Orthopedic Hand and Wrist Care at the DMC
Don’t let your hand and wrist pain control your life. Our orthopedic physicians who specialize in hand and wrist care are dedicated to providing quality and compassionate care as they treat a wide variety of conditions including:
- Osteoarthritis – the most common type of arthritis, also known as “wear and tear” arthritis that causes cartilage to wear away over time
- Inflammation of one or more of your joints
- Rheumatoid arthritis - an autoimmune disease that causes pain, swelling, stiffness and loss of functions in the joints. It can also affect the eyes, mouth and lungs
- Carpal tunnel syndrome
- Tendinitis – inflammation of the tendon
- Cubital tunnel syndrome – occurs when the ulnar nerve or funny bone nerve is stretched, compressed or irritated where it crosses the elbow. The ulnar nerve is one of the nerves that supplies sensory and movement to the arm and hand
- Sports injuries to the hand or wrist
- Trigger finger – a condition that affects the ability of the finger or thumb to bend and can result in a clicking sensation
- Wrist injuries and pain including wrist fractures, ligament injuries, sprains, arthritis
- Dupuytren's contracture - a genetic disorder that causes lumps and cords of abnormal scar tissue to form in the palms and fingers
- Tennis elbow - a condition that occurs when tendons in your elbow are overloaded, usually by repetitive motions of the wrist and arm
Who Is at Risk for Hand and Wrist Disorders?
- Sports such as gymnastics and contact sports, such as basketball, can put stress and strain on your wrists
- Activities that require repetitive motions such as typing on a keyboard, working on an assembly line or using power tools such as a drilling equipment
- Having underlying medical conditions such as rheumatoid arthritis
Why See a Hand Surgeon?
If you experience pain in your fingers, hands, wrists or arms, one of our experienced hand doctors may be able to help. While hand surgery may be a consideration, nonsurgical treatments, such as occupational therapy, are also options that
can help to restore movement and reduce or eliminate your pain.
Learn more about Hand Therapy
Types of Hand Surgery
Depending on your injury or underlying problem, it may be determined that surgery is the best option. An orthopedic hand surgeon may perform several types of surgical hand procedures, including:
- Fracture repair to fix bones in the hand or fingers
- Joint replacement, also called arthroplasty, in people with severe arthritis of the hand
- Nerve repair
- Surgical drainage to remove a collection of pus if there is an abscess in the hand
- Tendon repair
Types of Hand and Wrist Injuries and Disorders
Osteoarthritis
Osteoarthritis is the most common form of arthritis among older people. Healthy joints move easily because of cartilage which covers and protects the ends of bones where they meet to form a joint. As osteoarthritis progresses over time, the cartilage
wears away and causes pain, stiffness and swelling around the joint. It most commonly affects the hands, lower back, neck, and weight-bearing joints such as knees, hips, and feet. Symptoms range from stiffness and mild pain that comes and goes to
severe joint pain.
Symptoms may be worse in the morning or after a period of inactivity.
Non-surgical and Surgical Osteoarthritis Treatments
- Lifestyle changes such as exercise or weight loss
- Hand therapy
- Medication to help relieve pain or reduce inflammation
- Surgery
The sooner treatment is started, the better. Without treatment over time, osteoarthritis may worsen and lead to serious disability. Talk to your doctor about a treatment plan that will work for you.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is a condition that occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed as it passes through an opening from the wrist to the hand. This narrow and rigid passageway of ligament
and bones at the base of the hand is called the carpal tunnel.
The median nerve provides sensory and motor functions to the thumb and three middle fingers. Pain and numbness occur when the lining of irritated tendons or other swelling narrows the tunnel and compresses the median nerve. People with carpal tunnel syndrome
may also experience one or a combination of any of the following symptoms:
- Difficulty making a fist
- Difficulty in gripping objects with one or both hands
- Pain and/or numbness in one or both hands
- The feeling of being pricked with “pins and needles” in the fingers
- Swollen feeling in the fingers
- Burning or tingling in the fingers, especially the thumb, index and middle fingers
- Pain and/or numbness in one or both hands that gets worse at night, causing sleep interruptions
Treatments for carpal tunnel syndrome should begin as early as possible, under the direction of an orthopedic hand specialist. Early diagnosis and treatment are important to avoid permanent damage to the median nerve. If caught early, carpal tunnel syndrome
can be treated without surgery.
