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Wrist Arthroscopy

Wrist Arthroscopy

Wrist arthroscopy is a minimally invasive surgical procedure performed to view, diagnose and treat problems of your wrist joint. Recovery following wrist arthroscopy is generally more comfortable than an open surgery, which requires a larger incision. There is usually less pain following the procedure and the healing time is faster when compared to an open procedure.

Surgery for Thumb and Digit Arthritis

Surgery for Thumb and Digit Arthritis

Arthritis is an inflammatory condition of the joints. There are several types of arthritis; the most common type is osteoarthritis or wear-and-tear arthritis that affects the joint at the base of the thumb. Thumb arthritis is more common in women than men, and usually occurs after the age of 40 years.

Wrist Fracture Fixation

Wrist Fracture Fixation

Wrist fractures are breaks in any of the bones that form your wrist joint. Your wrist is made up of 8 small bones present in your hand and the adjacent ends of the 2 long bones of the forearm.

Carpal Tunnel Release Surgery

Carpal Tunnel Release Surgery

The common symptoms of carpal tunnel syndrome include numbness and tingling sensation in all the fingers except the little finger, pain and burning sensation in your hand and wrist that may radiate up the arm and elbow, and weakness in hand with diminished grip strength.

Open Carpal Tunnel Release Surgery

Open Carpal Tunnel Release Surgery

Carpal tunnel syndrome is a common, painful, progressive condition that is caused by compression of the median nerve at the wrist area.

Endoscopic Carpal Tunnel Surgery

Endoscopic Carpal Tunnel Surgery

Carpal tunnel can be treated with conservative measures or surgical intervention. Conservative treatment options may include treating any underlying medical conditions, such as diabetes and arthritis.

Wrist Ligament Reconstruction

Wrist Ligament Reconstruction

Surgical treatment in the form of wrist ligament reconstruction may be indicated in cases where the wrist ligament is completely torn. The ligament will usually need to be reconstructed when ligament damage is noted after a period of 6 months or more after the initial injury.

Artificial Finger Joint Replacement

Artificial Finger Joint Replacement

Arthritis develops when the cartilage wears-out, resulting in pain, stiffness and inflammation in the joints. It can affect any joint in the body, but the most commonly affected joints are the small joints of the fingers.

Peripheral Nerve Repair

Peripheral Nerve Repair

The peripheral nerves are the nerve fibers that compose the area from head to toe, connecting the brain and spinal cord with the rest of the body parts. Nerves transmit electrical impulses and signals to and from the brain. Peripheral nervous system disorders interrupt the transmission of signals and weaken the sensory and motor nerve functions.

Hand Fracture Surgery

Hand Fracture Surgery

A hand fracture is a break in one of the bones in the hand, which occurs when force greater than the bearable limit is applied against a bone.

Finger Joint Fusion

Finger Joint Fusion

Arthritis develops when the cartilage wears-out, resulting in pain, stiffness and inflammation in the joints. Arthritis can affect any joint in the body, but the most commonly affected joints are the small joints of the fingers.

Distal Radioulnar Joint Arthroscopy

Distal Radioulnar Joint Arthroscopy

The distal radioulnar joint (DRUJ) is a pivot type synovial joint located between the radius and the ulna just proximal to the wrist joint and assists in pronation and supination of the forearm.

Trapeziectomy

Trapeziectomy

Trapeziectomy is a surgical procedure to treat a medical condition called “thumb base arthritis”. The procedure involves removal of a small, cube-shaped bone known as the “trapezium” at the base of the thumb joint which joins your thumb to your wrist.

Elective Emergency Hand Surgery

Elective/Emergency Hand Surgery

Hand surgery is performed to restore the structure and functionality of the fingers, wrist and hand secondary to a traumatic injury, medical condition, severe infection, or birth defect causing pain and/or deformity of the hand. It is performed by trained and certified plastic surgeons. The surgery is done either as an emergency procedure or as an elective procedure depending on the condition and its severity.

