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Introduction to 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

A number of different disorders may affect the hands or fingers, including ganglia, deformities, disorders related to nerves or blood vessels, osteoarthritis, trigger finger, and infections. Some other disorders that affect the hands are covered elsewhere in the book, including fractures, other injuries, rheumatoid arthritis, tendinitis and tenosynovitis, de Quervain syndrome, Raynaud syndrome, finger clubbing, and certain birth defects.

Hand and finger deformities

Hand and finger deformities include swan-neck deformity (see Swan-Neck Deformity), boutonnière deformity (see Boutonnière Deformity), and Dupuytren contracture (see Dupuytren Contracture). These deformities may be caused by an injury or may result from another disorder (for example, rheumatoid arthritis—see see Rheumatoid Arthritis (RA)). Typically, doctors base the diagnosis 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.

Nerve compression syndromes

Carpal tunnel syndrome (see Carpal Tunnel Syndrome), cubital tunnel syndrome (see Cubital Tunnel Syndrome), and radial tunnel syndrome (see 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 include tingling, pain, loss of sensation, weakness, or a combination. The diagnosis is suggested by the examination and can be confirmed by electromyography and nerve conduction studies (see Tests for Brain, Spinal Cord, and Nerve Disorders : 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.

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 (see Felon), herpetic whitlow (see Herpetic Whitlow), hand abscess (see Hand Abscess), and infection of the tendon sheath (see Infection of the Tendon Sheath). Hand and finger infections can cause constant, intense, throbbing pain. Doctors base the diagnosis on an examination and sometimes x-rays. These infections are treated with antibiotics taken by mouth or by vein and surgery. Paronychia is discussed elsewhere (see Acute Paronychia).

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