WRIST AND HAND INJURIES: DIAGNOSIS AND TREATMENT

The wrist and hand These are fundamental anatomical structures for the mobility and function of the upper limb. Due to their constant use in work, sports, and daily activities, they are susceptible to various injuries, both traumatic and degenerative.

In the Dr. Narváez ClinicWe offer accurate diagnosis and treatments minimally invasive and regenerativeallowing for a quick and effective recovery to improve the quality of life of our patients.

Common Wrist and Hand Injuries

Carpal tunnel syndrome

He carpal tunnel syndrome It is one of the most common compression neuropathies. It occurs when the median nerve It becomes trapped in the carpal tunnel, a narrow channel in the wrist, due to inflammation of the surrounding tissues.

  • Causes:
    • Repetitive wrist movements (prolonged use of computers, hand tools, musical instruments).
    • Fluid retention in pregnant women or people with metabolic diseases.
    • Inflammatory pathologies such as rheumatoid arthritis.
  • Symptoms:
    • Tingling and numbness in the thumb, index, middle and half of the ring finger.
    • Nighttime pain that may radiate to the forearm.
    • Loss of strength and difficulty holding small objects.
  • Diagnosis:
    • Clinical examination with specific tests (Phalen, Tinel and Durkan).
    • Electromyography to assess nerve involvement.
    • High-resolution ultrasound to assess nerve compression.
  • Treatment:
    • Night splints and physiotherapy in mild cases.
    • Ultrasound-guided injections with corticosteroids or hyaluronic acid to relieve inflammation.
    • In advanced cases, minimally invasive carpal tunnel release surgerywith rapid recovery.

Wrist ganglia

The ganglia These are benign cysts filled with synovial fluid that appear on the wrist, usually on the dorsal side, although they can develop in any joint of the hand.

  • Causes:
    • Weakness of the joint capsule or synovial tissue.
    • Repetitive movements that generate microtrauma.
    • Genetic predisposition.
  • Symptoms:
    • Swelling on the wrist or fingers, of soft or firm consistency.
    • It may be painless or cause discomfort when flexing the wrist.
    • In some cases, it compresses nearby nerves, causing tingling or loss of strength.
  • Diagnosis:
    • Clinical examination and ultrasound to determine its liquid content.
    • Magnetic resonance imaging in atypical or difficult-to-localize cases.
  • Treatment:
    • Ultrasound-guided aspiration in small symptomatic ganglia.
    • Injections with hyaluronic acid or corticosteroids in inflammatory cases.
    • In cases of recurrence or painful ganglia, arthroscopic surgery to remove the cyst with minimal scarring and rapid recovery.

Rhizarthrosis (arthritis of the thumb)

The rhizarthrosis It is the degeneration of the cartilage at the base of the thumb (trapeziometacarpal joint), one of the most used joints of the hand.

  • Causes:
    • Progressive wear due to repetitive use.
    • Genetic and hormonal factors, more frequent in women over 50 years of age.
    • Sequelae of previous traumas.
  • Symptoms:
    • Pain at the base of the thumb, which increases with pinching movements or when opening jars.
    • Morning stiffness and loss of strength in the hand.
    • Progressive deformity in the most advanced cases.
  • Diagnosis:
    • Clinical examination with specific maneuvers (Grind Test).
    • X-ray to assess the degree of joint wear.
  • Treatment:
    • Immobilization splints and physiotherapy in early stages.
    • Injections with hyaluronic acid and growth factors to improve lubrication and reduce pain.
    • In severe cases, minimally invasive surgery (partial trapezectomy or thumb prosthesis) to restore mobility.

Carpal injuries

He carpus It is composed of eight small bones that form the base of the hand. Its complex structure makes it vulnerable to fractures, dislocations, and impact injuries.

  • Common injuries:
    • Scaphoid fracture: Common in falls with an outstretched hand. May not be visible on initial X-rays, requiring MRI for detection.
    • Perilunar luxation: It occurs when the carpal bones lose their alignment after severe trauma.
    • Carpal impingement syndrome: Caused by abnormal friction between the carpal bones, generating chronic pain.
  • Symptoms:
    • Persistent pain in the wrist.
    • Inflammation and stiffness in movement.
    • In untreated fractures, progressive loss of mobility.
  • Diagnosis:
    • X-ray and MRI to assess bone and ligament damage.
  • Treatment:
    • Immobilization with splints and physiotherapy in stable fractures.
    • Percutaneous or arthroscopic surgery in displaced fractures or dislocations.
    • In cases of chronic pain, injections with hyaluronic acid and growth factors to improve joint function.

Tendon injuries of the hand and wrist

The tendons of the hand and wrist can be affected by inflammation (tendinitis), entrapment, or rupture.

  • Common pathologies:
    • De Quervain’s tendinitis: Inflammation of the thumb extensor tendons, causing pain on the radial edge of the wrist.
    • Spring finger: Thickening of the flexor tendon that makes it difficult to move the finger, causing locking and clicking.
    • Tendon ruptures: They can occur after trauma or repetitive strain.
  • Diagnosis:
    • Clinical examination with functional tests.
    • Musculoskeletal ultrasound to assess for inflammation or tendon rupture.
  • Treatment:
    • Physiotherapy and functional splints in mild tendinitis.
    • Ultrasound-guided infiltrations with growth factors to promote regeneration.
    • In severe blockages or ruptures, minimally invasive surgery to release the tendon or perform its repair.

Dr. Narváez Clinic’s Approach

In the Dr. Narváez ClinicWe apply advanced techniques of diagnostic imaging, regenerative treatments and minimally invasive surgery To effectively address wrist and hand injuries. If you suffer from pain, stiffness, or loss of mobility, we offer personalized treatment to help you regain your quality of life and functionality as quickly as possible.