopy.

Ganglion Cysts

Ganglion cysts are one of the most common types of hand disorders. Ganglion cysts are a swelling due to accumulation of fluid in the back of the hand or wrists. The condition can be frightening as many may wonder if the fluid-filled capsule is cancer. Ganglion cysts are not cancerous, although they may grow as time progresses. While it is unknown what causes the formation of a ganglion, it is known that females [Page 773]are more likely to be afflicted than males. Depending upon the location of a ganglion cyst, a patient may complain of pain if the ganglion puts pressure upon nerves. To diagnose ganglions, physicians often order X-rays so that conditions such as bone tumors or arthritis can be ruled out. Additionally, if the ganglion is deep under the skin, a magnet resonance imaging (MRI) or ultrasound may also be ordered. Nonsurgical treatment of cysts include immobilization because activity may sometimes worsen symptoms and aspiration of the ganglion with a needle. Nonsurgical treatment of a cyst does not guarantee that the cyst will not return. In surgical treatment of a cyst, the entire ganglion (cyst and outer sac) is removed.

Acute hand injury is the leading cause of occupational injury treated in U. S. hospital emergency departments.

Trigger Finger

Trigger finger is a common hand problem that causes snapping and catching of the fingers as a patient tries to straighten his or her finger. Diagnosis of trigger finger usually includes patient description of symptoms; X-rays and other tests are usually not needed. Trigger finger is common in individuals aged 40–60 and those who are also afflicted by other diseases such as diabetes and rheumatoid arthritis. If catching or popping symptoms are mild, over-the-counter pain medications or resting the finger may be enough to relieve symptoms. Other treatment options include surgery to widen the tunnel in which the finger is getting caught. However, because trigger finger is not a progressive disorder, surgery is only recommended for patients with more severe symptoms.

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