Nonsurgical & Surgical Carpal Tunnel Treatments
- Splinting of the hand - prevents wrist movement and decreases nerve compression
- Oral or injected anti-inflammatory medications - reduces swelling
- Ergonomic interventions such as keyboard modification
- Hand therapy
- Surgery - relieves compression on the nerves in the carpal tunnel
Surgery can be performed either through traditional open manner or endoscopically, which is minimally invasive. During both procedures, the transverse carpal ligament is cut to release the pressure on the median nerve and relieve carpal tunnel symptoms.
DMC Huron Valley-Sinai Hospital is one of the first hospitals in Michigan to offer SX-One MicroKnife Treatment, a unique, less-invasive treatment for carpal tunnel syndrome.
Learn more about Carpal Tunnel Procedure
Trigger Finger
A trigger finger is a very common and treatable problem. The flexor tendons that bend the fingers have a lining on the outside. The tendon and lining are covered by a series of thick, soft tissue called pulleys. The tendon and its lining are designed
to glide through the pulleys without friction. The finger tendon and pulley system is designed to have the exact right sizes of each structure. The change in size of any of the important finger structures can cause problems.
Some symptoms of trigger finger can include:
- Pain: may start with discomfort with activity such as gripping but over time, an increase in fluid may cause pressure and pain even without hand use.
- Swelling
- Stiffness or loss of motion: can cause loss of the ability to bend the finger
- Mechanical symptoms: abnormal sensations or movement that are often described as popping, catching, or locking.
It is more common with certain medical conditions such as rheumatoid arthritis, gout and diabetes but can also be caused by repeated and strong gripping. Trigger finger can be diagnosed by the history, symptoms, and a physical exam.
Nonsurgical & Surgical Trigger Finger Treatments
- Splinting at night
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Changing your activity – limiting repetitive motion
- Steroid injection
- Hand therapy
If non-surgical treatments do not relieve the symptoms, surgery may be recommended. There are several surgical techniques, anesthesia options, and locations where the procedure can occur.
DMC Huron Valley-Sinai Hospital is the first in Michigan to offer trigger finger release (TFR) using real-time ultrasound guidance.
Learn more about Trigger Finger Release
Ganglion Cyst Removal
A ganglion cyst is a tumor or swelling on top of a joint. It appears as a fluid-filled lump that changes in size and may appear after injury. Other symptoms include:
- Swelling that may appear over time or suddenly. It may get smaller in size, and may even go away, only to come back after a period of time
- Non-stop or aching pain that is made worse by joint motion when the cyst is connected to a tendon
- A sense of weakness in the affected finger
Treatment Options
- Splinting of the wrist
- Hand therapy
- Aspiration
- Surgical removal - recommended when the mass is painful, interferes with daily function or when numbness or tingling of the hand or fingers occurs
Wrist Fracture Repair
A fracture is a partial or complete break in the bone. When a fracture occurs, it is classified as either open or closed.
- Open fracture - the bone exits and is visible through the skin or where a deep wound exposes the bone through the skin
- Closed fracture - the bone is broken but the skin is intact
Fractures occur when there is more force applied to the bone than the bone can absorb. Bones are weakest when they are twisted. Breaks in bones can occur from falls, trauma or because of a direct blow or kick to the body and may have one of or a combination
of the following symptoms:
- Pain in the injured area
- Swelling in the injured area
- Obvious deformity in the injured area
- Difficulty using or moving the injured area in a normal manner
- Warmth, bruising or redness in the injured area
- Treatment Options
Wrist fractures may be treated by casting, surgical repair and/or physical therapy or rehabilitation.
