Common Hand conditions including golfer's elbow, tennis elbow, olecranon bursitis, and cubital tunnel syndrome. These conditions can cause elbow pain, swelling, and stiffness.

Osteoarthritis of the Wrist

Arthritis is wear and tear of the joint. There are two main types of arthritis: 'Osteoarthritis' (Degeneration) and 'Inflammatory arthritis' (Rheumatoid arthritis). Osteoarthritis is a slow process that develops over many years. In this type of arthritis the joint cartilage gradually roughens and becomes thin. Small bits of loose cartilage may float around the joint. The bone underneath thickens and the bone at the edge grows outwards causing bony spurs (osteophytes).  The joint may swell as the body makes extra fluid to lubricate the joint.

DeQuervains Tenosynovitis

It is a painful condition that affects a couple of tendons of the thumb as they run through a tunnel on the thumb side of the wrist. It was described in the late 19th century by De Quervain.

There are two tendons (Abductor Pollicis Longus and Extensor Pollicis Brevis) that pass through a tunnel known as the first dorsal compartment on the thumb side of the wrist . They help move the thumb away from the hand. In De Quervain’s syndrome there is thickening of this tunnel resulting in narrowing of the area. The tendons get squeezed and the slippery covering over the tendons (synovium) become inflamed which causes pain. Many people have two small separate tendon tunnels and are predisposed to this problem.


Ganglion and Cysts

Our body has a lubricant in its joints or in the tunnels through which tendons pass. This lubricant is called the synovial fluid. Usually due to an unknown cause or sometimes due to an injury or arthritis, this lubricant leaks. This lubricant has special proteins that make it thick and the body is unable to absorb it. It so forms a ganglion which is like a balloon filled with thick fluid.

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Wrist Fracture

While any of the many bones in the wrist can break, fracture of the wrist normally refers to a break(s) of the end of the forearm bones, which are the 'radius' on the thumb side, and the 'ulna' on the little finger side. It is very commonly seen in children and in later life around the age of 60 due to osteopenia. In young adults, it is usually seen after high-energy injuries (biking accidents). Colles’ fracture or Smiths’ fracture (named after Abraham Colles and Robert Smith who described patterns of these fractures in 1814 and 1847 respectively). Colles described the fracture, which tips backwards, while Smith described the fracture that tips to the front.

Ligament and TFCC

The wrist is one of the most complex joints in the body. It consists of 8 carpal bones arranged in two rows. These bones articulate with one another and the two-forearm bones - the radius on the thumb side and the ulna on the little finger side. All the bones and the joints they form, are stabilized by a number of ligaments. The ligaments also control the movements of the bones with one another. In addition there is also a joint between the radius and ulna (the distal radio-ulnar joint). This joint is connected to the wrist by a complex of ligaments, tendon and a cartilage disc. The complex that stabilizes the wrist at the distal radioulnar joint is known at the ‘triangular fibrocartilage complex’ (TFCC). It also bears most of the forces that go through the wrist.

Carpal Tunel Syndrome

The hand is supplied by three nerves. One of them is called the median nerve and like a telephone cable it passes through a protective conduit (a tunnel) on the front of the wrist. This tunnel is called the carpal tunnel. It also contains tendons that bend the finger and thumb. The nerve can get compressed in this tunnel and cause symptoms. The condition is known as a Carpal Tunnel Syndrome. The main symptom is tingling or pins & needles in the hand. The symptoms usually affect the thumb, index, middle and ring fingers. This is because the median nerve supplies these fingers. Tingling is often worse at night or first thing in the morning. It may be provoked by gripping. In the early stages the symptoms are intermittent but later become continuous as the condition worsens. The patient will notice numbness in the fingers and thumb together with weakness and wasting of the muscles at the base of the thum. They may drop objects and feel clumsy with their hand(s). They may also complain of pain in the wrist and forearm.