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General Hands

Most Common Ways to Injure the Hand

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The hand is one of the most impressive parts of the human body. Its a complex piece of biological machinery that lets people hold and manipulate items in ways that other creatures cant. If not for our hands, despite the power of the human brain, we may not have evolved to become the most dominant species on the planet. As important as our hands might be, they are also prone to injury. If you injure your hand, you will find that you cant do many of the things that you take for granted right now. For example, you would not be able to use your phone or tablet. Typing would be difficult, even driving and opening doors would be difficult if you do not have full use of your hands!

What Types of Injuries Affect the Hand?

The hand is exposed to many different types of injuries. Lacerations are quite common. Cutting your hand with a knife in the kitchen, for example, has happened to nearly everyone. Most of the time, cleanup and a bandage are all that you need. In severe cases though, there could be a deep cut that includes nerve damage. In those instances surgery would likely be necessary to restore full function of the hand.

Fractures and dislocations are common as well. These types of injuries could require the doctor to set the bone, and then splint or cast it so it can heal properly. In the event that the bones are not setting properly, it could require hand surgery. Other potential injuries from the hands come from burns, infections, crushing, soft tissue injuries, and amputations. Naturally, the symptoms for these different types of injuries vary.

Anyone who has a hand injury thats more than just a small cut or bruise may want to seek out a medical professional. Even with the small cuts, you will need to be careful to ensure that infection does not set in and cause more issues to the hand.

If there are any deep wounds, fractures, dislocations, bites, or burns (other than minor burns), contact a physician to get the proper care. Whenever there is any doubt as to whether it is a minor injury that can heal on its own or a more substantial injury, you should err on the side of caution and speak with a doctor.

Treating the Injuries

Because there are so many different types of hand injuries, the types of treatments necessary to repair the problem vary quite a bit. In some cases, simply resting the hand may be all that you need. For those who have a fracture, they will need to have the hand doctor set the bone and make sure it heals properly, as mentioned. Those who have burns will need a different course of treatment, and those who have amputated fingers will need a variety of treatments. In some instances, reattachment of a lost finger may be possible. However, regaining full function of the finger is not a guarantee.

Talk with your doctor about your injuries to determine the proper course of treatment, and with a hand surgeon for those issues that require surgery to correct properly. Its the best way to minimize your risks.

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Conditions General Hands

How to Deal With Skin Cancer of the Hand – Arora Hand Surgery

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Cancer is a condition that ranges widely and which can appear in almost any part of the body. It does occur on the extremities, including the hands and arms, and it is best treated quickly and by a qualified hand surgeon or expert.

Naturally, it may be difficult to recognize when skin cancer of the hand is present. Interestingly enough, it is the skin that is the organ most commonly affected by cancer, and on the hands the most common types of cancer to appear are:

  • Squamous cell carcinoma
  • Basal cell carcinoma
  • Melanoma

There are other rare forms of skin cancer of the hand, as well, and it takes a medical professional to perform any diagnosis. However, you can know if you are at greater risk for developing it. The following list of factors tend to apply:

  • Chronic sun exposure
  • Immune suppression
  • Fair or light complexion
  • Exposure to chemicals and/or radiation
  • If you have pre-malignant lesions in the past
  • Family tendency to melanoma
  • Genetic conditions relating to skin cancer

And while there are many online resources with photographs of various forms of skin cancer of the hand or upper extremity, the best way to get diagnosed is through a visit to a hand expert. Though there are some very clear indicators that can be used to visually identify potential carcinomas and melanomas (such as discolored nodules appearing on the skin, cutaneous horns forming in odd locations, and areas that wont heal), the expert opinion is the best.

Diagnosis and Treatment

You hand doctor will do a visual inspection and take a biopsy or sample of the tissue in question. This is sent to a lab that assesses it and determines if the tissue is indeed cancerous or pre-cancerous. In some cases a larger sample may be required to make a definitive diagnosis.

