The Hand

An amputation is the removal, by accident or by surgery, of a body part. Amputations in the hand are commonly the result of a traumatic injury but may be the result of a planned operation to prevent the spread of disease in an infected finger or hand. Occasionally, traumatically-amputated fingers may be replanted (reattached). However, in many cases, reattachment of the amputated finger is not possible or advisable because a person may be more comfortable and have better function if the part is not reattached. This is due to risk that the reattached part could be chronically painful, stiff, and/or have an abnormal or absent feeling.

An animal bite to the hand is very common and can cause pain and other problems, especially when it becomes infected. Early and proper treatment is the key to prevent problems from an animal bite.

Splints and casts are supports that are used to protect injured bones and soft tissues. An arm cast completely encircles the limb with a hard, rigid outer shell. A splint provides rigid support along just a portion of the limb, with soft or open areas in between.

Replantation is the surgical reattachment of a finger, hand or arm that has been completely cut from a person’s body. The goal of this surgery is to give the patient back as much use of the injured area as possible.

A congenital hand difference is a birth defect involving a hand that is abnormal at birth. One in 20 children is born with this birth defect. These can be either major or minor. Some possible differences include missing parts (failure of formation), webbed or fused parts of the hand (failures of separation), extra parts in the hand (duplication), or parts that are larger or smaller than normal.

A Boutonniere deformity can happen for several reasons. It can happen from a cut of the tendon on the back of the finger or the thumb. It can also be due to tearing or weakening of the same tendon due to an injury or from a disease like rheumatoid arthritis.

A boxer’s fracture is a fracture (broken bone) of the hand. More specifically, it is a fracture of the neck of the fifth metacarpal (a bone in the “pinky finger"). It is referred to as a boxer’s fracture because, most commonly, it occurs when people punch something.

The brachial plexus is a group of nerves that come from the spinal cord in the neck and travel down the arm. These nerves control the muscles of the shoulder, elbow, wrist and hand, as well as provide feeling in the arm.

Finger tip injuries are one of the more common injuries in the hand. The finger tips are exposed in many of our activities.

The bones of the hand serve as a framework. This framework supports the muscles that make the wrist and fingers move. When one of these hand bones is broken (fractured), it can prevent you from using the hand, wrist and fingers.

A carpal boss is also known as a bossing. It is a bony overgrowth or lump on the back of the wrist at the base of the index (pointer finger) or long (middle finger) metacarpal bones where they join the carpal bones.

Carpal tunnel syndrome is essentially a pinched nerve in the wrist. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand. Carpal tunnel syndrome happens when swelling in this tunnel puts pressure on the nerve.

Smoking cigarettes, cigars, pipes and e-cigarettes have all been shown to negatively influence healing and worsen medical conditions in many parts of the body. This is due to nicotine, a chemical in these products. These effects can be seen in the hands and upper extremities.

Having cold hands at all times usually occurs due to decreased blood flow to the hands. Our bodies keep our hands warm primarily by regulating the blood flow that travels from the heart, down the arm, all the way to our fingertips. More blood to the hands means pink, warmer hands; less blood flow means colder and sometimes painful hands.

A cortisone shot can be used to treat some problems in the arm and hand. These can include trigger fingers, tendonitis, carpal tunnel syndrome, arthritis, tennis elbow and rotator cuff tendonitis. These injections usually contain a numbing medicine.

Cubital Tunnel Syndrome is a condition that involves pressure or stretching of the ulnar nerve (also known as the “funny bone” nerve), which can cause numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand.

Patients with de Quervain’s Tenosynovitis have painful tendons on the thumb side of the wrist. Tendons are the rope-like structures that the muscle uses to pull the bone. You can see them on the back of your hand when you straighten your fingers.

Dupuytren’s contracture is a disorder of the palm of the hand and fingers. In the normal hand there is a fibrous tissue called fascia. Fascia covers the important nerves, blood vessels, muscles, and tendons. Fascia also stabilizes the skin. In Dupuytren’s disease, this fascia can become abnormal. It becomes thicker, forming cords.

Extensor tendons are just under the skin. They lie next to the bone on the back of the hands and fingers and straighten the wrist, fingers and thumb. They can be injured by a minor cut or jamming a finger, which may cause the thin tendons to rip from their attachment to bone. If not treated, an extensor tendon injury may make it hard to straighten one or more joints.

