HAND and WRIST CONDITIONS
Condition
1) Carpal Tunnel Syndrome
2) De Quervains Disease
3) Game Keepers Thumb
4) Wrist/ Carpal Instability
5) Scaphoid Bone Fracture
6) Lunate Bone Dislocation
Cause
Symptoms
Compression of the Median nerve in the wrists ‘Pins and needles’ sensation in the thumb, index
Carpal Tunnel due to swelling or mechanical and middle finger. Wrist and hand pain.
compression.
Inflammation of the synovial sheath around the Gradual onset of localised pain at the thumbs
tendons of the thumb muscles (extensor pollicis attachment at the wrist or up the forearm. Pain
brevis and abductor pollicis longus) due to overuse. aggravated by movement and a ‘squeeking’
sensation may be felt.
Sprained ligaments in the thumb due to traumatic Individuals report a history of a traumatic injury
injury usually from sports. Occasionally dislocated involving backwards bending of the thumb. Pain on
or subluxated thumb.
medial aspect of thumbs metacarpal phalangeal
joint.
Loss of the connection or alignment between the Chronic and recurrent wrist pain with ‘clicking’
carpal bones in the wrist due to acute trauma, and ‘popping’ sounds.
repetitive
microtrauma
and
inflammatory
conditions.
Fracture of the scaphoid bone due to trauma (eg. History of wrist trauma, pain on certain wrist
Falling on outstretched hand).
movements (radial deviation) and wrist grip
weakness.
Dislocation of the wrists Lunate bone usually due Wrist pain and carpal bone instability. Wrist
7) Triangular Fibrocartilage Complex
(TFCC)
8) Ganglionic Cyst
to fall on outstretched hand.
Injury to the TFCC and cartilage structures that
attach the radius bone to the carpal bones (Lunate,
Triquetrum, hamate, lunate and distal ulna) due to
anatomical variances, repetitive microtrauma and
acute injury (fall on hand).
Bulge or swelling overlying a joint or tendon
sheath in the wrist (can occur elsewhere). Can be
caused by various anatomical defects in the
connective tissues.
swelling
History of direct or repetitive trauma with pain on
medial side of wrist which is aggravated by
movement and relieved by rest.
May have wrist pain, intermittent to constant. Pain
is aggravated by activity. Can occur spontaneously
and may also involve paraesthesias or weakness.
Some Common Hand Deformities
Position
Causes
Median nerve palsy causing the thumb to move backwards (loss of
opposition) and the fingers to extend at the metacarpalphalangeal joint.
Thenar compartment of muscles in the thumb may atrophy.
Ape Hand Deformity
Ulnar nerve palsy causing hypothenar muscle atrophy and flexed ring and
little finger. Commonly due to injury in the Cubital Tunnel.
Bishops (Benediction) Hand Deformity
Ulnar and Median nerve palsy- causing a flexion contracture in the hand
and fingers.
Claw Hand/ Claw Fingers
Radial Neuropathy- with lesion usually at or above the elbow.
Wrist Drop
Bouchards nodes- bone and cartilage enlargement at the proximal
interphalangeal joint associated with Osteoarthritis and Rheumatoid
Arthritis.
Heberdens Nodes- hard nodules at the distal interphalangeal joints due to
calcifications. Usually associated with osteoarthritis.
Rupture of finger extensor tendon causing hyperextension of
metacarpalphalangeal and distal interphalangeal joint with hyperflexion of
proximal interphalangeal joint. Commonly seen in Rheumatoid Arthritis or
sever finger sprain/ fracture injuries.
Boutonniere Deformity
Finger deformity where there is hyperextension of the proximal
interphalangeal joint and hyperflexion of the distal interphalangeal joint.
Common in individuals with Rheumatoid Arthritis.
Swan Neck Deformity