If cancer is present, the next step is often to examine the lymph nodes to be sure that the cancer has not metastasized (or expanded to another area of the body). This is done through biopsy or through a range of different scans, such as a CT scan.

When a full diagnosis and assessment is done, the most common treatment is removal of the tissue by a qualified hand surgeon. The traditional approach is to remove all of the tissue infected with cancer cells along with tissue at the edges of the cancerous region. A surgeon will also perform all essential repairs at the same time, such as grafting healthy skin over the excised area.

In certain types of cancer, removal is followed by radiation or chemotherapy to be sure that all cancerous tissue has been eradicated. And in extreme cases there can be a need for amputation, but this is, as indicated, an extreme.

If you suspect that you are at risk for developing skin cancer of the hand or upper extremity, or have noticed a long-lasting change in the skin of one part of the hand, do not hesitate to visit a surgeon. As the experts say, the best treatment for skin cancer of any kind is prevention (SkinCancer.org, 2015). If you suspect something wrong, your next best treatment is early detection and rapid action in the care of a hand surgeon.

Categories
General Hands

Injuries to the Extensor Tendon

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You have a number of important tendons throughout your hand. One of these is the extensor tendon, which is situated on the back of your hand and which allows you to straighten your fingers. The extensor tendons are all connected to muscles located in your arm and they extend all the way down the whole finger. Once in the finger, where space is smaller, the extensor tendons attach to smaller tendons that are, in turn, attached to small muscles. All of this works together to give you control over your fingers. At times, these tendons can become injured and can cause problems as well as pain.

Types of Extensor Tendon Injuries

Extensor tendons in your hand are very close to the surface of your skin. In fact, you can probably see them moving from time to time. Almost any injury to the back of the hand can do damage to the tendons, including:

  • Jamming your finger
  • Cutting the back of your hand
  • Bruising the back of your hand

Essentially, any injury can cause damage. Whenever the extensor tendon is injured, you may find it difficult to straighten your fingers properly. Tendon damage can be painful as well.

There are a few very common injuries to the extensor tendons, including the following:

  • Mallet Finger is a condition in which the extensor tendon is no longer connected to the bone in the finger, whether it was cut or torn away. When this happens, the fingertip will not be able to straighten. It happens most commonly through a cut or through jamming the finger and will require stitches to the tendon itself. Splinting will also be needed to ensure the finger stays straight.
  • Boutonniere deformities occur when the tendon is damaged at the middle joint of the finger, meaning the majority of the finger itself will not straighten out. If the tendon has been cut or torn, then it will need stitches. If it is just injured, then splinting will be used.
  • Cuts to the back of the hand can often sever one of the extensor tendons since they are so close to the skin. In this case, one or more fingers may not straighten. Splinting will need to extend from the wrist all the way down the injured finger.

Because the extensor tendons are so close to the surface, injury can happen very easily. It only takes a small amount of hand trauma to affect the tendons directly.

Treatment may change as well if there is other damage to the fingers, such as fractures or infections.

If you think you have an injury to an extensor tendon, then you will notice that you cannot straighten out one or more of your fingers. Additionally, if you have had damage or injury to the back of your hand, this will let you know the extensor tendons could be involved. You will need to see a doctor for treatment because a torn tendon will always require stitches. Additionally, you will need to learn how to properly splint your hand for healing.

Resources:

http://www.orthobullets.com/hand/6028/extensor-tendon-injuries

Categories
Conditions General Hands

Dealing with Psoriatic Arthritis of the Hand

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A lot of people know about osteoarthritis and rheumatoid arthritis, but not many realize that you can develop arthritis from the skin condition known as psoriasis. Psoriatic arthritis of the hand is somewhat rare, with around five to twenty percent of people with psoriasis developing arthritis related to it. However, it is common enough that it is very useful for anyone with psoriasis to learn about it, and its symptoms.

