|

The upper extremity is frequently injured at work, at play, and sometimes
as simply the result of adding another year to your life. The common problems
that are seen in the upper extremity include tennis elbow, carpal tunnel
syndrome, tendinitis about the wrist, DuPuytren's contracture of the fingers,
trigger finger, ganglion cysts, and various types of arthritis in the wrist,
hand or fingers.

Carpal Tunnel Syndrome is probably the most common condition seen. Symptoms
of CTS include numbness in the index and middle fingers, usually at night,
but sometimes when at work, driving or writing. People with CTS frequently
drop things and have difficulty picking up small objects, such as buttons
or pins. The usual treatment for CTS includes splint immobilization, anti-inflammatories,
cortisone injections, and discontinuance of repetitive activities. If these
procedures fail, surgical division of the transverse volar carpal ligament
is usually successful in symptomatic relief.

Tendinitis of the wrist is frequently seen in people who use word processors
throughout the day. This
is a reaction of the body to repetitive use and is frequently called overuse
syndrome. Treatment of anti-inflammatories, steroid injections, and splinting
is usually successful in relieving the complaints, particularly if you
are able to modify the work conditions by adding a wrist rest for the keyboard,
or perhaps varying the height of your work station or work chair. Rarely
surgery is required.

Ganglion Cysts about the wrist are extremely common. They
are sometimes the results of a single traumatic event, but more commonly,
simply appear without any known cause. If these ganglion cysts are painful,
cortisone injections are often effective in relieving the problem. For
recurrent symptomatic ganglion cysts, surgical excision is sometimes required.

Trigger Fingers commonly affect the dominant hand and are also often associated
with repetitive use.
The cause for trigger fingers is usually swelling of the tendon, which
causes blockage within the tendon sheath lining, resulting in inability
to easily straighten the finger. When the finger does straighten, it snaps;
hence, the term, trigger finger. Treatment involves anti-inflammatories,
rest, cortisone injections, and occasionally surgical release.

Tennis Elbow is not restricted to tennis players but can develop in anyone
who uses the arm for heavy activities. It can also be related to a sudden
injury to the arm. The cause for tennis elbow (lateral epicondylitis) is
thought to be partial tearing of the extensor muscles as they hook into
the prominent bone on the outside of your elbow. Treatment is directed
to that point and consists of immobilization, anti-inflammatories, cortisone
injections, and rarely, surgical release.
 
DuPuytren's Contracture is an uncommon condition which causes the fourth
and fifth fingers to draw down into the palm so you are unable to straighten
the fingers completely. This condition tends to run in families and its
only correction is surgical release.

Arthritis of the arm, wrist, hand and fingers is an ongoing problem that
we are forced to deal with on a regular basis. Most of the arthritis seen
is secondary to chronic wear and tear and is called osteoarthritis. A less
prominent form, unrelated
to use, is rheumatoid arthritis. The treatment may vary, depending on the
type of arthritis. Anti-inflammatory drugs are the first line of defense
against arthritic conditions and are usually very effective. Cortisone
shots sometimes play a role. Surgical correction is frequently necessary
and might involve an artificial joint implant into the elbow, wrist or
fingers, or might involve stiffening the joint (fusion), if necessary.

Fractures of the
upper extremity are treated somewhat differently than those of the weight
bearing bones. Sometimes cast immobilization is all that is needed but
frequently surgery is required for proper alignment. Immobilization is
generally shorter for upper extremity fractures than for lower extremity
fractures.
For more information, please contact:

HAQ ORTHOPAEDIC HOSPITAL
18 Sanda Road, Lahore
Pakistan.
Phone:92-42-7312860 to 2
Email: info@haq-ortho.com
|