HandThe carpal tunnel is located under the base of your palm. It has rigid, unyielding boundaries: The back and sides of the carpal tunnel is made up of the bones of your wrist. The front of the carpal tunnel, just under your palm, is made up of a very thick ligament, the transverse carpal ligament. Your median nerve is the nerve that provides sensation to your thumb, index finger, middle finger and half of your ring finger. It runs through the carpal tunnel along with nine tendons that move your fingers and thumb, and the tendons’ lining, which is called the tenosynovium. more
Cubital tunnel syndrome is very similar to carpal tunnel syndrome. Cubital tunnel syndrome is when the ulnar (funny bone) nerve is pinched at your elbow. It gets pinched by the fascia (ligament-like tissue) over it. It gets pinched more when you bend your elbow, as this decreases the space under the fascia available for the nerve. It’s also worse when you put pressure on it, such as when leaning on you’re the funny bone part of your elbow while at a desk or when driving. This leads to numbness of the small finger, and often the ring finger. If other fingers are involved you probably also have carpal tunnel syndrome, as they often occur together. more
Trigger finger is when the tendon that flexes your finger (or thumb) gets stuck in the pulley (tunnel) that it goes through. As we age, or due to diabetes, thyroid disorders, or sometimes for unknown reasons, the tunnel stiffens and shrinks. The tendon that goes through it gets stuck and often ‘balls up’ to form a palpable nodule in front of the pulley. Trigger finger is often worse in the morning, and is often associated with carpal tunnel syndrome. more
Arthritis commonly affects the base of the thumb. In fact, approximately 11% of post-menopausal women develop painful arthritis in this area. It’s often worse with pinching and gripping, such as when opening up a jar or turning a key. It may also occur in people who have fractured or dislocated their thumb. more
Arthritis can occasionally affect the fingers. The fingers can be affected by osteoarthritis (‘wear and tear’ arthritis), rheumatoid (inflammatory) arthritis, or arthritis that occurs because of joint injury (post-traumatic arthritis). There are three finger joints that can be affected. The distal interphalangeal joint (DIJ) is the smallest joint closest to your finger tip. The proximal interphalangeal joint (PIJ) is the joint in the middle of the finger. The metacarpophalangeal joint (MPJ) is the main big knuckle, where the finger attaches to the hand. more
Rheumatoid arthritis (RA) is a systemic disease (ie. it affects much of the body). The primary treatment for RA is medical, and there are many new excellent drugs that can decrease pain and greatly slow the progression of RA. Surgery is used mainly to prevent and correct deformities, to protect and repair the finger tendons that this disease damages, to treat destroyed and painful joints, and to return function. In addition, cosmesis is usually improved by surgery. more
Dupytren’s contracture is a genetic disorder in which the fascia of your hand contracts so that you can’t extend your fingers. What is fascia? When you order a piece of meat, the tough grisel around the meat is fascia.
Dupytren’s contracture occurs in people of Scandinavian (viking) ancestry. Now, the vikings got around back then, so their genes can show up in people that don’t realize that they have some vikings in their family tree. more
Tendon lacerations in the hand are a serious problem, especially on the palmar side, where the flexor tendons are. The anatomy of the tendon complex is complicated. The flexor tendons have to go through sheaths (tunnels) in order to function properly. There is a limited amount of space in these tunnels, and just a little bit of scar can cause the tendon to stick down so that the finger doesn’t move. more
Spinal cord injury resulting in tetraplegia is a devastating, life-changing injury. Life becomes a battle for independence when even the smallest activity of daily living becomes a challenge.
The human mind and the human hand are wonderfully adaptable. Many determined tetraplegics can accomplish much without functioning fingers. Writing can be accomplished by wedging pens and pencils in the web spaces of the fingers. Both hands and the mouth can be used to manipulate objects. However, performing tasks in this way is neither fluid, effective, or time efficient. more
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