Miss Kirsten Beyermann | Wrist Surgery Salisbury
Information on wrist conditions treated in Salisbury
wrist surgery salisbury, carpal tunnel syndrome, dupuytren's contracture, ganglion cyst, trigger finger, wrist arthritis, wrist ligament injury, wrist surgery, wrist conditions
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Wrist Surgery Salisbury

The information outlined below on common conditions and treatments is provided as a guide only and it is not intended to be comprehensive.

 

Discussion with Miss Beyermann is important to answer any questions that you may have. For information about any additional conditions not featured within the site, please contact us for more information or go to the ASSH website.

COMMON CONDITIONS OF THE WRIST
CARPAL TUNNEL SYNDROME

Carpal tunnel syndrome (CTS) is a condition where the median nerve is compressed where it passes through a short tunnel at the wrist. The tunnel contains the tendons that bend the fingers and thumb as well as the nerve (see diagram). CTS commonly affects women in middle age but can occur at any age in either sex. CTS can occur with pregnancy, diabetes, thyroid problems, rheumatoid arthritis and other less common conditions, but most sufferers have none of these. CTS may be associated with swelling in the tunnel which may be caused by inflammation of the tendons, a fracture of the wrist, wrist arthritis and other less common conditions. In most cases, the cause is not identifiable.

 

 

For more information on the symptoms and treatment of carpal tunnel syndrome, please visit the BSSH website here.

DISTAL RADIUS FRACTURES

The radius is the larger of the two bones of the forearm. The end toward the wrist is called the distal end. A fracture of the distal radius occurs when the area of the radius near the wrist breaks.

 

Distal radius fractures are very common. In fact, the radius is the most commonly broken bone in the arm. A distal radius fracture almost always occurs about 1 inch from the end of the bone. The break can occur in many different ways, however.

 

For more information on the symptoms and treatment of hand and wrist fractures, please visit the BSSH website here.

NERVE DAMAGE

A nerve injury can occur when the wrist is cut, overstretched, crushed or burned. Symptoms include numbness and difficulty moving the affected area.

 

Treatment depends on the severity of the injury, and may include rest, immobilization, physical therapy, and in some cases, surgery.

 

For more information on the symptoms and treatment of nerve injury, please visit the BSSH website here.

SCAPHOID FRACTURES

A scaphoid (navicular) fracture is a break in one of the small bones of the wrist. This type of fracture occurs most often after a fall onto an outstretched hand. Symptoms of a scaphoid fracture typically include pain and tenderness in the area just below the base of the thumb. These symptoms may worsen when you try to pinch or grasp something.

 

For more information on the symptoms and treatment of hand and wrist fractures, please visit the BSSH website here.

TENDON / LIGAMENT REPAIR

If any of the tendons in your hand are damaged, surgery may be needed to repair them and help restore movement in the affected fingers or thumb.

 

Tendons are tough cords of tissue that connect muscles to bones. When a group of muscles contract (tighten), the attached tendons will pull on certain bones, allowing you to make a wide range of movements.

 

For more information on the symptoms and treatment of tendon and ligament injuries, please visit the BSSH website here.

WRIST LIGAMENT INJURIES

Ligaments are the connective tissues that connect bones to bones; they could be thought of as tape that holds the bones together at a joint.

 

The most common ligament to be injured in the wrist is the scapho-lunate ligament. It is the ligament between two of the small bones in the wrist, the scaphoid bone and the lunate bone. There are many other ligaments in the wrist, but they are less frequently injured. Sprains can have a wide range of severity; minor sprains may have minimal stretch of the ligaments, and more severe sprains may represent complete tears of the ligament(s). Another common ligament injured is the TFCC (triangular fibrocartilage complex).

 

What is the cause?

 

Wrist sprains are common when a person falls. The wrist is usually bent backwards when the hand hits the ground.

 

What are the symptoms?

 

After injury, the wrist will usually swell and may show bruising. It is usually painful to move.

 

What is the treatment?

 

Initially Miss Beyermann will examine your wrist to see where it hurts and to check how it moves. X-rays are taken to make sure there are no broken bones or dislocated joints (see Figure 3). Occasionally other studies, such as Magnetic Resonance Imaging (MRI), may be performed.

 

Treatment
Treatment may range from wearing a splint or cast to surgery. Surgery may consist of arthroscopic (with an internal camera) or open surgery. Arthroscopic surgery is performed through small (3-4 millimeter) incisions in the skin. A camera and other special instruments are placed inside the wrist to confirm the diagnosis and potentially treat the ligament injury. Some injuries require open surgery, where an incision is made to repair the ligament. A variety of repair methods exist, which could include metal pins, screws, and other specialized devices. Patients are usually placed in a splint or cast that may need to remain on for several weeks after surgery. Miss Beyermann will determine the best course of treatment.

 

Chronic injuries
The term “chronic” refers to an old injury of greater than several months to years. If there is no or minimal cartilage damage, the ligament may be reconstructed. If there is moderate to severe cartilage damage (arthritis), symptoms may include pain, stiffness, and swelling. Chronic injuries may first be treated with splinting and non-steroidal anti-inflammatory medicines, and later with cortisone injections. If these treatments fail, surgery may be an option. Various types of procedures are possible, including a partial wrist fusion, removal of arthritic bones (“proximal row carpectomy”), wrist replacement, or complete wrist fusion. Miss Beyermann will determine the best course of treatment.

 

Associated injuries
Occasionally fractures occur along with this type of sprain.These may require additional procedures to repair the fracture with metal pins, screws, or plates. Cartilage damage may also be present, which does not show up on the x-ray.

 

Future treatments
The optimum treatment for these injuries is not always clear. There is much research underway searching for better methods to treat these serious injuries.They include stronger and more precise ligament reconstructions using either local tissues (tendons) or distant tissues (ligaments from the hand or foot).

WRIST ARTHROSCOPY

Wrist arthroscopy is a surgery that allows a doctor to see the inside of a joint. It is performed after a patient sustains an injury such as a fall or a twisting of the wrist and is experiencing pain, clicks or swelling. These symptoms may mean there is an internal problem of the wrist. Arthroscopy is often the best way of directly looking at the injury and repairing it. The procedure can be used to help align fractures of the wrist, remove some ganglions of the wrist, wash out infection, or remove excess joint lining associated with inflammation from conditions like rheumatoid arthritis.

 

In the last five years, the wrist has become the third most common joint to undergo arthroscopy, after the knee and shoulder. Because the cuts used with this procedure are smaller and disrupt less soft tissue than typical surgery, pain, swelling and stiffness are minimal, and recovery is often faster.

 

Procedure

 

Miss Beyermann can see the ligaments and cartilage surfaces of bones with wrist arthroscopy. Some parts of ligaments have a good blood supply and can be repaired and heal, whereas other parts do not have a blood supply and don’t heal, so they are removed.

 

 

During the procedure, a small camera fixed to the end of a narrow tube is placed through a small cut in the skin directly into the back of the wrist joint. The image is projected onto a television screen for better viewing. Several small cuts are used to allow the surgeon to place the camera in a number of positions to see the cartilage of each bone, the ligaments and the joint lining called synovium.

 

If you would like to get more information and videos on wrist arthroscopy, please visit the ASSH website here.

 

Discussion with Miss Beyermann is important to answer any questions that you may have. For information about any additional conditions not featured within the site, please contact us for more information.

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