WRIST AND HAND ELBOW SHOULDER LOWER BACK AND HIP KNEE FOOT AND ANKLE

A. WRIST AND HAND


TRIGGER FINGER

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Trigger finger is commonly seen around age of 40s. It starts with a painful straightening of affected finger. Later the finger triggers associated with sharp pain. When the condition advances, the affected finger needs to be pulled to straighten it. It may even get locked in severe cases. The condition can affect any of the fingers. But it commonly affects ring finger and thumb of diabetics.

We will assess how severely your finger is affected and suggest treatment. Milder forms will settle with medication. Moderately severe ones need a tiny injection. More severe trigger fingers will need operative release of tendon block at the base of the finger. This is a minor operation done under a local anesthetic. It will take about 7-10 minutes to complete the procedure in outpatient setting. The wound will heal in 5-7 days after which the sutures will be removed.

The condition may recur following medical treatment and injection. Recurrence is rare after surgery.

No known major complications


CARPAL TUNNEL SYNDROME

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This is another common condition affecting mainly females. it could affect any age but it is found to be common around 40-50 years of age. The condition caused by internal pressure on one of the nerves serving the hand at the wrist.

You will have pain and numbness over 1-3 fingers. Pain may radiate up to the elbow. Pain and numbness are worse at nights. You would feel comfortable after shaking the hand few times. Some will find it difficult to hold on to something above your head, milking coconut and squeezing anything for few seconds. Individuals with arthritis, thyroid hormone lack and during pregnancy may develop this condition.

A nerve function test named nerve conduction study for median nerve will be done. The test will confirm if you have nerve compression and it will also say how severe the compression is. Night splinting and medication will help in milder forms. Others will need surgical release of pressure on the nerve.

This is a minor operation done as opd basis. 3-4 cm cut is made over the palmar side of the wrist under a local anesthetic. There will be a pressure cuff inflated over the upper arm which you will feel little tight towards the end of the procedure however everyone manages it without a problem.

The procedure can be done under 10 minutes. The will be 3-4 stitches. Your hand will be bandaged with cotton and crepe. You will be given few pain killers and an antibiotic to take home.

The wound will be checked in one week and the stitches will be taken off in 10 days.


PAIN AND SWELLING SIDE OF THE WRIST AT THE BASE OF THE THUMB.(DE QUIERVAIN’S TENOSYNOVITIS)

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This condition arises with inflammation and swelling of tendons serving the thumb at the side of the wrist at the base of the thumb as they slide under a tissue sling. Movements of the thumb aggravate the pain. Swelling will be felt bony hard as the problem becomes chronic. Pregnancy may precipitate or aggravate the condition.

Milder forms can be treated with medication and cortisone injections. It may recur. Severe ones will need surgical release under a local anesthetic. The procedure is similar to carpal tunnel release described above.