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Overview of Hand Disorders

By David R. Steinberg, MD, Associate Professor, Department of Orthopaedic Surgery, and Director, Hand and Upper Extremity Fellowship, Perelman School of Medicine at the University of Pennsylvania

Hand and finger disorders include ganglia, deformities, disorders related to nerves or blood vessels, osteoarthritis, trigger finger, Kienböck disease, and infections.

Some other disorders that affect the hands and fingers, including fractures, other injuries, rheumatoid arthritis, tendinitis and tenosynovitis, De Quervain syndrome, Raynaud syndrome, finger clubbing, complex regional pain syndrome, and certain birth defects, are covered elsewhere.

Hand and finger deformities

Hand and finger deformities include swan-neck deformity, boutonnière deformity, and Dupuytren contracture. These deformities may be caused by an injury or may result from another disorder (for example, rheumatoid arthritis).

Typically, doctors base the diagnosis of hand and finger deformities on an examination.

Deformities can sometimes be treated by splinting or exercises, but if the deformity has lasted for weeks or months, these treatments may be ineffective because scarring has developed. When splinting or exercises are not helpful, surgery may be needed.

Hand and finger infections

Human and animal bites can cause an infection of the hands (see Hand Infections Caused By Bites). Some other infections are felon, herpetic whitlow, hand abscess, and infection of the tendon sheath. Hand and finger infections can cause constant, intense, throbbing pain.

Doctors base the diagnosis of hand and finger infections on an examination and sometimes x-rays.

These infections are treated with antibiotics taken by mouth or by vein and sometimes surgery.

Paronychia (a bacterial infection of the skin around the fingernail) is discussed elsewhere.

Nerve compression syndromes of the hand

Carpal tunnel syndrome, cubital tunnel syndrome, and radial tunnel syndrome are nerve compression syndromes. In these disorders, something, usually bone or connective tissue, presses on a nerve, causing abnormalities of sensation, movement, or both. Symptoms of nerve compression syndromes include tingling, pain, loss of sensation, weakness, or a combination.

The diagnosis of nerve compression syndromes is suggested by the examination and can be confirmed by electromyography and nerve conduction studies.

In these syndromes, surgery may be necessary to relieve pressure on the nerve if symptoms are severe despite other treatments or if there is persistent loss of sensation or weakness.

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