Sports Injury Management of Hand, Wrist and Elbow

Sports Injury Management of Hand, Wrist and Elbow

Sports injuries are injuries that most commonly occur during sports and exercises. These injuries may result from accidents, poor training practices, and use of improper protective gear, lack of conditioning, and insufficient warm-up and stretching. The sports injuries may be either acute (sprains, fractures, tears) or chronic (tendinitis, overuse injury) injuries..

Arthritis of the Thumb

Arthritis of the Thumb

Arthritis is an inflammatory condition of the joints. There are several types of arthritis. The most common type is osteoarthritis or wear-and-tear arthritis that affects the joint at the base of the thumb. Thumb arthritis is more common in women than men, and usually occurs after the age of 40 years.

Trapeziometacarpal (TMC) Arthritis

Trapeziometacarpal (TMC) Arthritis

Trapeziometacarapal (TMC) joint arthritis, also known as carpometacarpal (CMC) joint arthritis or basilar thumb arthritis or rhizarthrosis, is a common form of arthritis that affects the first carpometacarpal (trapeziometacarpal) joint of the thumb. It is an inflammatory condition characterized by gradual wearing away of the cartilaginous surface of the TMC joint and the bones rubbing against each other causing inflammation and pain. It occurs most commonly in middle-aged, elderly, and postmenopausal women.

Wrist Sprain

Wrist Sprain

Injuries caused due to stretching or tearing of the ligaments in the wrist are called wrist sprains. Sprains can range from mild to severe, based on the extent of injury to the ligament.

Triangular Fibrocartilage Complex Injury (TFCC)

Triangular Fibrocartilage Complex Injury (TFCC)

The triangular fibrocartilage complex, or TFCC, is a complex of cartilage and ligaments located near the outer region of the wrist, below the little finger. It serves to stabilize the wrist, allowing easy movement and shock-absorption. Sports activities or falls can damage or injure the TFCC, causing wrist pain and instability. The injured TFCC may also produce a clicking sound with certain wrist movements.

Wrist Fracture

Wrist Fracture

The wrist is comprised of two bones in the forearm, the radius and ulna, and eight tiny carpal bones in the palm. The bones meet to form multiple large and small joints.

Scaphoid Fracture

Scaphoid Fracture

The scaphoid bone is a small, boat-shaped bone in the wrist, which, along with 7 other bones, forms the wrist joint. It is present on the thumb side of the wrist and is at high risk for fractures. A scaphoid fracture is usually seen in young men aged 20 to 30 years. They can occur at two places: near the thumb or near the forearm.

Distal Radius Fracture

Distal Radius Fracture

The forearm consists of two bones, the radius and ulna. The radius is the larger of the two forearm bones. The region towards the wrist is called the distal end. Fractures in this end are most common.

Distal Radioulnar Joint (DRUJ) Arthritis

Distal Radioulnar Joint (DRUJ) Arthritis

Distal radioulnar joint (DRUJ) arthritis is an inflammatory condition characterized by gradual wearing away of the cartilaginous surface of the radioulnar joint resulting in significant pain, swelling, stiffness, and interference in the functioning of the wrist and/or arm.

Arthritis of the Hand and Wrist

Arthritis of the Hand and Wrist

Arthritis is an inflammatory condition of the joints. There are several types of arthritis and the most common type is osteoarthritis or wear-and-tear arthritis. Arthritis affects various joints in the body and the arthritis in the hand affects the joint at the base of the thumb.

Triscaphoid Joint Arthritis

Triscaphoid Joint Arthritis

Arthritis is an inflammatory condition of one or more joints in your body. Triscaphoid joint arthritis is the localised pain and inflammation of the shared joint between the 3 carpal bones of your wrist. These bones are called scaphoid, trapezium, and trapezoid and are present at the base of your thumb.

Metacarpophalangeal Joint Arthritis

Metacarpophalangeal Joint Arthritis

The bones of the hand are called metacarpals and the bones of the fingers are called phalanges. The metacarpophalangeal joint or MP joint, also known as the first knuckle, is the large joint in the hand where the finger bones meet the hand bones. The MCP joint acts as a hinge joint and is vital during gripping and pinching. When arthritis affects the MP joint, the condition is called MP joint arthritis. The condition is more common in the thumb joint and index finger joint.

