The Wimsey Hand Clinic

Hand

Hand Anatomy

The human hand is made up of the wrist, palm, and fingers. The hands enable us to perform many of our daily activities such as driving, writing and cooking. It is important to understand the normal anatomy of the hand in order to learn more about diseases and conditions that can affect our hands.

Fractures of the Hand and Fingers

The hand is one of the most flexible and useful parts of our body. Because of overuse in various activities, the hands are more prone to injuries, such as sprains and strains, fractures and dislocations, lacerations and amputations while operating machinery, bracing against a fall and sports-related injuries.

Trigger Finger

The ability to bend the fingers is governed by supportive tendons that connect muscles to the bones of the fingers. The tendons run along the length of the bone and are kept in place at intervals by tunnels of ligaments called pulleys. When the fingers bend or are straightened, a slippery coating called tenosynovium helps the tendons smoothly glide through the ligaments with reduced friction. Inflammation in the tenosynovium leads to a condition called trigger finger

Dupuytren's Contracture

Dupuytren’s Contracture is a hand condition where thickening of the underlying fibrous tissues of the palm cause the fingers to bend inward. Patients with this condition are unable to fully straighten the affected fingers. The cause of Dupuytren’s contracture is unknown.

De Quervain's Tenosynovitis

The muscles and bones of the hand are connected by thick flexible tissue called tendons. Tendons are covered by a thin soft sheath of tissue known as synovium. Inflammation and swelling of the tendon sheaths puts pressure on the adjacent nerves and leads to pain and numbness in the thumb side of the wrist. Strain on these tendons can cause swelling and irritation and lead to a condition called De Quervain's tenosynovitis, which is characterized by inflammation.

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a common, painful, progressive condition that is caused by compression of the median nerve at the wrist area. Common symptoms of carpal tunnel syndrome include numbness and tingling sensation in all the fingers except little finger; pain and burning sensation in hand and wrist that may radiate up the arm and elbow; and weakness in hand with diminished grip strength.

Treatment of Dupuytren's contracture with Xiaflex

Dupuytren’s contracture can be treated by both non-surgical and surgical methods. The new and effective treatment for Dupuytren’s contracture is treatment with Xiaflex (collagenase Clostridium histolyticum). Xiaflex is comprised of two collagen enzymes that have hydrolytic activity and breaks the collagen that causes contracture.

Flexor Tendon Injuries

Tendons are the bands of fibrous connective tissue that connect muscles to bone. Tendons aid in movement of the fingers, hand and all other body parts.

Mallet Finger

Mallet finger is a condition where the end of the finger is bent and does not straighten. It occurs when the extensor tendon on the back of the finger is damaged. The finger joint is a hinge-joint that allows bending and straightening of the fingers. Each finger is composed of 3 phalanges bones, joined by 2 interphalangeal joints (IP joints).

Finger & Thumb Sprain

Injuries that involve tearing or stretching of the ligaments of your fingers are termed as sprains. Sprains in the fingers are most often caused from a fall when you extend your arms to reduce the impact of the fall, or from overuse or repetitive activity of the thumb such as with texting.

Thumb Fracture

A break or a crack in the bones of the thumb is known as a thumb fracture. Thumb fractures can occur from a direct blow, a fall, and muscle contractions or twisting during sports such as football, hockey, skiing and wrestling. Fractures may occur anywhere on the thumb, but a fracture at the base of the thumb, near the wrist, is considered the most serious.

Boutonnière Deformity

Tendons in your fingers connect the finger bones to finger muscles and help bend and straighten the finger at the joint when the muscles contract. Boutonnière deformity is a condition in which a tendon injury to the middle joint of the finger results in the inability to straighten the affected finger.

Thumb Arthritis

Arthritis is an inflammatory condition of joints. There are several types of arthritis; the most common type is osteoarthritis or wear-and-tear arthritis that affects the joint at the base of the thumb. Thumb arthritis is more common in women than men, and usually occurs after the age of 40 years. Patients who have arthritis of the fingers may have swelling, pain, stiffness, and malformation all of which interfere with use of the hand.