Hand/Wrist

The wrist is a complicated joint. On the hand side of the wrist, there are two rows of bones, four bones in each row called the carpals. The long thin bones of the hand radiate out from one row of carpals and form the basis of the fingers and thumb. The radius and the ulna are the two bones of the forearm that form a joint with the first row of carpals.

The ends of the bones are covered with an elastic tissue, cartilage. Cartilage creates a slick surface that enables the bones to move smoothly when they move against each other.

HAND/WRIST

Hand fractures can occur in the small bones of the fingers (phalanges) or the long bones (metacarpals). Fractures can result from a twisting injury, a crushing injury or direct contact in sports.

Symptoms

  • Swelling
  • Tenderness
  • Deformity
  • Inability to move the finger(s)
  • Shortened finger
  • Depressed knuckle

Diagnostic procedures

If symptoms suggest a hand fracture, seek qualified orthopedic medical treatment.  Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as range of motions tests, assessment of feeling in the fingers and X-rays in order to determine proper non-operative or operative treatment.
A finger dislocation is a joint injury where the bones are no longer aligned normally. The bones in the fingers are phalanges and metacarpal bones. Every knuckle in the hands and fingers contains a joint between two of these bones and any of these joints can be dislocated in an injury.

Symptoms

  • Finger(s) crooked and swollen
  • Deformed appearance
  • Pain
  • Unstable or weak fingers

Diagnostic procedures

If symptoms suggest finger dislocation, seek qualified orthopedic medical treatment.  Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as an evaluation of joint stability, stress tests, range of motion tests, neurovascular assessment, and X-rays in order to determine proper non-operative or operative treatment.
Tendons are tissues that connect muscles to bone. The muscles that move the fingers and thumb are in the forearm. Long tendons extend from these muscles through the wrist and attach to the small bones of the fingers and thumb. The extensor tendons straighten the fingers and thumb. Swelling of the tendons results in friction and pain with certain thumb and wrist movements. Tendonitis may be caused by overuse or rheumatoid disease.

Symptoms

  • Swelling on the thumb side of the wrist
  • Pain in the wrist and up the forearm
  • A snapping sensation when moving the thumb
  • Difficulty moving thumb and wrist

Diagnostic procedures

If symptoms suggest tendonitis, seek qualified orthopedic medical treatment.  Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as range of motions tests, assessment of movement in the thumb, wrist and fingers, and X-rays in order to determine proper non-operative or operative treatment.
The carpal tunnel is a narrow passageway in the wrist. Small wrist bones called carpal bones form the floor and sides of the tunnel. Carpal tunnel syndrome occurs when one of the major nerves, the median nerve, to the hand is compressed as it travels through the wrist. The median nerve provides feeling in the thumb, index, middle and ring fingers. The flexor tendons that bend the fingers and thumb also travel through the carpal tunnel. If the tendons swell, they put pressure on the median nerve and the swelling takes up space in the tunnel, crowding the nerve. The abnormal pressure on the nerve can result in pain and weakness.

Symptoms

  • Night pain or aching
  • Numbness, tingling and pain in the hand
  • Pain in the forearm that may travel toward the shoulder
  • A feeling of electric shock in the fingers or hand

Diagnostic procedures

If symptoms suggest carpal tunnel syndrome, seek qualified orthopedic medical treatment.  Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as wrist and finger range of motion tests, fingertip sensitivity test, muscle weakness evaluation, and electrophysiological tests, EMG, an ultrasound, X-rays, and MRI in order to determine proper non-operative or operative treatment.

Hand Treatment Testimonials

hand injury treatment

Here's how you go from this to this in one short jump!

I am an orthopedic surgeon and I mountain and road bike. My friends and I were mountain biking in Big Sky, Montana. When the other riders called it a day, I wanted one more, gnarly ride on a trail called Lobo, a double-black diamond run. I went alone and ended up washed out with an injured right hand. It was shred time until it wasn’t!

I recognized the signs of a bone fracture in my hand: Swelling Tenderness Deformity Inability to move the finger Shortened finger Finger crosses over another when making a partial fist Depressed knuckle or "boxer's fracture”

Instead of the ER, I went to Direct Orthopedic Care for diagnosis, a 4th metacarpal bone fracture in my right hand. X-rays identified the location and extent of the fracture. The hand has 5 metacarpal bones, one for each finger. The 4th is the ring finger. When the metacarpals meet up with finger bones, they form knuckles, joints that allow fingers to move. Knuckles are commonly broken while punching something. I punched a rock with my fist to break the fall and broke my hand instead of something else.

Surgical intervention was necessary to stabilize and align the bones. Bone healing begins at six weeks and my recovery took a few months before I was in the OR again, not as a patient, but an orthopedic surgeon repairing injured knees, hips and shoulders.

DOC got this doc back, not only in the OR, but back on the bike and training to ride the Breck Epic in August, a 6-day mountain bike race, 240 miles with 40,000 feet of vertical gain in the backcountry of Breckenridge, Colorado.

thumb pain treatmentMichele has a serious aversion to doctors . . . until she met the orthopedic care team at DOC. Instead of going to the doctor, she suffered for months with left wrist pain, which radiated into her thumb. Finally she took her swollen wrist to her primary care physician. When Michele’s doctor examined the painful wrist, she sent Michele to Direct Orthopedic Care to confirm her tendonitis diagnosis and provide treatment.

When Michele entered DOC’s lobby she felt comfortable in the soothing green setting. When I met the staff they made me feel at ease. I am a very petite woman and the staff realized that my wrist didn’t match my body and needed immediate attention.

Michele had all of the signs of de Quervain's tendinosis, including pain and swelling on the thumb side of the wrist, and a snapping sensation when moving the thumb. To confirm the diagnosis, Blake Lyman, PA and orthopedic specialist at DOC, had Michele perform the Finkelstein test by placing her thumb against her hand, making a fist with her fingers closed over her thumb, and then bending her wrist toward her little finger. The staff made her laugh through the pain of the test.

She was diagnosed with de Quervain’s tendinosis of the left wrist. The goal in treating this condition is to relieve the pain caused by irritation and swelling. Blake gave Michele an injection of corticosteroids into the tendon sheath to reduce swelling and pain. He put her in a splint to rest her thumb and wrist and gave her a topical gel.

When I had a very serious operation, no one ever called to check on my recovery at home. After my first visit to DOC, Andrew, the X-ray tech, called the next day to check on me. After my follow-up visit, Andrew called me to follow-up on the follow-up visit. They have wonderful customer service. At the follow-up visit, Blake asked Michele on a scale of 1 to 100 how her wrist and thumb felt and she responded about 85%. Blake told her that it could be 100%, but Michele said that all of the rest of her parts are not even 85% so she was happy.

I did not second-guess my diagnosis or treatment. I trust Blake Lyman. It was worth the drive for me. I have a new job and cannot take off work so the extended evening hours and weekends make it easy for me to keep my appointments. I have had a shoulder problem for 15 years. Now I want to see Blake for that condition. DOC restored my faith in doctors.

Direct Orthopedic Care, Specialist Skills Without the High ER Bill!

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