What Happens When You Have Psoriatic Arthritis?

If you have psoriasis, you are well aware of its appearance. Your skin takes on a very dry and scaly look, and it can often appear as if you have rashes in many areas of the body. The condition does tend to cause prolonged or even constant irritation to the skin, and it is this sort of irritation that eventually leads to the development of arthritis in the underlying bones and cartilage.

Because arthritis, which means “inflamed joint”, is something that can be due to chronic inflammation, it makes sense that psoriasis might eventually cause problems in the hands and wrists, where it is so prevalent. It does many of the same things that other forms of arthritis do when it does appear in the hands, and will lead to swelling, deformity of the joints, and a lack of stability in the wrist. The swelling of this condition, though, is more pronounced than any other form of arthritis (MayoClinic, 2015).

This is all due to the fact that the psoriatic arthritis is actually causing the lining of the joints to swell and to then degrade and allow bones to erode and rub against one another.

Many patients with psoriatic arthritis display many similar symptoms as those with rheumatoid arthritis. Their hands will appear swollen and with a red discoloration. They can be warm to the touch and will often have difficulty with stiffness and movement. However, unlike rheumatoid arthritis, psoriatic arthritis is usually asymmetrical (meaning it may appear on one hand and not the other), it causes skin lesions, and it tends to strike the PIP and DIP joint (the middle and end joints), rather than the middle joints or the wrist areas.

Diagnosing and Treating Psoriatic Arthritis

You must visit a hand doctor if you suspect that your psoriasis has now caused you to develop arthritis, especially if others in your family already have this condition. The physician will do a thorough history and exam. They may order a few tests and X-rays to determine if you do have the condition.

Should you be diagnosed with it, your doctor is going to focus on pain relief, alleviation of the swelling and inflammation, and function as the goals of treatment. This means you will work with more than just the hand doctor and may find yourself working with a therapist as well as other specialists. Medications and ongoing therapies are usually the most conservative treatments, and a hand doctor is likely to refrain from surgery until it is absolutely necessary. This is because it is a progressive issue, and surgery may be used as an intervention rather than an initial treatment of symptoms.

Dont hesitate to contact your doctor simply because the sooner you begin your treatment, the better the outcome.

Source

MayoClinic. Psoriatic arthritis: Symptoms. 2015. http://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/basics/symptoms/con-20015006

Categories
General Hands

Hand Numbness and Tingling Is Not Always Carpal Tunnel

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There has been so much press about the condition known as carpal tunnel syndrome, or CTS, that many people automatically assume that any numbness or tingling in their hands or fingers must be this fairly common condition. However, there are several other issues that can just as easily lead to symptoms shared with CTS.

For example, the American Society for Surgery of the Hand indicates that the “potential conditions” leading to numbness in the hands include: vascular disorders, cold hand disease, Erbs palsy, CTS, Complex Regional Pain Syndrome, nerve injury, and cubital tunnel syndrome.

Are these the only reasons behind numbness and tingling in the hands or arms? No, there is a surprisingly long list of possibilities. Injury can be to blame, muscle thickening, blood vessel enlargement, and cysts and spurs can also be the cause of any loss of sensation or tingling.

However, one of the most common terms associated with the sensation of tingling or loss of feeling in the hands, though, is “nerves”. From compression of nerves in the arms, spine, and neck, to damage to the nerves, it seems that the greatest number of problems can begin with nerve related issues.

Compression neuropathy or pressure on a nerve can cause a sensation of numbness in the hands. Additionally, because some nerves in the hands have their sources in the area around the neck, any sort of compression or pressure on the neck can lead to numbness, as well.

When we start to look at the neck, though, we realize that the spine is also a major factor in nerves and how they affect the hands. Arthritis in the neck or spine, as an example, can be compressed due to bone spurs or disc problems, and these might impair nerves that relate to the hands and arms.