Fibromyalgia is a condition that typically involves widespread pain. This diagnosis can have many different manifestations. The condition is generally considered to be centered around a heightened sensitivity of the nervous system, especially in the brain.

Movement in the hand and fingers is controlled by a system of muscles and tendons located in the forearm, wrist and hand. Tendons connect muscles to bone. When a muscle contracts, or tightens, the muscles power the tendons to move our bones. The ability to bend our fingers to make a fist is controlled by the flexor tendon.

Among the most common injuries to the hand and wrist in children are broken bones, also known as fractures. Children are not just small adults. Their bones have a different consistency and quality, like soft, fresh wood, as compared to when we age, our bones become more dried-out and brittle. Because children are still growing, their injuries need different evaluation, and sometimes different treatment.

Frostbite is an injury caused by exposure to freezing temperatures. Before freezing, skin of the fingers and hands may become red, then pale and numb. This is due to the body’s attempt to keep the major organs warm by constricting the blood vessels in the limbs.

A ganglion cyst is a lump at the hand and wrist that occurs near joints or tendons. It may be described as a mass, swelling, or bump.

Hand, wrist and elbow injuries are common for golfers of all skill levels. The golf swing is a complex, coordinated series of motions. Golf injuries can result from poor technique or overuse.

Gout is a type of arthritis that results in sore joints. With gout, crystals form in the joint. This causes irritation that is sometimes also present in the tendons near the joint.

These common hand and finger exercises are typically recommended by a hand therapist or a hand surgeon. They may be helpful in recovering after surgery, to relieve pain or to regain mobility.

Hand cramps, sometimes referred to as writers’ cramps or musicians’ cramps, are types of nerve disorders. Unwanted movements (spasms) or muscle aches (cramps) of hand muscles may occur when writing or playing a musical instrument, although they may also occur during other specific, fastmoving hand tasks.

Hand infections are common. They can affect patients of all ages. There are multiple types and causes of infections. Therefore, the treatment of these infections varies. It is important to recognize that long-term complications from hand infections can occur.

Anesthesia is a way to control pain during a surgery or procedure using medication. The types of medications used for this purpose are called anesthetics. Anesthesia can help control breathing, blood pressure, and heart rate.

Hand therapy is a type of rehabilitation performed by an occupational or physical therapist for patients that have conditions affecting the hands and upper extremities.

Applying a heat treatment or cold treatment is a common method for treating injuries, stiffness, swelling and pain.

When the skin comes in contact with something hot, it may be damaged, with death of cells in the skin. The severity of the injury depends on the intensity of the heat and the length of time that it is in contact with either heat or certain chemicals.

A jammed finger is common in sports but may also occur during regular daily activities. Even if the injured finger looks normal and can move normally, it may require medical treatment.

A “jersey finger” refers to a rupture of the flexor tendon, which is the tendon that bends the fingertip down. Its name comes from football athletes who have gripped the jersey of an opposing player who is trying to get away.

Kienbock’s disease is also known as avascular necrosis (AVN) of the lunate. The lunate is one of the eight small bones in the wrist. In this condition, the lunate bone loses its blood supply, leading to death of the bone.

In a joint replacement, the abnormal structures of the joint are removed and replaced. These structures are bone, cartilage, and synovium.

A mallet finger is a deformity of the finger. It occurs when the tendon that straightens the finger (the extensor tendon) is damaged at the fingertip.

Hand bones are called metacarpals. The finger bones are called phalanges. The metacarpophalangeal joint (MCP joint), or knuckle, is where the finger bones meet the hand bones. At the MCP joint, the fingers can move in multiple directions.

A nail bed injury can be very painful and prevent you from using your fingers; however, these injuries are treatable.

Nerve repair is required after a nerve is injured in such a way that it will not recover on its own. Nerves are bundles of fibers that carry messages between the brain and the rest of the body.

Nerves are the body’s “telephone wiring” system that carries messages between the brain and the rest of the body. Some nerves carry messages from the brain to muscles to make the body move. Other nerves carry messages about pain, pressure, or temperature from the body to the brain.

