The Hand

Basic anatomy

The Hand is one of the most complex parts of the skeleton whose close array of small bones and muscles make it one of the reasons the human being has been so successful.

Therefore any pain, stiffness or weakness has a dramatic effect on our ability to function.

With such a vast number of problems which can affect this vital organ I summarise just few in this section.

Common problems

Of the many conditions which may affect the hand the following are some of the more frequent problems that I encounter.

Carpal tunnel syndrome

This occurs when a nerve in the wrist becomes tight in its tunnel resulting in tingling and numbness affecting mainly the thumb, index and middle fingers. Sensation in these areas is reduced. The hand feels clumsy and fine tasks such as using buttons, inserting earings or holding a pen may be difficult. Pain is often a feature and maybe worse in the very early morning or when the hand is raised up.

Treatment may involve a splint at night or a simple operation under local anaesthetic to release the nerve at the wrist.

Trigger finger

The finger (or thumb) becomes trapped when flexed and will only open with force or assistance from the other hand. This is very successfully treated with a cortisone injection or a simple operation under local anaesthetic.

Dupuytren's Disease

This causes the finger(s) to become flexed down tethered by a tight band in the palm. In the early stages no treatment is needed but if it progresses to cause a fixed contracture which obstructs hand function surgery can be used to release the tight tissue.