Hand Tumors

Hand Tumors

Any abnormal lump or bump on the hand is considered a hand tumor. Hand tumors can occur on the skin as a mole or a wart, underneath the skin soft tissue or on the bone. Most hand tumors are benign (non-cancerous); however, they can also rarely be malignant (cancerous).

De Quervain's Tendinosis

De Quervain's Tendinosis

Inflammation and swelling of the tendon sheaths put pressure on the adjacent nerves and leads to pain and numbness in the thumb side of the wrist. Strain on these tendons can cause swelling and irritation, and lead to a condition called De Quervain's tenosynovitis, which is characterized by inflammation.

Dupuytren's Contracture

Dupuytren's Contracture

Dupuytren’s contracture is a hand condition where thickening of the underlying fibrous tissues of the palm causes the fingers to bend inward. This makes it difficult to fully straighten the affected fingers.

Trigger Finger

Trigger Finger

Inflammation in the tenosynovium leads to a condition called trigger finger, also known as stenosing tenosynovitis or flexor tendonitis, where one of the fingers or thumb of the hand is caught in a bent position. The affected digit may straighten with a quick snap, like pulling and releasing the trigger on a gun, hence the name trigger finger.

Fractures of the Hand and Fingers

Fractures of the Hand and Fingers

A fracture is a break in the bone, which occurs when force greater than the bearable limit is applied against a bone. The most common symptoms of any fracture include severe pain, swelling, bruising or bleeding, deformity and discoloration of the skin and limited mobility of the hand.

Thumb Fracture

Thumb Fracture

A break or a crack in the bones of the thumb is known as a thumb fracture. Fractures may occur anywhere on the thumb, but a fracture at the base of the thumb, near the wrist, is considered the most serious.

Wrist Injuries and Conditions

Wrist Injuries and Conditions

Wrist injuries commonly occur due to falls or certain sports and activities that involve repetitive use or excessive stress or strain on the wrists. These include gymnastics, basketball, working on an assembly line, or typing. Some wrist conditions have no clear cause.

Wrist Injuries

Wrist Injuries

The wrist is a commonly injured joint in the body. Problems include sprains and strains as well as fractures that can occur with lifting and carrying heavy objects, while operating machinery, bracing against a fall, or from sports-related injuries.

Wrist Pain

Wrist Pain

Wrist pain is defined as any ache or discomfort in the wrist. The wrist is comprised of two bones in the forearm, the radius and ulna, and eight tiny carpal bones in the palm.

Wrist Ligament Tear and Instability

Wrist Ligament Tear and Instability

A ligament is a strong, flexible band of fibrous tissue. The wrist has many ligaments that help to keep the wrist bones in proper position providing stability to the joint.

Hand Injuries and Conditions

Hand Injuries and Conditions

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.

Flexor Tendon Injuries

Flexor Tendon Injuries

Tendons are bands of fibrous connective tissue that connect muscles to bone. Tendons aid in the movement of the fingers, hand and all other body parts.

Finger Sprain

Finger Sprain

Injuries that involve tearing or stretching of the ligaments of your fingers are termed as sprains. Sprains in the fingers are most often caused from a fall when you extend your arms to reduce the impact of the fall, or from overuse or repetitive activity of the thumb such as with texting.

Finger Dislocation

Finger Dislocation

Finger dislocation is a condition in which the bone of your finger has moved away from its normal position.

Extensor Tendon Injuries

Extensor Tendon Injuries

Tendons are bands of tissue connecting muscles to bones. The extensor tendon is a strong, smooth cord that connects finger bones to muscles in the hand. Extensor tendons are located just under the skin, directly on the bone, on the back of the hand and fingers. They allow you to open your hands and move or straighten your wrist, fingers, and thumb.

Hand Anatomy

The human hand is made up of the wrist, palm, and fingers and consists of 27 bones, 27 joints, 34 muscles, over 100 ligaments and tendons, and many blood vessels and nerves.

The hands enable us to perform many of our daily activities such as driving, writing and cooking. It is important to understand the normal anatomy of the hand to learn more about diseases and conditions that can affect our hands.

