• Home » Hand Surgery

Hand Surgery

hand-trauma

Industrial Hand Trauma

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

dupuytren-contracture

Dupuytren's Contracture

Dupuytren’s contracture is a hand condition where thickening of the underlying fibrous tissues of the palm causes the fingers to bend inward.

De Quervain's Tendinosis

De Quervain's Tendinosis

Inflammation and swelling of the tendon sheaths put pressure on the adjacent nerves and leads to pain and numbness in the thumb side of the wrist.

Forearm Fractures in Children

Forearm Fractures in Children

The radius (bone on the thumb side) and ulna (bone on the little-finger side) are the two bones of the forearm. Forearm fractures can occur near the wrist, near the elbow or in the middle of the forearm. Apart from this, the bones in children are prone to a unique injury known as a growth plate fracture.

Finger Sprain

Finger 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

Thumb Fracture

A break or a crack in the bones of the thumb is known as a thumb fracture. Fractures may occur anywhere on the thumb, but a fracture at the base of the thumb, near the wrist, is considered the most serious.

Boxer's Fracture

Boxer's Fracture

A boxer’s fracture is a break in the neck of the fifth metacarpal bone of the hand (below the pinky finger) close to the knuckle. The hand is composed of 3 types of bones: carpal or wrist bones, metacarpals or long hand bones, and phalanges or finger bones. Metacarpals consist of five long bones that connect the carpal with the phalanges.

Finger Dislocation

Finger Dislocation

Finger dislocation is a condition in which the bone of your finger has moved away from its normal position.

Carpal Instability

Carpal Instability

Carpal instability is the loss of alignment of the carpal bones and/or radioulnar joint. The wrist is a complex joint that connects the forearm to the hand and allows it to move.

finger-dislocation

Finger Joint Dislocation and Volar Plate Injury

Finger dislocation is a condition where the bones of your finger have moved away from its normal anatomical position.

flexor-tendon-injuries

Flexor Tendon Injuries

Deep cuts on the under surface of the wrist, hand or fingers can cut and injure the tendon, and make it unable to bend one or more joints in a finger.

Extensor Tendon Injuries

Extensor Tendon Injuries

Tendons are bands of tissue connecting muscles to bones. The extensor tendon is a strong, smooth cord that connects finger bones to muscles in the hand.

Fingertip Injuries

Fingertip Injuries

A fingertip injury is a wound or damage caused to the most distal portion of the finger. It can be a crush, a sharp cut, a tear or a combination of these, and can result in damage to the skin, nail or nailbed, tendon, pulp, bone, and nerve endings. It is one of the most common injuries to the hand and may occur due to accidents at home, work, or play.

Arthritis of the Thumb

Arthritis of the Thumb

Arthritis is an inflammatory condition of the 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.

ganglion-cyst

Ganglion Cyst

Ganglion cysts are swellings that most commonly develop along the tendons or joints of wrists or hands.

boutonniere-deformity

Boutonniere 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.

carpal-tunnel-syndrome

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.

Trigger Finger

Trigger Finger

Inflammation in the tenosynovium leads to a condition called trigger finger, also known as stenosing tenosynovitis or flexor tendonitis, where one of the fingers or thumb of the hand is caught in a bent position. The affected digit may straighten with a quick snap, like pulling and releasing the trigger on a gun, hence the name trigger finger.

Gamekeeper's Thumb

Gamekeeper's Thumb

Gamekeeper's thumb, also known as skier's thumb, is a tear of the ulnar collateral ligament, a band of tissue that supports the joint at the base of the thumb.

Skier's Thumb

Skier's Thumb

Skier's thumb, also known as, Gamekeeper's thumb is a tear of the ulnar collateral ligament, a band of tissue that supports the joint at the base of the thumb. Damage to the ulnar collateral ligament may lead to chronic instability of the thumb, creating problems in its normal functioning.

Distal Radioulnar Joint

Distal Radioulnar Joint (DRUJ) Instability

Distal radioulnar joint instability is the abnormal orientation or movement of the radius and ulna bones at the wrist in relation to one another.

Nerve Transfer

Nerve Transfer

A nerve transfer is a surgical procedure in which a portion of a healthy nerve is transferred to the site of a damaged nerve. This procedure is performed to restore normal function at the injured site. Healthy nerves that are near the site of injury and have a similar function to the injured nerve are ideally selected as donor's nerves to improve surgical outcomes.

Tendon Repair

Tendon Repair

Tendons are bands of tissue connecting muscles to bones. The extensor tendon is a strong, smooth cord that connects finger bones to muscles in the hand. Extensor tendons are located just under the skin, directly on the bone, on the back of the hand and fingers. They allow you to open your hands and move or straighten your wrist, fingers, and thumb.

Carpal Tunnel Release Surgery

Carpal Tunnel Release Surgery

The common symptoms of carpal tunnel syndrome include numbness and tingling sensation in all the fingers except the little finger, pain and burning sensation in your hand and wrist that may radiate up the arm and elbow, and weakness in hand with diminished grip strength.

Sports Injury Management of Hand, Wrist and Elbow Elective Emergency Hand Surgery

Sports Injury Management of Hand, Wrist and Elbow Elective Emergency Hand Surgery

Sports injuries are injuries that most commonly occur during sports and exercises. These injuries may result from accidents, poor training practices, and use of improper protective gear, lack of conditioning, and insufficient warm-up and stretching. The sports injuries may be either acute (sprains, fractures, tears) or chronic (tendinitis, overuse injury) injuries.

Surgery for Thumb and Digit Arthritis

Surgery for Thumb and Digit Arthritis

Arthritis is an inflammatory condition of the 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. Arthritis of the fingers causes swelling, pain, stiffness and malformation, all of which interfere with the use of the hand.

Hand Fracture Surgery

Hand Fracture Surgery

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.

Artificial Finger Joint Replacement

Artificial Finger Joint Replacement

Arthritis develops when the cartilage wears-out, resulting in pain, stiffness and inflammation in the joints. It can affect any joint in the body, but the most commonly affected joints are the small joints of the fingers.

Finger Joint Fusion

Finger Joint Fusion

The hands are made up of 27 bones, which are grouped into carpals, metacarpals and phalanges. Each bone is separated by the articular cartilage, which helps provide smooth gliding movements of the fingers.

Hand Anatomy

The human hand is made up of the wrist, palm, and fingers and consists of 27 bones, 27 joints, 34 muscles, over 100 ligaments and tendons, and many blood vessels and nerves. 
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 to learn more about diseases and conditions that can affect our hands.

Bones of the Hand

The wrist is comprised of 8 carpal bones. These wrist bones are attached to the radius and ulna of the forearm to form the wrist joint. They connect to 5 metacarpal bones that form the palm of the hand. Each metacarpal bone connects to one finger at a joint called the metacarpophalangeal joint (MCP joint). This joint is commonly referred to as the knuckle joint. 

The bones in our fingers and thumb are called phalanges. Each finger has 3 phalanges separated by two interphalangeal joints, except for the thumb, which has only 2 phalanges and one interphalangeal joint.

The first joint close to the knuckle joint is called the proximal interphalangeal joint (PIP joint). The joint closest to the end of the finger is called the distal interphalangeal joint (DIP joint).

The MCP and PIP joint act like hinges when the fingers bend and straighten.

Soft Tissues of the Hand

Our hand bones are held in place and supported by various soft tissues. These include: articular cartilage, ligaments, muscles and tendons.

Articular cartilages are smooth material that act as shock absorbers and cushion the ends of bones at each of the 27 joints, allowing smooth movement of the hand.

Muscles and ligaments function to control the movement of the hand.

Ligaments are tough rope-like tissues that connect bones to other bones, holding them in place and providing stability to the joints. Each finger joint has two collateral ligaments on either side, which prevents the abnormal sideways bending of the joints. The volar plate is the strongest ligament in the hand. It joins the proximal and middle phalanx on the palm side of the joint and prevents backward bending of the PIP joint (hyperextension).

Muscles of the Hand

Muscles are fibrous tissues that help produce movement. They work by contracting. 

There are two types of muscles in the hand:

  • Intrinsic muscles are small muscles that originate in the wrist and hand. They are responsible for fine motor movements of the fingers during activities such as writing or playing the piano.
  • Extrinsic muscles that originate in the forearm or elbow control the movement of the wrist and hand. These muscles are responsible for gross hand movements. They position the wrist and hand while the fingers perform fine motor movements. 

Each finger has six muscles controlling its movement: three extrinsic and three intrinsic muscles. The index and little finger each have an extra extrinsic extensor.

Tendons of the Hand

Tendons are soft tissues that connect muscles to bones. When muscles contract, tendons pull the bones, causing the finger to move. The extrinsic muscles are attached to finger bones through long tendons that extend from the forearm through the wrist. Tendons located on the palm side help in bending the fingers and are called flexor tendons, while tendons on top of the hand called extensor tendons help in straightening the fingers.

Nerves of the Hand

Nerves of the hand carry electrical signals from the brain to the muscles in the forearm and hand, enabling movement. They also carry the senses of touch, pain and temperature back from the hands to the brain.

The three main nerves of the hand and wrist include: 

  • Ulnar nerve: The ulnar nerve crosses the wrist through an area called Guyon’s canal and branches to provide sensation to the little finger and half of the ring finger. 
  • Median nerve: The median nerve crosses the wrist through a tunnel called the carpal tunnel. The median nerve provides sensation to the palm, thumb, index finger, middle finger and part of the ring finger. 
  • Radial nerve: The radial nerve runs down the thumb side of the forearm and provides sensation to the back of the hand from the thumb to the middle finger. 

All three nerves originate at the shoulder and travel down the arm to the hand. Each of these nerves has sensory and motor components.

Blood Vessels of the Hand

Blood vessels travel beside the nerves to supply blood to the hand. The main arteries are the ulnar and radial arteries, which supply blood to the front of the hand, fingers, and thumb. The ulnar artery travels next to the ulnar nerve through the Guyon’s canal in the wrist. The radial artery is the largest artery of the hand, traveling across the front of the wrist, near the thumb. Pulse is measured at the radial artery. 

Other blood vessels travel across the back of the wrist to supply blood to the back of the hand, fingers and thumb.

Bursae of the Hand

Bursae are small fluid-filled sacs that decrease friction between tendons and bone or skin. They contain special cells called synovial cells that secrete a lubricating fluid. 

isforhiparthroscopy aaos aossm aana nys-society-of-orthopedic-surgeons

X

Tell a Friend