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Hand & Upper Extremity

Hand & Upper Extremity

Hand and Wrist

Normal Hand Anatomy

The human hand is an intricate instrument that is both tough and delicate. Its functions of sensation and motion allow us to experience and control the world around us.

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Trigger Finger

The tendons of the thumb and each of the fingers pass through a sheath on the palm side of the hand. Certain diseases and overuse activities can cause a thickening of this sheath. As the tendon passes through a thickened sheath, the tendon eventually
becomes irritated and swells. Pain, catching and eventually locking of the finger will occur. Early treatment consists of anti-inflammatory medication or Cortisone injection. If these fail to provide relief, the sheath is opened surgically through
a small incision at the base of the finger.

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Dupuytren’s Contracture

This is a disorder of thickened ligament in the palm, resulting in nodules on the ligament; which if severe enough can cause an inability to fully straighten the fingers. The ring and small fingers are most commonly affected.

The cause of this disorder is unknown. It is seen more commonly in men and is usually found in individuals of Northern European extraction.

If deformity is mild and there is no functional loss, no surgery is needed. If, however, there is significant contracture that interferes with full use of the hand, surgical removal of a portion of the ligament is the treatment of choice to improve function
and to prevent further deformity.

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De Quervain’s Tenosynovitis

Tendonitis on the thumb side of the wrist can be a very painful and disabling condition. Simple pinching and twisting activities can almost be impossible. The tendons to the thumb become inflamed as they pass under a ligament and the slightest motion
of the wrist can cause pain.

Treatment consists of rest, medication and occasionally the use of a steroid injection. If these treatments do not provide relief over time, the tendons can be surgically released.

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Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common hand problem resulting from pressure on the median nerve at the wrist. Symptoms, which often get worse at night, consist of numbness and/or pain in the wrist and fingers. Eventually there is loss of strength, fine motor
control and sensation.

Early treatment consists of splinting and anti-inflammatory medication. If symptoms do not improve, an outpatient surgical procedure to relieve the pressure on the nerve is suggested.

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Congenital Hand Deformities

Congenital hand deformities are deformities of the hand or any part of hand that are present at birth. These deformities can be particularly disabling as the hands are important for the child for its interaction. Congenital hand deformities may be as
simple as digital disproportion or may be the complete absence of a bone. Congenital deformities may be developed because of injury, diseases conditions or may be present during birth because of any abnormalities during the growth in womb. It should
be treated at an early stage before the problem becomes severe.

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Arthroscopic Wrist Surgery

Wrist is also called as carpus, a complex joint comprised of bones and joints, ligaments and tendons, nerves, blood vessels, and muscles that hold the bones together.

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Microvascular Surgery

Microvascular surgery or microsurgery is a surgical technique for joining or repairing the damaged blood vessels and nerves during reconstructive surgery of body parts. Reconstructive surgery restores the functioning of the body parts by improving the

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Peripheral Nerve Surgery

The human nervous system comprises of the brain, spinal cord, autonomic nervous system, and the peripheral nerves. The peripheral nerves are cord-like structures and are made up of nerve fiber bundles that transmit sensory information from the body parts
to the spinal cord. They also send signals from the spinal cord to rest of the body. Peripheral nerves have an inherent capacity for healing and regeneration unlike the brain and spinal cord. Even the most badly injured peripheral nerve will recover
completely if repair is done at the right time.

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Ilizarov Apparatus

An Ilizarov apparatus is an orthopedic device used to stimulate bone growth and is generally used to lengthen and straighten the extremities. It may also be used to treat complex and/or open bone fractures and in cases of infected non-union of bones that
are not responsive to other techniques. The apparatus was named after its inventor, a Siberian orthopedic surgeon named ‘Gavriil Abramovich Ilizarov’. The Ilizarov fixator uses the principle of distraction osteogenesis which refers to the pulling
apart of bone to stimulate new bone growth through neovascularization.

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Click on the topics below to find out more from the Orthopaedic connection website ofAmerican Academy of Orthopaedic Surgeons.

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