Bones of the Hand

The wrist is comprised of 8 carpal bones. These wrist bones are attached to the radius and ulna of the forearm to form the wrist joint. They connect to 5 metacarpal bones that form the palm of the hand. Each metacarpal bone connects to one finger at a joint called the metacarpophalangeal joint (MCP joint). This joint is commonly referred to as the knuckle joint.

The bones in our fingers and thumb are called phalanges. Each finger has 3 phalanges separated by two interphalangeal joints, except for the thumb, which has only 2 phalanges and one interphalangeal joint.

The first joint close to the knuckle joint is called the proximal interphalangeal joint (PIP joint). The joint closest to the end of the finger is called the distal interphalangeal joint (DIP joint).

The MCP and PIP joint act like hinges when the fingers bend and straighten.

Soft Tissues of the Hand

Our hand bones are held in place and supported by various soft tissues. These include: articular cartilage, ligaments, muscles and tendons.

Articular cartilages are smooth material that act as shock absorbers and cushion the ends of bones at each of the 27 joints, allowing smooth movement of the hand.

Muscles and ligaments function to control the movement of the hand.

Ligaments are tough rope-like tissues that connect bones to other bones, holding them in place and providing stability to the joints. Each finger joint has two collateral ligaments on either side, which prevents the abnormal sideways bending of the joints. The volar plate is the strongest ligament in the hand. It joins the proximal and middle phalanx on the palm side of the joint and prevents backward bending of the PIP joint (hyperextension).

Muscles of the Hand

Muscles are fibrous tissues that help produce movement. They work by contracting.

There are two types of muscles in the hand:

  • Intrinsic muscles are small muscles that originate in the wrist and hand. They are responsible for fine motor movements of the fingers during activities such as writing or playing the piano.
  • Extrinsic muscles that originate in the forearm or elbow control the movement of the wrist and hand. These muscles are responsible for gross hand movements. They position the wrist and hand while the fingers perform fine motor movements.

Each finger has six muscles controlling its movement: three extrinsic and three intrinsic muscles. The index and little finger each have an extra extrinsic extensor.

Tendons of the Hand

Tendons are soft tissues that connect muscles to bones. When muscles contract, tendons pull the bones, causing the finger to move. The extrinsic muscles are attached to finger bones through long tendons that extend from the forearm through the wrist. Tendons located on the palm side help in bending the fingers and are called flexor tendons, while tendons on top of the hand called extensor tendons help in straightening the fingers.

Nerves of the Hand

Nerves of the hand carry electrical signals from the brain to the muscles in the forearm and hand, enabling movement. They also carry the senses of touch, pain and temperature back from the hands to the brain.

The three main nerves of the hand and wrist include:

  • Ulnar nerve: The ulnar nerve crosses the wrist through an area called Guyon’s canal and branches to provide sensation to the little finger and half of the ring finger.
  • Median nerve: The median nerve crosses the wrist through a tunnel called the carpal tunnel. The median nerve provides sensation to the palm, thumb, index finger, middle finger and part of the ring finger.
  • Radial nerve: The radial nerve runs down the thumb side of the forearm and provides sensation to the back of the hand from the thumb to the middle finger.

All three nerves originate at the shoulder and travel down the arm to the hand. Each of these nerves has sensory and motor components.

Blood Vessels of the Hand

Blood vessels travel beside the nerves to supply blood to the hand. The main arteries are the ulnar and radial arteries, which supply blood to the front of the hand, fingers, and thumb. The ulnar artery travels next to the ulnar nerve through the Guyon’s canal in the wrist. The radial artery is the largest artery of the hand, traveling across the front of the wrist, near the thumb. Pulse is measured at the radial artery.

Other blood vessels travel across the back of the wrist to supply blood to the back of the hand, fingers and thumb.

Bursae of the Hand

Bursae are small fluid-filled sacs that decrease friction between tendons and bone or skin. They contain special cells called synovial cells that secrete a lubricating fluid.

  • American Society for Surgery of the Hand
  • American Academy of Orthopaedic Surgeons
  • California Orthopaedic Association
  • American Association for Hand Surgery
  • Orange County Medical Association