Other Hand Conditions
What is a Ganglion?
A Ganglion is a cyst which usually arises from a joint, ligament or tendon. It is lined with synovium and contains mucin or joint fluid. Ganglions can fluctuate in size and have a tendency to re-occur even after rupture or aspiration. They are most commonly found on the dorsal wrist, then volar wrist and fingers.
What causes Ganglions?
Ganglions can arise from:
What are the symptoms of Ganglions?
Ganglions are not harmful. The primary complaint most patients have is impingement or annoyance. Sometimes Ganglions can be painful or cause nerve compression.
How do you treat Ganglions?
There are many ways to treat Ganglions. The primary risk of all treatments is recurrence which is high. Surgery has the best chance of preventing recurrence. Other non-surgical methods include:
Surgery can be performed arthroscopically or open. The aim of surgery is to excise the cyst but the most important component is to ensure the stalk and origin of the Ganglion is excised. Failure to do so has high rate of recurrence.
What is a “trigger finger” or stenosing tenosynovitis?
Trigger finger is the “catching” or “locking” of the finger due to the tendon being unable to glide smoothly through its pulley in the palm, the A1 Pulley. This is caused by mechanical impingement.
What are the symptoms of trigger finger?
Trigger finger is usually progressive disease. There is usually pain at the A1 pulley, clicking and catching of the finger. Approximately 60% of patients with trigger finger usually also suffer from carpal tunnel syndrome.
How do you treat trigger finger?
Non operative methods of treating Trigger finger include:
If this fails or becomes exhausted. The next best option would be surgical one.
Failing these options, surgery can be considered for definitive treatment. The surgery for trigger finger is a small day only procedure. It involves a small incision less then 1cm and the release of the A1 pulley of the flexor tendon. Following surgery, you are able to bend and use all your fingers immediately. The wound will take 10-14 days to heal.
De Quervain’s Tenosynovitis
What is De Quervain’s Tenosynovitis?
De Quervain’s Tenosynovitis is a syndrome in which there is pain on the thumb side of the wrist. This is caused by inflammation of the tendon sheath in this area.
What causes De Quervain’s Tenosynovitis?
De Quervain’s Tenosynovitis is caused by the narrowing of the 1st Dorsal extensor compartment in which the EPB and APL tendons run. This causes irritation, inflammation and in turn pain.
How do you treat De Quervain’s Tenosynovitis?
De Quervain’s Tenosynovitis is initially treated non operatively with:
Failing non operative measures to treat De Quervain’s Tenosynovitis, surgery is then indicated. This is a small day only procedure which involves a small incision and release of the 1st Dorsal compartment. Symptoms generally settle down quickly and you have full use of the fingers and hands immediately post operatively.
What is Dupytren’s Contracture?
Dupytren’s contracture is a condition in which a nodule in the palm evolves into a cord which causes a contracture of one or more fingers. This progresses with time and the finger is tethered bent.
What are the symptoms of Dupytrens Contracture?
With Dupytren’s contracture the nodules can sometimes be painful but the primary complaint is the disability associated with the contracted finger or fingers. As the contracture progresses it effects daily activities.
How do you treat Dupytren’s Contracture?
Dupytren’s disease is usually managed non operatively until the degree of the contracture is severe enough effect daily activities. The main reason for this is due to the inevitable recurrence of the disease.
Treating the contracture can be addressed by the following methods: