Common Injuries of the Wrist and Hand

Wrist and Hand Anatomy

The hand including the wrist consists of 27 bones

8 carpals make up the wrist

5 metacarpals form the structure of the hand

14 Phalanges are the bones of the fingers

Wrist and Hand Anatomy

8 muscles create movement at the wrist

3 Muscles move the hand8 muscles move the thumb9 muscles move the fingers

Did you know…

Injury to the thumb ligament is one of the more common skiing injuries. It ranks second only to knee sprains.

Fractures of the Wrist and Hand

Finger fractures- can involve any of the three phalanges (bones) in each finger (two in the thumb) Most finger fractures can be treated with a finger

splint, but if the fracture is severe may be necessary to use pins, wires or screws

Boxers fracture – break in the 5 metacarpal leading to the little finger Often the result of slamming a clenched first against a

solid object

Fractures of the Wrist and Hand

Baseball Finger- an injury to the finger resulting from tearing of the finger tendon and damage to the cartilage Occurs when a ball or other object strikes the tip of the

finger bending it beyond its normal range of motion

Scaphoid fracture – a break in the scaphoid bone in the thumb The most commonly fractured bone in athletics – often

occurs from falling onto an outstretched hand

Tendonitis

Inflammation of tendons caused by overuse or repetitive stress

deQuervains Tenosynovitis- tendonitis originating at the base of the thumb

Tendonitis – Signs and Symptoms

Ache or pain at the wrist

Worsens with forceful gripping, rapid wrist movements or moving the wrist and fingers to an extreme position

Tendonitis – Treatment

Rest

Ice – Ice bath or Ice Massage

Anti-Inflammatory medications

Carpal Tunnel Syndrome

Carpal Tunnel is a passageway that runs from the forearm through the wrist, the median nerve runs through here

Median nerve – supplies feeling to the thumb, index and ring fingers

Carpal Tunnel Syndrome – an inflammatory disorder caused by irritation of the tissues and nerves around the median nerve

Carpal Tunnel Syndrome

Women are three times more likely than men to get carpal tunnel syndrome

Certain conditions can increase your risk: Diabetes Gout Hypothyroidism Rheumatoid arthritis Pregnancy Sprain or fracture of the wrist

Carpal Tunnel Syndrome – Signs and Symptoms

Pain, numbness and tingling in the wrist, hand and fingers

May experience sense of weakness and develop a tendency to drop things

May have trouble fastening buttons

Carpal Tunnel Syndrome – Signs and Symptoms

May feel that hands are swollen even though there are no visible signs of swelling

May lose a sense of heat and cold

Symptoms occur both when the hand is being used and when at rest

Carpal Tunnel Syndrome - Treatment

Affected hand and wrist should be rested for at least 2 weeks

Wear a wrist splint or brace to keep the wrist from bending

Ice massage or ice bath

Strengthening exercises

Carpal Tunnel Syndrome - Treatment

If carpal tunnel syndrome is left untreated the muscles on the thumb side of the hand can atrophy (shrink and waste away)

Rheumatoid Arthritis

A disorder that causes inflammation of the lining of the joints.

The body is mistakenly attacked by its own immune system.

It is a chronic disorder that can worsen over time and may never go away.

Rheumatoid Arthritis

Affects about 1% of the US population

Usually occurs between the ages of 30 and 60, but can also affect younger and older individuals.

Occurs three times more often in women than men.

Cigarette smoking and family history increase the likelihood of developing rheumatoid arthritis.

Rheumatoid Arthritis Signs and Symptoms

Pain, warmth and swelling at the joint

Joint pain usually occurs on both sides of the body at the same time.

Joint stiffness that usually occurs in the morning or after periods of inactivity.

Ongoing fatigue and low grade fever.

Rheumatoid Arthritis Signs and Symptoms

Inflammation of the lining of the joints can destroy cartilage and bone which can cause deformity of the joints.

As the condition progresses joints can develop considerable pain and loss of function.

Rheumatoid Arthritis X-Ray

Juvenile Rheumatoid Arthritis

The most common type of arthritis in kids.

Causes joint inflammation, stiffness and damage

Can affect a child’s growth.

Rheumatoid Arthritis - Treatment

There is no known cure for rheumatoid arthritis. Goal of treatment is to reduce inflammation and pain.

Moist heat, paraffin bath, acupuncture and regular exercise (avoid high impact activities) have been shown to help with symptoms related to rheumatoid arthritis.

Wrist and Hand Strengthening Exercises

Squeeze a stress ball Firmly squeeze the ball 20 times rest for

30 – 45 seconds and repeat

Wrist Stretch Extend hand away from the body Pull fingers towards the ground Hold the stretch for 20-30 seconds

Wrist and Hand Strengthening Exercises

Wrist Flexion Hold a dumbbell and bring arm over the

edge of a table with palm towards ceiling Bring hand up towards ceiling and lower

back down – repeat 15-20 times

Wrist Extension Hold a dumbbell and bring arm over the

edge of a table with palm towards floor Bring hand up towards ceiling and lower

back down – repeat 15-20 times

Preventing Overuse Injuries

Read the following article (click on hyperlink) Write a 300 word summary of the article (can be

written or typed Create 3 questions for a class discussion (print a

copy of the article if you want to refer to it during the class discussion)

Preventing Overuse Injuries