Diagnosis and treatment

We treat a range of hand, wrist and elbow conditions. These include:

• Arthritis. Arthritis is the name for a number of conditions affecting the joints. Depending on the type of arthritis you have, it can cause symptoms such as pain and swelling, reduced movement, and the breakdown of the bone and surrounding tissue.
• Conditions affecting the tendons, which connect bones with muscles. Common tendon problems include:
  
  • tendonitis (where a tendon is swollen and sore);
  • Dequrvains tenosynovits (tendon irritation over the thumb side of the wrist)
  • trigger finger (when a finger or thumb gets stuck in a bent or straight position, as a result of a knot forming in the tendon that is connected to the finger);
  • Tennis elbow (where the tendons in the elbow have been slightly torn).
  • Tendon ruptures ie jersey finger a flexor tendon rupture common in rugby players, also biceps tendon ruptures at the elbow seen in middle-aged men.
• Other common hand conditions
  • Ganglions (synovial swellins that can be found at the wrist and in the fingers, only painfull ganglions need treatment)
  • Dupuytren's contracture (where the tissue in the hand thickens so that the small joints of the hand develop contractures and cannot move freely)
• Nerve (neurological) conditions such as carpal tunnel syndrome (pain, tingling, or numbness in the hand caused by a compressed nerve) and nerve tumours (growths on the nerves).
• Other musculoskeletal disorders (affecting the bones or muscles) such as fractures (broken bones) and crush injuries.

Treatments and services

Our specialist team of surgeons and therapists work together to treat condition and injuries affecting the hands, wrists and elbows.

You can watch videos of one of our consultants, Mr David Warwick, talking about treatment options for Dupuytren's contracture| and trigger finger|.

Surgical procedures carried out by our hand and wrist specialists include:

• Surgically repairing a broken bone with screws, plates or rods.
• Joint replacement (arthroplasty). We replace joints ranging from wrists to smaller joints such as thumbs. For example, we may replace the distal interphalangeal joint (DIP joint, closest to the fingertip) or the proximal interphalangeal joint (PIP joint, or knuckle) in order to treat arthritis.
• Tenolysis, which is surgery to help a tendon move freely. This may be needed after an injury to the tendon or plating of finger fractures.
• A dermo-fasciectomy, which can be used to treat Dupuytren's disease. The skin and thickened tissue is removed to enable the tendons to move. A skin graft is then applied.
• Carpal tunnel release, where some of the ligament in the wrist is cut, in order to reduce the pressure on the nerve that causes carpal tunnel syndrome.
• Tendon grafts and transfers. These may be required after a stroke or brain injury or to reconstruct a joint following a major traumatic injury.

Our specialist physiotherapists and occupational therapists can treat some conditions as an alternative to surgery, depending on the type of problem and how severe it is.

Therapists also provide, fit and train you how to use support equipment, such asa wrist splint to help treat mild carpal tunnel syndrome.

So for example, tennis elbow treatment can include exercises to stretch and strengthen the forearm muscles, along with the use of supports to encourage the tendons to heal.

Therapists also help patients recover from surgery, for example re-learning how to use their hand, wrist or elbow, or carrying out range of movement strengthening and control exercises, helping you to return to a fully functional everyday life.

Useful links

http://www.eatonhand.com/| Electronic Textbook of Hand Surgery explains common hand problems in plain English, with helpful diagrams.