Hand Injuries

Osteoarthritis at the CMC joint (thumb)

A full rupture of the UCL (ulnar collateral ligament) that often requires surgery

Triangular fibrocartilage complex affects the ligaments between the ulnar, lunate, and triquetrum

Conservative treatment is most effective

Compression of the median nerve at the carpal tunnel

Instability

Ulnar wrist pain with reduced rotation

Phalen's, Durkan's, Tinel's, and Levine questionnaire

Immobilization for 6 weeks, with possible surgery if necessary and gradual weaning with a night splint for over 12 weeks.

Splinting of the DIP and PIP joints for the first 3 weeks, DIP joint only for 6-8 weeks, and PIP joint in 30 degrees of flexion to prevent swan neck deformity.

Swan neck deformity is the permanent hyperextension of the interphalangeal joint, often resulting from rheumatoid arthritis. Chronic cases may require surgery, but it is avoided for as long as possible. Additionally, immobilization of the DIP and PIP joints in full extension for 1 week is part of the management.

The management involves immobilization of the DIP and PIP joints in full extension for 1 week, followed by freeing the DIP joint and starting DIP joint range of motion. The splint is removed at 5 weeks.

Management options include splinting for 6 weeks using a money bag splint, tendon gliding exercises, forearm soft tissue massage, stretches, strengthening exercises, taping, and possibly steroid injection.

DeQuervain’s tendinopathy affects the thumb tendons in the first dorsal compartment, causing pain at the radial styloid and during thumb motion, wrist deviation, or wide grasp. The differential diagnosis includes 1st CMCJ OA, radial nerve issues, and intersection syndrome.

The recommended treatment includes splinting, steroid injection if splinting is ineffective, and surgery if necessary. Additionally, setting pain then strengthening (bunny ears exercise) is part of the treatment.

Depuytren’s disease is the contracture of fascial bands in the palm, and its cause is unknown. The only conservative treatment option available is management through non-surgical means, as it can develop even after trauma.