Hand Prof. Dr. Tzou
de Quervain Syndrome
De Quervain Syndrome is a painful tenosynovitis affecting the extensor tendons of the thumb. It can initially be treated conservatively, with a splint that stops movement of the thumb and wrist and with anti-inflammatory medication. If conservative and cortisone steroid injection into the tendon compartment shows no improvements, surgery can be applied. Surgery decompresses the tendon tunnel to release the pressure so the tendons can glide freely.
Dupuytren Disease
Dupuytren Disease is a hand deformity that develops over years. It affects a layer of tissue that lies under the skin of the palm. Knots of tissue under the skin successively become thick cords, which bend one or more fingers. The affected fingers can't be straightened—which results in daily life impairment, for which people sometimes keep their hands in their pockets or wear gloves. In mild cases, especially if hand function is good, only observation is needed. For severe cases, surgery can almost completely restore the full finger functions. Splint and hand therapies assist the postoperative functional recovery of the hand.
Ganglion Cyst
A ganglion cyst can simply be observed, especially if it is painless, as such cysts frequently disappear spontaneously. If a cyst becomes painful or limits functions, it can be treated with anti-inflammatory and needle aspiration to remove the fluid from the cyst. When nonsurgical options fail to provide relief, or if the cyst recurs, surgical alternatives are available. Surgical removal of the cyst is generally successful, although cysts may recur.
Osteoarthritis
Osteoarthritis of the thumb (rhizarthrosis) occurs when cartilage wears away from the ends of the bones that form the carpometacarpal of the thumb joint. It can cause severe pain, swelling, and decreased strength and range of motion of the hand. In mild cases, it can be treated with anti-inflammatory medication and splints. Severe thumb arthritis requires surgery, removing the joint with connecting bones and replacing it with an adjacent tendon graft (resection-suspension-arthroplasty). Splint and hand therapies assist the postoperative functional recovery of the thumb.
Trigger Finger
Trigger Finger (stenosing tendovaginitis) is when the fingers stick in a bent position and may be straightened only with a painful snap, like a trigger being pulled and released. Inflammation narrows the space within the pulley at the base of the finger that surrounds the flexor tendon of the affected finger. Treatment of trigger finger varies depending on the severity. The most common conservative treatments are splints, anti-inflammatory medication, and steroid injection. If nonsurgical treatments do not relieve the symptoms, surgery opens the pulley at the base of the finger so that the tendon can glide freely, releasing the finger from the clicking or popping effect. Finger motion returns, in some cases with some stiffness. Occasionally, hand therapy is induced to assist the functional recovery of the finger.
HAND
de Quervain Syndrome
De Quervain Syndrome is a painful tenosynovitis affecting the extensor tendons of the thumb. It can initially be treated conservatively, with a splint that stops movement of the thumb and wrist and with anti-inflammatory medication. If conservative and cortisone steroid injection into the tendon compartment shows no improvements, surgery can be applied. Surgery decompresses the tendon tunnel to release the pressure so the tendons can glide freely.
Dupuytren Disease
Dupuytren Disease is a hand deformity that develops over years. It affects a layer of tissue that lies under the skin of the palm. Knots of tissue under the skin successively become thick cords, which bend one or more fingers. The affected fingers can't be straightened—which results in daily life impairment, for which people sometimes keep their hands in their pockets or wear gloves. In mild cases, especially if hand function is good, only observation is needed. For severe cases, surgery can almost completely restore the full finger functions. Splint and hand therapies assist the postoperative functional recovery of the hand.
Ganglion Cyst
A ganglion cyst can simply be observed, especially if it is painless, as such cysts frequently disappear spontaneously. If a cyst becomes painful or limits functions, it can be treated with anti-inflammatory and needle aspiration to remove the fluid from the cyst. When nonsurgical options fail to provide relief, or if the cyst recurs, surgical alternatives are available. Surgical removal of the cyst is generally successful.
Osteoarthritis
Osteoarthritis of the thumb (rhizarthrosis) occurs when cartilage wears away from the ends of the bones that form the carpometacarpal of the thumb joint. It can cause severe pain, swelling, and decreased strength and range of motion of the hand. In mild cases, it can be treated with anti-inflammatory medication and splints. Severe thumb arthritis requires surgery, removing the joint with connecting bones and replacing it with an adjacent tendon graft (resection-suspension-arthroplasty). Splint and hand therapies assist the postoperative functional recovery of the thumb.
Trigger Finger
Trigger Finger (stenosing tendovaginitis) is when the fingers stick in a bent position and may be straightened only with a painful snap, like a trigger being pulled and released. Inflammation narrows the space within the pulley at the base of the finger that surrounds the flexor tendon of the affected finger. Treatment of trigger finger varies depending on the severity. The most common conservative treatments are splints, anti-inflammatory medication, and steroid injection. If nonsurgical treatments do not relieve the symptoms, surgery opens the pulley at the base of the finger so that the tendon can glide freely, releasing the finger from the clicking or popping effect. Occasionally, hand therapy is induced to assist the functional recovery of the finger.