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Wrist and Hand Injuries
Acute injuries to the wrist often occur as a result of a fall onto an outstretched hand. Common injuries include fractures of the distal radius and scaphoid bones, or ligament tears.
Fractures are confirmed on x-ray and are managed with immobilisation in a cast for 4-6 weeks. A short course of physiotherapy once the cast is removed is often required to restore range of motion and to increase the strength of the muscles that move and stabilise the wrist.
Sprains are managed with physiotherapy treatment, including bracing, joint mobilisation, massage, stretching and strengthening exercises.
Carpal Tunnel Syndrome
The carpal tunnel is a space in your wrist in which several tendons and a nerve called the median nerve run through.
In patients with carpal tunnel syndrome the median nerve gets compressed by the surrounding tendons. This causes a burning pain on the under-surface of your wrist, along with numbness or pins and needles in the thumb, index, middle and ring fingers. Occasionally pain can be felt radiating up further along the arm.
Most mild cases respond well to conservative treatment including physiotherapy and splinting. In more severe cases surgery may be required.
De Quervain's Tenosynovitis
De Quervain’s tenosynovitis is an overuse condition affecting two of the tendons that attach to and are responsible for some of the primary movements of the thumb. Pain is felt along the base of the thumb, extending down the outside of the wrist and forearm.
It is most common is new mothers due to repetitive lifting and is best treated with splinting and referral to a specialist for a cortisone injection.
Sprains and Fractures
Ligament sprains and bony fractures can typically occur to the fingers in contact or ball sports. Both may be managed with splinting or taping and physiotherapy to restore range of motion and strength
Mallet Finger
Mallet finger is a flexion deformity of the finger, in which damage to the tendon means you are unable to fully straighten the end of your finger. It commonly results from a ball striking the top of your fingertip.
Treatment of an uncomplicated mallet finger involves splinting the finger in an extended position for a period of 8 weeks, with the splint then worn for a further 6-8 weeks when competing in sport and at night.
Failure to fully comply with treatment can result in a chronic deformity of the finger.
