Hand

Preferred First Treatment for de Quervain's

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A common problem affecting the wrist called de Quervain's tenosynovitis causes pain on the inside of the wrist and forearm just above the thumb. Dr. A.M. Ilyas from the Temple Hand Center in Philadelphia uses this case report to bring us up-to-date on the evidence on how to treat this problem.




A group of us at work are concerned about the number of hand injuries from power tools. We are seeing people get hurt who never make it back to work. We are trying to put together some figures to help show our boss how much these injuries are costing all of us in terms of time off work, medical care, and worry. Are there any studies like that out there?

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There is a recent study from the Mayo Clinic where the cost of electric saw injuries was calculated in terms of dollars and cents. Lost wages, physician charges, emergency room treatments, rehab, and hospitalization costs are some of the major costs incurred.




Our family is worried about Dad's use of power tools in his garage shop. He's always worked around saws and other potentially dangerous tools. But his eyesight's not what it used to be. He takes blood thinners to prevent a stroke. It just doesn't seem like a good combination for continuing his hobby. Should we say something? How can you take away a man's hobby after all these years?

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Every year, 100,000 people of all ages from young to old receive medical care for hand injuries linked to power tools. The sharp, rotating blade can tear up soft tissues, blood vessels, nerves, and even fracture bones and amputate fingers. That's a gruesome picture but one that should be considered by anybody using these tools at home or at work.




The Cost of Electric Saw Hand Injuries

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No matter how you slice it, hand injuries from electric saws are expensive and devastating. Table saws, electric band saws, and hand-held electric saws are involved in thousands of hand injuries every year. People of all ages from young to old are affected.

In this study from the Mayo Clinic, the cost of these injuries is calculated in terms of dollars and cents. Lost wages, physician charges, emergency room treatments, rehab, and hospitalization costs are some of the major costs incurred.




Acupuncture Works for Carpal Tunnel Syndrome

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Carpal tunnel syndrome (CTS) is a common problem affecting the thumb, hand, and wrist. Symptoms begin when the median nerve gets squeezed inside the carpal tunnel of the wrist. The result is a medical condition known as nerve entrapment or compressive neuropathy. Any condition that decreases the size of the carpal tunnel or enlarges the tissues inside the tunnel can produce the symptoms of CTS.




Is there any benefit to taking acupuncture treatments for carpal tunnel syndrome? I'd really like to avoid surgery or drugs if I can.

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A recent study from Taiwan of 18- to 55-year-old patients with confirmed mild-to-moderate carpal tunnel syndrome says Yes to your question. They compared two groups of similar patients with carpal tunnel syndrome. One group was treated with oral steroids for a period of four weeks. The other group was given a series of acupuncture sessions twice a week for four weeks.




I have several friends who get acupuncture treatment every week for various aches and pains. I have carpal tunnel syndrome that seems to come and go depending on what I'm doing at work. Can acupuncture help with this? And what kind of side effects can occur?

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Acupuncture has been shown to be safe and effective for short-term (two to four weeks) treatment of mild-to-moderate carpal tunnel syndrome. Long-term studies are needed to confirm the benefit of acupuncture for this same problem.




I've been trying to read up on a thumb injury I have but I keep getting confused about whether it's a gamekeeper's thumb or a skier's thumb. What's the difference between these two?

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There is no difference. Both refer to an injury to the ulnar collateral ligament (UCL) of the thumb. This ligament is a strong band of tissue attached to the middle joint of the thumb, the joint next to the web space of the thumb. The joint that is affected is called the metacarpophalangeal joint, or MCP joint.




What do you recommend for a severe skier's thumb? I tried wearing a cast for six weeks but it still hurts terribly and I can't really pick anything up with that hand.

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Skier's thumb refers to an injury affecting the ulnar collateral ligament (UCL) of the thumb.Partial tears can be treated nonoperatively with conservative care. But complete ruptures (which it sounds like you may have) often require surgical repair.




Surgical Management of Skier's Thumb

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To you it's a sprained thumb. To the hand surgeon, it's an injury of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb. In the old days it was called a gamekeeper's thumb. Today, it's more likely to be a sports injury, sometimes referred to as skier's thumb. Jamming the web of the thumb into the ski pole tears the ulnar collateral ligament (UCL). It's a common problem that orthopedic surgeons and primary care physicians deal with routinely.





*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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