Carpal and Cubital Tunnel Syndromes
Disorders of the upper extremity include problems of the hand, wrist, and elbow. Disability often can be chronic or work-related overuse injuries and can also be traumatic fractures or ligament disruptions.
Carpal tunnel syndrome occurs when the tissues surrounding the flexor tendons in the wrist swell and put pressure on the median nerve. These tissues are called the synovium. The synovium lubricates the tendons and makes it easier to move the fingers. This swelling of the synovium narrows the confined space of the carpal tunnel, and over time, crowds the nerve. Similarly, pressure on the ulnar nerve at the elbow from overuse or anatomy problems can cause symptoms similar to carpal tunnel in the hand. Our physicians can help diagnose and treat these problems both surgically and non-operatively.
Wrist fractures are one of the mostly seen injuries in our office. Slips and falls onto outstretched arm will often cause a break in the bone. Some fractures just need to be casted while others require surgery to stabilize the fracture.
The TFCC is a cushioning cartilage in the wrist, akin to the meniscus of the knee. Like the meniscus, it has a poor blood supply providing limited ability to heal. Oftentimes, the wrist pain associated with TFCC tears are felt on the ulnar side (on the pinky side) of the wrist. The pain can often be managed with activity modification, bracing or injections. Sometimes arthroscopic surgery is necessary to repair or clean the tear to alleviate the pain.
De Quervain's tenosynovitis occurs when the tendons around the base of the thumb are irritated or constricted. The word "tendinosis" refers to a swelling of the tendons. Swelling of the tendons, and the tendon sheath, can cause pain and tenderness along the thumb side of the wrist. This is particularly noticeable when forming a fist, grasping or gripping something, or when turning the wrist. Bracing and anti-inflammatory medication are often very helpful to reduce the pain and improve function. Sometimes injections or surgery is necessary when other modalities have failed.