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Wrist and Hand

The Wrist

Sprains and fractures

Acute injuries to the wrist often occur as a result of a fall onto an outstretched hand. Common injuries include fractures of the distal radius and scaphoid bones, or ligament tears. Fractures are confirmed on x-ray and are managed with immobilisation in a cast for 4-6 weeks. A short course of physiotherapy once the cast is removed is often required to restore range of motion and to increase the strength of the muscles that move and stabilise the wrist. Sprains are managed with physiotherapy treatment, including bracing, joint mobilisation, massage, stretching and strengthening exercises.

de Quervain's tenosynovitis

de Quervain's tenosynovitis is an overuse condition affecting two of the tendons that attach to and are responsible for some of the primary movements of the thumb. Pain is felt along the base of the thumb, often extending down into the radial aspect of the wrist and forearm. de Quervain's typically responds well to physiotherapy when treated in its early stages. In some cases referral to a specialist for a cortisone injection may be required.

Carpal tunnel syndrome

The carpal tunnel is a space in your wrist in which several tendons and a nerve called the median nerve run through. In patients with carpal tunnel syndrome the median nerve gets compressed by the surrounding tendons. This causes a burning pain on the under-surface of your wrist, along with numbness or pins and needles in the thumb, index, middle and ring fingers. Occasionally pain can be felt radiating up further along the arm. Most mild cases respond well to conservative treatment including physiotherapy and splinting. In more severe cases surgery may be required.

The Hand

Mallet finger

Mallet finger is a flexion deformity of the finger, in which damage to the tendon means you are unable to fully straighten the end of your finger. It commonly results from a ball striking the top of your fingertip. Treatment of an uncomplicated mallet finger involves splinting the finger in an extended position for a period of 8 weeks, with the splint then worn for a further 6-8 weeks when competing in sport and at night. Failure to fully comply with treatment can result in a chronic deformity of the finger.

Sprains and fractures

Ligament sprains and bony fractures can typically occur to the fingers in contact or ball sports. Both may be managed with splinting or taping and physiotherapy to restore range of motion and strength.

 

 

 

 


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