Diseases of the spinal cord can also cause problems if they manifest as tumors, swollen blood vessels or other things that can constrict or press on the nerves. These can lead to weakened muscles if compressed as well, and this can further complicate matters by making the source of the problem more difficult to detect.

Not all nerve activity is in the spine though and it is understood that some diseases that affect the nervous system can lead to symptoms that include numbness in the hands. Multiple sclerosis is a key example of this, but other issues may also present in this way. Peripheral neuropathy is yet another nerve-related issue that can be caused by disease and which presents in a glove-like pattern on the hands and arms. Diabetes is a common cause of this sort of hand numbness or tingling.

You may have numbness in a finger after an injury, and some medication and treatments can also have side effects that include numbness and tingling in the hands.

Diagnosis and Treatment of Hand Numbness and Tingling

Clearly, you must never just guess at what is causing you tingling or numbness in your hands, and you should never ignore it. Instead, the wisest course of action is to visit a physician or hand doctor who can take a full history, do an assessment of your condition and help you overcome whatever issue has led to your discomfort.

Categories
General Hands

Nerve Injuries of the Hands

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If there were some sort of illustration that showed us how much of our brains functions went to operating the hands, it might astonish you. A huge amount of communication and activity between the hands and the brains occurs each day of your life, and when there are nerve injuries it can be tremendously disruptive to your ability to function completely.

As the American Society for the Surgery of the Hand indicates, the nerves are like a “telephone wiring” system in the body which sends and transports messages from the brain and out to every possible location. Just as in a real world setting, if those lines are damaged or downed in some way, communication ceases and messages cannot head back and forth as usual.

Nerves are also, physically, a lot like phone lines with their outer protection and their many inner lines and fibers. Additionally, the various inner lines have different tasks, too, and there are motor nerves for making your body move, sensory nerves that indicate everything from pain to temperature. Any nerve fiber can carry only one message – either sensory or motor, but all nerve tissue is made up of both types of nerves.

Should a nerve be harmed due to injury, pressure, crushing, or stretching, all of the messages stop, too. This can leave you unable to move a limb or experience sensation or feeling in the area where the nerve once communicated. Interestingly enough, the part of the damaged nerve that is closest to the brain does not die when injured. It remains alive and can continue to function and even grow. Though this can develop into a painful condition known as neuroma, it also means that a nerve that has been damaged does have a chance at being restored.

Can Damaged Nerves Come Back to Life?

If a nerve is severed, the various lines and connections can be reconnected through a surgical procedure. However, it is not as simple as it sounds, particularly when speaking about the nerves of the hand, which are thin strands no bigger than threads of yarn.

The good news is that it can be done, but it does have a lengthy recovery process. The initial goal is to get that outer sheath back together in order to encourage the inner nerves to reconnect and restore themselves. This is why any surgeries for nerve injuries demand at least three weeks of “downtime” after the procedure. Even then, the pace of regrowth is very slow, and to prevent any further damage, the patient is discouraged from using the digit or hand during the initial recovery period.

After that, however, there will be the need to use therapy to help the hand or fingers regain flexibility and function.

Your hand surgeon can review the options for nerve repair, and let you know your expected prognosis. With time and work, though, even severed nerves can be recovered or restored to at least partial function and health.

Source

ASSH.org. Nerve Injury. 2015. http://handcare.assh.org/SearchResults/tabid/145/SearchModuleID/1720/sites/1/Default.aspx?SearchTerm=damaged+nerves

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General Hands

Dealing with Animal Bites and the Hand

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Animal bites are very common in humans, and they often occur on the hands. Thats because people may be reaching toward the animal or holding out their hands in defense. These bites are painful and they often lead to infection because of bacteria found in the animals mouth. Complications from this type of infection can be very minor, resulting in just discomfort, but they can also be very serious, to the point that they are life threatening.

