QUESTION: A 28 year old female fell over at soccer and had another player accidentally step on her hand. Her hand is now swollen and bruised, however, she has full range of movement of her fingers and wrist.

broken hand

A 4th metacarpal spiral fracture

What is it?

A broken hand is when a break/fracture occurs to one of the bones in your hand. The hand has a number of bones which support its framework. Many people believe that a fracture and a break are different, but they are actually the same thing.

Common Causes

Any forced applied in excess to the bone can break it. This can occur from a fall, punching a wall, or having someone or something else hit it.

Symptoms

Usually with fractures in the hand, they can present with lots of swelling (also known as oedema), pain, bruising and potentially a loss of movement or deformity.

However, some people with a broken hand can still move their fingers and wrist without issue and don’t necessarily present with deformity.

Some fractures are simple, although some others may be displace or have multiple fragments on x-ray.

Treatment

A medical evaluation including x-ray is required for diagnosis. This will help your doctor and hand therapist
determine what treatment is required or if referral to a hand surgeon is required.

Some hand fractures require a hand splint for protection while others may require a plate a screws to fix through a
small incision (open reduction and internal fixation: ORIF).broken finger

Here at Hand Therapy Group, we can fabricate customised thermoplastic hand splints to accommodate for all fractures in the hand with any level or injury (pre or post-op).

We ensure that only the joints that need to be immobilised are immobilised and the rest are available for gentle range of movement and use.

If you have any further questions, please feel free to contact us here and we’ll be happy to help!

What is the Issue?

Arm pain relates to any pain or discomfort in the arm. It can be caused by a wide variety of problems, not only those that originate in the area, but also issues with the neck, back or hand that extend to the arm. Issues can range from fractures to compressed nerves and repetition strain injuries and there can manifest immediately, or develop over time. The issue above sounds like Tennis Elbow could be the culprit.

Causes of Arm Pain

There are numerous causes of arm pain, some serious and some easily treatable. Here are some of the most common:

Tennis Elbow: Tennis Elbow – or lateral epicondylalgia – is an injury to the muscles that extend from the elbow to the wrist caused by an excess of stress on the muscle tissue at the anchor point where the arm bone meets the elbow.

Broken arm/wrist/hand: A crack or break in the bones of the arm, wrist or hand, usually caused by a traumatic blow.

Dequervains Syndrome: Dequervains Syndrome is the irritation of the two tendons that insert at the base of the thumb as they pass through the extensor sheath. Repetitive movements of the thumb and wrist as well as activities requiring pinching can cause pain and swelling around the tendon.

Carpal Tunnel Syndrome: Carpal tunnel syndrome is the compression of the median nerve as it passes through the carpal tunnel. Compression of the nerve can cause symptoms such as numbness, pins and needles, tingling, swelling, pain and weakness.

Angina: A condition caused by reduced blood flow to the heart. Can result in pain in the arm, back, shoulders and chest.

Pinched nerve: A pinched nerve can be the result of increased pressure on a nerve from surrounding bones, muscles or tendons (carpal tunnel syndrome is an example of a pinched nerve).

Rotator Cuff injury: The Rotator Cuff is a collection of muscles and tendons that help move the shoulder and aid with general stabilisation. Overuse or a heavy blow may cause small tears or strains in the Rotator Cuff, leading to pain and discomfort in the arm.

Clinical Examinations

For many causes of arm pain, an X-Ray or MRI may be appropriate. Your hand therapist will let you know if this is required.

Symptoms – when should you see a doctor or hand therapist?

Use your best judgement when assessing whether to seek medical assistance or not. It is always better to be on the safe side.

Many of the conditions above may require medical assistance and therapy. For example, if you have broken your arm, your doctor will refer you for x-rays to help determine whether you can be managed conservatively by cast immobilisation or require surgery to obtain correct bone alignment in order to ensure a healthy healing process. Your hand therapist can fit you with a waterproof cast once your swelling is down, and assist you regain motion and strength once the fracture is healed.

Treatment

Mild symptoms of arm pain can be self-treated. Rest is the key: avoid using your arm in way that can cause pain or discomfort. Icing the affected area 15-20 minutes a day can help reduce pain and swelling.Depending on the severity of the condition, therapy may include education and advice, creation of an appropriate  exercise program, massage and provision of braces and supports if required.arm pain

Surgical Treatment

Surgical treatment may be required in extreme cases of arm pain. Your therapist can discuss this with you and your GP and arrange a referral to a surgeon if required. If you have any questions regarding a condition you have or to book an appointment, feel free to contact us here. We’d be more than happy to help.

A broken finger refers to a crack or break in any of the three ‘sections’ – called phalanges – of the finger (except the thumb which has only two). A broken finger can be very painful and require immediate medical attention in order to ensure a healthy healing process.

What Are The Symptoms of a Broken Finger?

Often the first indicator of a broken finger is an audible crack upon impact. Major symptoms include:

• Pain
• Swelling
• Bruising
• Tenderness at the touch
• Deformity – the finger might be pointing in the wrong direction!

Causes of a Broken Finger

The fingers are the most vulnerable part of the hand and can be damaged by any number of different accidents. A broken finger is quite common in sports and in the workplace, especially when the finger is struck awkwardly by a ball or other tools. The severity of the injury will depend on the strength of impact and the health of the bone. Conditions such as osteoporosis or osteoarthritis may make the bone more susceptible to breaking.

Types of Broken Fingers

The following terms describe how broken (or fractured) fingers are categorised:

Skin Involvement:

• Open fractures are when the bone pierces the skin.broken finger

• Closed breaks are when the skin remain intact.

