Hand & Wrist
The Swedish Orthopedic Institute features some of the region’s leading hand and wrist specialists. These surgeons are skilled in treating a wide range of hand problems, from the common to the complex.
The following are common hand and wrist problems treated at Swedish.
Carpal tunnel syndrome
Carpal tunnel syndrome is a condition in which one of the major nerves that controls the functioning of the hand and fingers becomes compressed inside a “tunnel” in the wrist. This compression can cause pain, numbness, tingling or a “funny feeling” in the fingers, hand or wrist. Treatments include rest, anti-inflammatory drugs or a wrist brace. Surgery is generally recommended if pain persists after six months of nonsurgical therapy. If not properly treated, carpal tunnel syndrome can cause irreversible nerve damage and permanent disability of varying degrees.
Dupuytren’s disease is an abnormal thickening of tissue beneath the skin in the palm of the hand. When this tissue thickens, it may eventually restrict movement. It is a genetic disease that commonly affects people of northern European heritage. Symptoms include a small knot in the palm of the hand, and later, in more advanced stages, a cord may develop between the palm and fingers drawing the fingers in to the palm. There is no permanent cure for Dupuytren’s disease. Surgery may be recommended to improve restriction of motion and restore function. Even following surgery, progression of the disease may occur.
Ganglions are the most common noncancerous soft-tissue bumps on the hands and wrists. They may be as small as a seed or as big as a cherry. One common type of ganglion, called a mucous cyst, develops in association with osteoarthritis of the hands and is frequently seen on the small joints of the fingers. Symptoms include bumps that may be tender to the touch, weakened grip and increased pain with activity. Nonsurgical treatment includes wearing a splint or draining the fluid within the bump. If pain persists or the cyst interferes with activity and motion, surgery may be recommended to permanently remove the cyst.
Rheumatoid arthritis is an inflammatory disease that affects the joints and surrounding tissues causing swelling, pain, stiffness and the possible loss of function. Rupture of chronically inflamed tendons is common, often requiring surgical reconstruction to restore function. Gradual erosion of wrist and finger joints may require joint replacement or fusion to restore stability and mobility.
Syndactyly (webbed fingers)
Syndactyly is a congenital abnormality, where a child is born with two fingers joined together. It may be as simple as a web of skin bridging the digits or as complex as fingers being bridged by bone. In most cases, separation of the fingers is recommended to improve function. Surgery is typically done between six to 12 months of age when the child is able to have anesthesia with minimal risk.
Trigger finger and thumb are painful conditions that cause the fingers or thumb to catch or lock in a bent position. The problems often stem from inflammation of tendons located within a protective covering called the tendon sheath. Symptoms include soreness at the base of the finger or thumb and a painful clicking or snapping when attempting to flex or extend the affected finger. Treatment usually involves anti-inflammatory medicines, wearing a splint and changing activities to reduce impact on the hand. If these methods prove unsuccessful, surgery may be recommended to release the pressure on the tendon sheath and restore movement.
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