Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a progressive condition that occurs when the tissues surrounding the tendons in the wrist swell and put pressure on the median nerve.

Symptoms

CTS causes pain, numbness, and tingling in the hand and arm. It’s also an important cause of work disability. 

Causes

CTS is often caused by overuse and repetitive motion.

Treatment

Nonsurgical treatments are available for mild cases of CTS. These treatment options include splinting, hand therapy, and steroid injections.

In moderate to severe cases of CTS, when non-surgical treatments fail to provide relief, surgical intervention is recommended.

During endoscopic surgery, a small incision is made at the base of the wrist. After the incision is made, an operative scope (camera) is inserted into the wrist, enabling the surgeon to navigate the nerves, tendons, and the area of compression. The camera is equipped with a surgical knife which is used to cut the transverse carpal ligament, relieving pressure on the median nerve.

Trinity Health’s hand and wrist surgeons are experienced in minimally-invasive, endoscopic techniques that result in less pain and scarring than traditional open surgery.

Hand Fracture

A hand fracture is a break or crack in any of the various bones that comprise the hand.

Symptoms

Signs of a hand fracture include pain, swelling, bruising, and an appearance of deformity.

Causes

Trauma is the most frequent cause of hand fractures, most often due to falls, motor vehicle crashes, sports, or workplace injuries.

Treatment

Depending on the severity of the fracture, a hand/wrist surgeon will suggest a range of approaches.

Immobilization involves limiting movement of the broken bone by applying a splint or cast. Reduction involves setting or positioning the fractured bones into position. In some cases, pins, rods, plates, or screws may be implanted to secure the bones during the healing process.

Hand therapy is extremely important in the rehabilitation of hand fractures. After your cast or splint is removed, you’ll likely need rehabilitation exercises or physical therapy to reduce stiffness and restore movement, strength, and function.

Hand Arthritis

Arthritis is most often associated with hips and knees, but hands can be just as vulnerable to its painful effects.

Symptoms

The most common symptoms of arthritis include pain, swelling, stiffness, decreased range of motion, and joint weakness.

Causes

Hand arthritis can stem from many factors – an old sprain or fracture, or simply wear and tear over years of usage. The important thing is not to ignore the pain. The sooner you address hand arthritis, the more successful you will be in relieving the symptoms of pain and limited movement.

Treatment

Supportive measures can help slow the progression of hand arthritis and promote healing. These include medications, splints, cortisone injections, and braces – including custom braces that can be molded to the shape of an individual’s hand.

Patients with advanced disease who don’t get relief from conservative treatments have multiple surgical options available. Hand procedures have advanced through the years, employing techniques that remove diseased bone and tissue and replace them with implanted material or involve fusion to promote relief. In the case of thumb arthritis, hand and wrist surgeons use slings and other methods to ease pain while preserving the thumb’s movement and flexibility.

Hand Tumors

A hand tumor is any bulge or bump on the hand or wrist that is not normally present. Tumors can occur in many forms, depending on the type of tissue. For example, there are lipomas or fatty tumors, neuromas or nerve tumors. Some common types of hand tumors are giant cell tumors and epidermal inclusions cysts. The term “tumor” doesn’t necessarily mean a bump is malignant. Most hand and wrist tumors are benign.

Symptoms and Causes

Giant Cell Tumor of the Tendon Sheath (TGCT) is a type of typically non-malignant tumor that occurs in or around a joint. Its effects can be significant, resulting in a loss of function and damage to neighboring tissue. Two types of TGCT tumors are localized tumors, which are the most common type and often can be surgically removed without recurrence; and diffuse tumors, which are harder to treat and more likely to recur. After removal, diffuse TGCT return in 20% to 50% of cases. If TGCT recurs, it can result in multiple surgeries and damage to the affected joints over time.

Epidermal Inclusion Cysts are benign tumors that form just under the skin in places where there may have been a cut or puncture. The cyst is filled with keratin – a soft, waxy material.

Treatment

Typically, the most successful treatment is removing the tumor with surgery. This allows a pathologist to analyze it and to determine the type of tumor. Often, surgery is done on an outpatient basis. Some patients may choose to do nothing and simply live with the tumor once they learn that it is non-cancerous. You and your hand surgeon can choose the best treatment plan.