Bone Position:

• Non-displaced fractures are when the bone breaks, but the bony fragment remains in normal position.

• Displaced fractures are when the two pieces of bone are separated and move out of their normal positions.

• Comminuted fractures are when the bone breaks or splinters into more than two fragments.

Other types of fracture:

• An impacted fracture is when the ends of the bone are driven into each other.broken finger

• An avulsion fracture is when the tendon or ligament pulls off a piece of the bone. It can occur in the thumb with a skiing injury (skier’s thumb). It can cause inability to either bend or straighten the tip of your finger after a sports injury.

When Is Hand Therapy Necessary?

For most broken fingers it is necessary to see your doctor. They will refer you for x-rays to help determine whether you can be managed conservatively by custom made orthotics or require surgery to obtain correct bone alignment in order to ensure a healthy healing process. Your hand therapist can fit you with hand splints or buddy straps to protect the fracture and help the swelling settle down. They will assist you regain motion and strength once the fracture is healed.

Surgical Treatment

Surgery is generally required for severe breaks with displaced fractures. Fixation devices including screws, plates, nails or K-wire will help stabilise the healing bones. You will usually be referred to a hand therapist following surgery to help control swelling, regain motion, and provide a removable brace to protect the surgical site.

If you have any questions regarding a condition you have or to book an appointment, feel free to contact us here. Hand Therapy Group would be more than happy to help.

WRIST PAIN – QUESTION: A 17 year old male is complaining of pain in the right wrist after falling heavily on it during a rugby match. It has since started swelling and is painful to move and touch. What should he do?

What Is Wrist Pain?

The wrist is a complex region, and much like shoulder pain, it can be difficult to diagnose due to this reason. However, correct diagnosis is essential for proper treatment. Wrist pain is any kind of pain or discomfort in the wrist or surrounding areas. In general, touching or movement will cause an increase in pain.

Symptoms of wrist pain will vary depending on the issue. They can range from a dull ache to pins and needles, swelling, disfigurement and tenderness.

wrist pain

Causes of Wrist Pain

The causes of wrist pain are numerous, resulting from direct injury or diseases and conditions:

 Sudden impact: There are a number of injuries that can result from sudden impact, usually from falling directly on an outstretched hand. This can result in strains, sprains, fractures or dislocations. Hand pain from sudden impact is a common occurrence in sports and other strenuous activity and can often require immediate treatment.

Repetitive stress: Repetitive use of the wrist can result in a number of different conditions. This can be from something as minimal as typing on a computer, to hitting a tennis ball or using equipment such as a hammer at work. These can inflame joints and tissue. Tennis Elbow is an example of a repetitive stress condition, causing pain in the wrist, arm and shoulder.

Osteoarthritis: A type of arthritis that occurs when the soft cushiony cartilage on the end of your bones wears away. Although this is quite an uncommon condition in the wrist, it can happen. Those who have suffer as wrist injury in the past are often more susceptible to osteoarthritis.

wrist pain

DeQuervain’s Syndrome

Rheumatoid arthritis: Far more common condition in the wrist. Occurs when wrist tissue is attacked by the body’s immune system.

Carpal Tunnel Syndrome: Carpal Tunnel Syndrome is the compression of the median nerve as it passes through the carpal tunnel causing symptoms such as numbness, pins and needles, tingling, swelling, pain and weakness. It can be a result of other injuries or conditions, like a fracture or rheumatoid arthritis, that compress the median nerve.

Ganglion cysts: Small soft tissue cysts that occur in the wrist opposite the palms.

Keinbock’s disease: Occurs when blood flow to the wrist is compromised causing damage to the bones in the wrist. Often occurs in young adults.

DeQuervain’s syndrome: DeQuervain’s Syndrome is the irritation of the two tendons that insert at the base of the thumb as they pass through the extensor sheath. Can be caused by repetitive use of the thumb or wrist.

When Should You See Your Hand Therapist?

Some minor sprains and strains can be quite easily self-managed with ice and rest. If symptoms persist see your therapist.

Hand therapy is often necessary for conditions such as DeQuervain’s syndrome, Carpal Tunnel syndrome and Rheumatoid arthritis. If you are suffering from acute pain in the wrist, it is best to be safe and see a hand specialist.

Treatment

Therapists can allocate specific exercises for wrist injuries and conditions, and these will vary depending on the issue. Risk assessment in the workplace may be recommended for injuries caused by repetitive stress, and orthotic devices or hand splints may be necessary to help injuries heal.

Surgical treatment may also be necessary for some extreme cases (badly broken bones, carpal tunnel syndrome, ligament damage) and hand therapy may be required in the rehabilitation process.

If you have any questions regarding wrist pain or any other conditions you have, or to book an appointment, feel free to contact us here. We’d be more than happy to help!

What is shoulder pain?

Shoulder pain relates to any pain or discomfort that is located in or around the shoulder. It may originate from the joint or from any of the surrounding muscles or tendons. The shoulder is a complex region with many interconnected parts and a versatile range of motion, so locating the exact source of the pain may be difficult. In general, movement of the arm or shoulder will make the pain worse.

 

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The Hand Therapy Group are recognised leaders in therapy for the hand and upper limb. Lead by Director, Dr Anne Wajon, PhD, we employ highly qualified and experienced hand therapists (physiotherapists and occupational therapists) who offer expert assessment, diagnosis and treatment for people with hand and upper limb pain or dysfunction. You can follow Dr Wajon on Twitter!

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