DESERT ORTHOPEDICS

Hand & Wrist

Our specialists have expert training in the treatment of the complex joints, bones, and muscles of the fingers, hands, and wrists. The intricate and mobile design, coupled with the use and abuse sustained each day, can make this region of the body highly susceptible to injury. We treat the following conditions:

Wrist Conditions
- Carpal Tunnel Syndrome
- Tendonitis
- Arthritis
- Fractures (including Colles and Scaphoid)
- Ligament Injuries and Instabillites
- Paralytic Deformities
- Pediatric and Congential Conditions
- Conditions Resulting From Stoke and Cerebral Palsy

Hand Conditions
- Arthritis
- Burns and Fireworks Injuries
- Crush Injuries and Fractures
- Cysts / Ganglions / Tumors
- Dupuytren's Contracture
- Tendon Injuries
- Infections / inflamations
- Animal bites and lacerations
- Nerve Injuries
- Tenosynovitis
- Trigger Finger
- Paralytic Deformities
- Conditions Resulting From Stroke and Cerebral Palsy

CARPAL TUNNEL SYNDROME

Do you often feel a numbness or tingling in your hand, especially at night? Maybe you experience clumsiness in handling objects and sometimes you feel a pain that goes up the arm to as high as the shoulder. These may be the symptoms of carpal tunnel syndrome.

The median nerve travels from the forearm into your hand through a "tunnel" in your wrist. The bottom and sides of this tunnel are formed by wrist bones and the top of the tunnel is covered by a strong band of connective tissue called a ligament. This tunnel also contains nine tendons that connect muscles to bones and bend your fingers and thumb. These tendons are covered with a lubricating membrane called synovium which may enlarge and swell under some circumstances. If the swelling is sufficient it may cause the median nerve to be pressed up against this strong ligament which may result in numbness, tingling in your hand, clumsiness or pain described above.

Common Causes of Carpal Tunnel

-Repetitive and forceful grasping with the hands

-Repetitive bending of the wrist

-Broken or dislocated bones in the wrist which produce swelling

-Arthritis, especially the rheumatoid type

-Thyroid gland imbalance

-Sugar diabetes

-Hormonal changes associated with menopause

-Pregnancy

Non-Surgical Treatments for Carpal Tunnel

Mild cases may be treated by applying a brace or splint which is usually worn at night and keeps your wrist from bending. Resting your wrist allows the swollen and inflamed synovial membranes to shrink; this relieves the pressure on the nerve. These swollen membranes may also be reduced in size by medications taken by mouth called non-steroidal anti-inflammatories. In more severe cases, your doctor may advise a cortisone injection into the carpal tunnel. This medicine spreads around the swollen synovial membranes surrounding the tendons and shrinks them, and, in turn, relieves the pressure on the median nerve. The dosage of cortisone is small and when used in this manner it usually has no harmful side effects. The effectiveness of non-surgical treatment is often dependent on early diagnosis and treatment.

Surgical Treatments for Carpal Tunnel

In those patients who do not gain relief from these non-surgical measures it may be necessary to perform surgery. The site of the operation is made pain-free by local anesthesia injected either into the wrist and hand or higher up in the arm. This may be done by your orthopaedic surgeon or an anesthesia doctor. The surgery itself is called a "release" - cutting the ligament that forms the roof of the carpal tunnel to relieve the pressure on the median nerve. The surgery is usually performed in an outpatient facility and you are generally not required to stay over night.