Carpal tunnel syndrome is a common condition with numbness in hands. However, it is not the only cause of hand numbness.

Arthritis—which literally means “inflamed joint”—can affect any joint in the body, including the joints between the 29 bones of the wrist, hand, and fingers. Arthritis of the hand can hurt and keep you from being able to do what you want or need to do.

Pain after an injury or surgery is common. There are many ways to manage and reduce this pain that may or may not include medication. Each patient, surgery, and surgeon are unique, and the approach to pain management is different for everyone.

Opioids are a type of pain medication made from the poppy plant. It is the same plant that is used to make opium and heroin. They are effective for treating acute or new pain after an injury or surgery.

A paraffin wax unit is a machine that heats and holds paraffin wax, a type of wax used for candles. The wax is intended to completely cover the hand (or other body parts such as the feet). Its warm temperature is meant to provide relief from arthritis pain, sore joints or sore muscles.

Pseudogout is a type of inflammatory arthritis that causes joint inflammation due to the body depositing calcium pyrophosphate crystals in the joint and soft tissues. Pseudogout is also called calcium pyrophosphate deposition disease (CPPD).

Arthritis describes any condition where cartilage in the joint breaks down. Normally, a joint consists of two smooth, cartilage-covered bone surfaces that fit together as a matched set and glide against one other.

There are several types of arthritis. Some kinds of arthritis are caused by trauma or over-use. Rheumatoid arthritis is different. Rheumatoid arthritis is caused by inflammation in the joint. This inflammation breaks down cartilage, which is the smooth lining of joints.

A ligament is a thick band of tissue that connects two bones. There are many ligaments in the wrist. When a ligament is injured, this is referred to as a sprain. A very common ligament injured in a sprained wrist is the scapholunate ligament.

Scar formation is a normal response following any injury or surgery; it is the way the body heals injured structures. Scar tissue may involve only the superficial skin, or it may involve the deeper tissues beneath the skin, including nerves and tendons.

Skiing and snowboarding are some of the most popular winter sports and can result in different injuries to the upper extremity. Fortunately, there are some ways to decrease the chance for injury.

Cancer of the skin is a change in your skin cells during which they grow abnormally and form a malignant tumor. These abnormal cells can invade your body, become implanted in other organs, and continue to grow, a process called metastasis.

A sprain is an injury to a ligament, which is a soft tissue that connects bones to each other at joints.

The most common ligament to be injured in the thumb is the ulnar collateral ligament. This helps connect the thumb to the hand on the side near the index finger.

A variety of problems can cause stiff hands, limiting the use and function that we often take for granted. Stiffness can occur when there are problems within and around the structures of a joint, including ligaments and muscles.

In a swan neck deformity, the middle joint of a finger is extended (bent back) more than normal. The end joint is flexed (bent down).

Swollen fingers and general swelling in the hands and arms is common with many injuries and medical conditions. It is important to identify the cause so that appropriate treatment can be started, and complications can be avoided.

The hands, being composed of many types of tissue, including blood vessels, nerves, skin and skin-related tissues, bones, and muscles/tendons/ligaments, may show changes that reflect a disease that affects other parts of, or even the whole body (systemic disease).

The tendon is the strong cord at either end of a muscle that is attached to bone. Tendons, combined with their muscles, allow you to move your joints.

A joint is formed when two bones meet and articulate, which allows movement. Joints are lined with smooth cartilage that allows for the easy movement of one bone relative to another. Osteoarthritis, or degenerative arthritis, is a process that occurs with aging and describes the deterioration of the joint cartilage.

A trigger finger is a very common and treatable problem. It can occur in both fingers and the thumbs, which have tendons that help them to bend.

A vascular disease is a problem with arteries and veins. Arteries are hose-like structures that bring oxygen-rich blood away from the heart to the fingers. Veins are also hose-like structures or pipes that return the used blood back to the heart and lungs.

Warts are bumps on the skin and may feel rough to the touch. The technical name is verruca vulgaris. They appear in areas of skin that grow faster than normal due to a virus called human papilloma virus (HPV).

Any abnormal lump or bump in the hand or wrist is considered a tumor. The term “tumor” does not necessarily mean it is malignant or that it is a cancer. In fact, most wrist and hand tumors are benign (not cancer).