Every year, millions of people in the United States are bitten by dogs, cats, rodents, rabbits, monkeys, and ferrets. Of course, the vast majority of these are dog bites, specifically.

The Problem with Animal Bites

When animal bites occur in the hand or fingers, the wound itself is usually not that bad. However, there is a high risk of infection. In fact, the infection can be so bad that it could lead to hospitalization and does in about 1% of people who have been bitten by dogs and 6% of people who have been bitten by cats.

When it comes to animal bites, there could be a risk for rabies infection, but this is fairly rare. However, no matter what, if you have been bitten by an animal other than your own pet, you will need to report this bit to the health department. The animal will need to be tracked down.

The Problem of Human Bites

Human bites are, in essence, more dangerous than animal bites. Thats because humans have more bacteria in their mouth and this puts the bitten individual at high risk. Human bites can occur in different ways, including children biting people or broken skin that occurs during a fistfight.

Signs That a Bite Is Infected

Redness and swelling from a bite to the hand or fingers should only last about 24 hours. Symptoms of an infection include:

  • Swelling
  • Red Streaks Extending from the Bite
  • Swollen Lymph Nodes in the Arm
  • Pus in the Bite Wound
  • Loss of Sensation in the Hand or Fingers
  • Fever

Treatment of the Bite

If you have been bitten by an animal or human, it is a good idea to seek help from a physician. If it is showing signs of infection, then you definitely need to make an appointment. The hand will be examined and then cleansed carefully. The doctor may need to remove any dead skin from the wound. You will be given antibiotics, either in oral or intravenous form, to stop any infection. You will need to continue with follow up appointments to ensure the infection is being managed and is diminishing.

Animal and human bites can be very dangerous, leading to infection that can spread quickly. If not controlled, this could lead to permanent damage or even loss of part of the hand. If the infection spreads, then this could even lead to other medical problems throughout the body. So, if you have been bitten by an animal or a human, you will need to visit a physician as soon as possible.

Resources:

http://www.webmd.com/first-aid/tc/animal-and-human-bites-topic-overview

Categories
General Hands

Congenital Hand Problems in Children

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Congenital differences refer to problems that a baby is born with. In the hands, this can result in a couple of different fairly common problems, which can range from very minor to major, requiring surgical correction. When a baby is being formed in the mothers womb, thousands upon thousands of different things happen to form each part of its body. In the case of the arms, when the woman is about four to eight weeks pregnant, the fetus will develop an arm bud, or the beginnings of the arm itself. Over time, signals will be sent to the cells to form the arm. If any step is missed or confused, then a congenital hand problem could develop. Sometimes these are genetic, but often there is no diagnosable cause for the issue.

Types of Congenital Hand Problems

There are a few different types of congenital hand problems that could develop and appear in a newborn. These can include:

  • Webbed Fingers
  • Fused Fingers
  • Missing Parts of the Hand or Arm
  • Extra Fingers or Other Parts
  • Fetal Band Syndrome

We will go over most of those momentarily. Fetal band syndrome occurs when a band of tissue stretches from the placenta and wraps around a part of the baby. In some cases, this will mean wrapping around the hand, wrist or arm, cutting off circulation. This often results in amputation of all or part of the hand or arm.

Common Congenital Hand Problems

About one out of every 20 children will have a difference of some type. Some of them are so minor that very little has to be done. However, in many cases, correction will be needed to ensure the hand looks and functions normally. Common problems include:

  • Webbed or fused fingers (called syndactyly). The fingers can be separated through surgical procedures.
  • An extra pinky finger (called post axial polydactyly). Again, this can be corrected with surgery.
  • An extra thumb (called thumb polydactyly)

If the congenital problem is an issue, then it will likely need to be treated through surgical means.

Surgery to Correct Problems

When a congenital hand problem has been identified, then a surgeon will discuss options with you. In most cases, any problem can be corrected with surgery. Webbed or fused fingers can be separated. Extra fingers can be removed and the other finger, which may have been effected, can be surgically reconstructed.

