Hand

ANATOMY OVERVIEW OF THE HAND

The part of the human anatomy that collectively contains the most bones – one- quarter of the bones in the body – is the hand, with a total of 27 bones. Fingers are made up of 14 bones, with two phalanges in the thumbs and three in each finger. Additionally, there are 20 joints plus three primary nerves – the radial, median and ulnar – in each hand. Nine tendons in the hand connect the muscles to bone and assist in hand movement.

INJURIES TO THE HAND

Hand injuries can be quite painful and disabling. Without full sensation and movement in the joints, tendons and muscles, injuries can limit the ability to use your hands, thumb and fingers for many daily activities and functions.

While arthritis can take many forms, the condition generally is inflammation of one or more of the joints in your hand. Left untreated, the joints can lose their normal shape and lead to more pain and further limitations.

One of the prevalent types of arthritis is osteoarthritis (sometimes referred to as “wear and tear” and typically is found in older people); it often affects the joint at the base of the thumb (the basal joint).

Rheumatoid arthritis is a chronic autoimmune disease that causes joints to swell, resulting in painful stiffness of the joint. It is one of the most common forms of arthritis in the hand, in addition to osteoarthritis and post-traumatic arthritis.

Hand fractures typically occur following an injury related to trauma, such as twisting, falling and crushing, or playing sports. A common hand fracture is known as a “boxer’s fracture” where the fifth metacarpal is fractured and the knuckle becomes depressed.

Trauma can also be the cause of tendon injuries in the hand. When the flexor tendon is cut, it becomes impossible to bend the joints in the finger and the thumb.

Other types of hand impairments include sprains, nerve injuries and cysts.

COMMON CONDITIONS

Trigger finger – affects the tendons in the fingers and thumb and limits movement

Mallet finger – a tendon or bony injury causing the fingertip to droop which cannot be actively straightened

Dupuytren’s Disease – causes contracture of the fingers or thumb inward toward the palm

De Quervain’s Tendinosis – occurs when the tendons at the base of the thumb become irritated

WHEN TO SEE A SPECIALIST

It may be time to seek medical treatment from a hand specialist if you are experiencing any of the following symptoms:

• Increased hand and arm discomfort
• Pain in the fingers while carrying, gripping, grasping or twisting objects
• Swelling and discomfort in the hand or afflicted joint
• Changes in range of motion in the surrounding joints; for instance, if you are experiencing thumb joint pain, your adjacent finger joints may become more mobile than usual
• Warmth and/or redness in the hand, palm and fingers
• Numbness, tingling or throbbing of the hand while resting or sleeping
• The development of cysts on the end joints of your fingers

TREATMENT OPTIONS

Your doctor will discuss all treatment options with you. The best treatment for your injury or condition will be determined in combination with your overall health.

There are several nonoperative treatment options for hand pain. These might include activity modification, occupational hand therapy, pain management in the form of over-the-counter or prescribed medications and/or anti-inflammatories, injections and splinting. If surgery is necessary, PSO hand specialists can perform a wide variety of procedures ranging from minimally invasive to major reconstruction such as finger joint replacement.