The only time when surgery would not be considered is if it would severely compromise use of the childs hand. This is something that will be evaluated by a hand surgeon and discussed with you.

You can find out more about these surgeries by visiting the American Society for Surgery of the Hand at www.assh.org. Congenital hand problems do not have to be a lifelong issue. Instead, through corrective surgery, the hand can be restored to normal, often providing better functionality. If you have any reason to believe that your child has a congenital hand problem, then it is best to make an appointment with a hand specialist.

Resources:

www.assh.org

Categories
General Hands

Hand Fractures in Children

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Children have a different bone structure than adults. Their bones are softer and are growing. An adult will have harder bones that are completely grown. Because there is such a difference, when a child has a broken bone, it needs to be treated differently than it would be in an adult.

Fractures of the hand and fingers are common in children for a variety of reasons, including:

  • Curious children may put their hands in something dangerous
  • Hands and fingers can be crushed in closing doors
  • Sports injuries can break bones
  • Falling and twisting while playing can cause fractures as well

Essentially, you must remember that children are active and curious. They are more prone to injury simply because they dont know how to keep themselves out of harms way.

Types of Fractures in Children

Most people assume that they will see a deformity that indicates the hand, finger, or arm has been fractured. A vast majority of fractures in children will be non-displaced. This means the bones did not move out of place. Another name for this is hairline fracture. The bone may not even be fully broken into two pieces, but the fracture could still be present.

Fractures in children have to be handled in the proper manner. Thats because growing kids have something called growth plates at the ends of the bones. These cart ledge plates allow the bone to continue growing and lengthening, and the whole area is weaker, making it especially prone to breaking. If the bone doesnt heal properly at the growth plate area, then this could actually limit the growth of the bone in the future.

Treating a Hand Fracture in Children

As long as the break is clean, there is no need for surgery and the physician may be able to “set” the bone and then place a cast or splint on the hand or arm. In most of these cases, the break will be healed in a month. Thats because children heal quickly. However, if the fracture is severe, then surgery may be needed. Pins may be placed to keep the broken areas in the proper alignment until the bone is able to heal properly. It is important that fractures in the joints or those that are twisted are realigned exactly to ensure proper healing. That means the child will need surgery to ensure the fracture is aligned in the right manner.

While you may be able to prevent certain fractures in your children, many of them will not be preventable. Its important that you teach your child not to reach out and touch machines or other types of equipment. Additionally, you can have your child wear wrist guards whenever they are engaging in sports. While this will lower the risk of a fracture in the hand or fingers, it will not take away all of the risk. Children are naturally curious and full of energy. They will likely put themselves in more than a few dangerous situations no matter how careful you are as a parent.

Resources:

http://kidshealth.org/parent/general/aches/b_bone.html

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Dr. Aroras office from my first call to schedule my appointment was friendly. Walking in the first day, I felt like I was in a nice atmosphere. Dr. Arora was EXCELLENT in taking great care of my hand injury. He was gentle and very understanding to the concerns I had about my hand. His expertise was admirable and I would recommend anyone with an injury to their hand to his office to be under his care. Because of him, I have healed faster than expected and will make an 100% recovery! Thank you Dr.

Jackie S.

I first thought I was going to have to have painful injections or surgery, but Dr. Arora suggested physical therapy may do the trick. I was doubtful, but I agreed to do it. Now, my pain is gone, and with the help of an ergonomic keyboard at work to keep my hands in the correct position, I am virtually pain free. The therapy strengthened my wrists and shoulders, and built more flexibility into my wrists.

Jerry T.

My experience with this doctor was positive from the outset. Dr. Arora was kind and spent a great deal of time with me. Staff was friendly. The office was nice and bright.

Ariel G.

Very friendly and helpful Great staff!!! Doctor Arora was very professional and did great work. I was very happy with everything!

L B.