Michigan Hand Services

Please see below for more information on select conditions treated and services provided at the Michigan Hand Center.

Arthritis of the Hand, Thumb and Wrist
Joints of the hand, thumb and wrist are common targets for arthritis, a disease that causes pain, swelling, and loss of movement in the joints. Arthritis may cause difficulty in performing everyday activities such as holding a cup or a tool, and is often best treated through surgery.

Arthroscopic Surgery
Our physicians commonly perform arthroscopy of the shoulder, elbow and wrist. This may be done as a less invasive way of diagnosing and treating a wide variety of problems; arthroscopic surgery avoids a larger incision and can speed up the healing process and rehabilitation.

Baseball Finger
Also known as Mallet Finger, Baseball Finger is caused by a sudden impact or blow to the tip of the finger, such as from a batted baseball. Following the impact, the tip of the finger can not be straightened out. Depending on the severity, this condition may require a finger splint or surgery.

Boutonnière Deformity
Boutonnière Deformity, or "buttonhole deformity," causes the middle joint of the finger to bend in a fixed position toward the palm, while the fingertip is bent away from the palm. Resulting from and injury, rheumatoid arthritis or osteoarthritis, this deformity may often be treated by splinting, but may require surgery in extreme cases.

Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) arises when pressure is put on the median nerve of the wrist that runs through a "tunnel" of bone and ligament. Certain medical conditions, wrist injuries, repetitive movements, and pregnancy may all cause CTS. This condition may cause numbness, tingling or pain in the hand. Treatments vary from splinting, medication and exercises to surgery.

Colles' Fracture
A common injury often resulting from a fall, Colles' Fracture occurs when the lower arm bone fractures right above the wrist. Immobilization or surgery may be required for optimum healing.

Congenital Disorders
Upper extremity difference that are present at birth are called classified as congenital abnormalities or disorders. These differences may range from mild, such as constriction bands on the fingers, to severe, such as part of an arm remaining unformed. Some congenital problems may be inherited, others may be traced to the forming of the baby within the womb, and others have no known cause. Many types of treatments are currently available, including therapy, prostheses, and surgery. The specialists at the Michigan Hand Center will work with you to find the best solution for your child.

DeQuervain's Tenosynovitis
De Quervain's tenosynovitis is a type of tendonitis that involves the tendons on the thumb side of the wrist. This condition can be caused by an injury, but most often is seen with repetitive activities such as unscrewing jar lids, grasping tools and frequent picking up children under the arms. In some instances the disease is referred to as nursemaid's wrist. The symptoms are pain and swelling at the thumb side or radial side of the wrist. Pain is felt mainly while gripping or pinching with simultaneous twisting of the wrist. Sometimes with simple flexion and extension of the thumb, a clicking sensation can be felt and is associated with pain. When the condition is diagnosed, and especially when it is mild or early, conservative treatment consisting of anti-inflammatory medications and use of a thumb splint may result in resolution. Unresolved de Quervain's tenosynovitis can then be treated surgically by releasing or opening up the tendon sheath. Recurrence is very unusual.

Dupuytren's Contracture
Dupuytren's disease is an abnormal thickening of the fascia, which is the tissue between the skin and the tendons in the palm of the hand. The disease may affect all digits but most commonly affects the middle, ring and little fingers; it may also affect the feet. This condition is most common in Caucasians with ancestors from northern Europe, and tends to run in families. Dupuytren's disease is significantly more common in men than in women, and usually starts after age forty. This condition may first present itself as a painless lump in the palm of the hand, usually at the base of the ring or little fingers. As the disease progresses, it may cause a flexion contracture or gradual bending of the affected fingers. When the contracture becomes severe enough that the patient cannot fully extend or straighten the fingers, surgical treatment is usually indicated. Diseased tissue is then completely removed, allowing near-full extension of the fingers and thus improving the function and appearance of the hand. However, patients should be fully aware that the disease has a strong history of returning in the same or in new areas. Severe cases may require therapy and the use of splints after surgery; the healing time after surgery is usually about four to six weeks.

Emergency Hand Surgery
Hand surgeons are qualified to treat many upper extremity conditions, including immediate injury care.

Fingernail Problems
Minor infections involving the fingernail are common, and most can be treated in the office with antibiotics and soaks. Some more serious infections require removal of all or part of the fingernail, but permanent nail deformities from infection are uncommon. The most common injuries of the hand are crush or laceration injuries of the fingernail bed. Unfortunately, deformities of the fingernail are quite common after this type of injury, though proper initial care of the nail bed minimizes the deformity.

Fingertip Injuries/Amputations
Although the occurrence of finger amputations in the workplace has fallen 50% over the past twenty years due to current safety measures, amputations still occur all too frequently both on and off the job. Saws remain the tool most often involved. The goal of the surgeon is to properly advise and treat the patient, preserving function of the hand and minimizing long term pain problems. Preservation of severely injured and useless tissues can have a negative impact on hand function.

Flexor Tendon Injuries
Injuries to the flexor tendons of the fingers represent some of the more challenging injuries in hand surgery. The flexor tendons run in very intricate tunnels in the fingers that are very prone to severe scarring. The scarring which occurs after repair of the tendons frequently limits the motion in the fingers once healing has occurred. Hand therapy in a carefully supervised program improves results. Secondary surgery months after the injury can improve the result in some situations.

Fracture of the Finger
Although you might think a broken finger is a minor injury, without proper treatment it can result in major problems. Normally, the bones in the hand line up precisely, letting you perform specialized functions and fine motor activities. However, a finger fracture can put your whole hand out of alignment. Signs of a finger fracture (break) include swelling, tenderness, inability to move it completely, and deformity. Without proper treatment, a broken finger might become chronically painful and stiff. Seeking medical care swiftly can minimize the likelihood of the development of these problems.

Ganglions (Cysts) of the Wrist
Ganglions (cysts) commonly grow on the top of the wrist (dorsal ganglions), but they may also occur on the underside of the wrist between the thumb and the pulse point. A ganglion grows out of a joint on a stalk, and is filled with thick, slippery fluid. Usually, the more active you are the larger the cyst becomes; when you rest it may decrease in size. No one knows what triggers the formation of a ganglion, but they can be painful if they put pressure on the nearby nerves and tendons. Smaller ganglions that remain hidden under the skin (occult ganglions) may be quite painful. Treatment options include observation, immobilization, aspiration, and surgical excision.

Hand Fractures
Metacarpal fractures account for one-third of all hand fractures. The hand can break near the knuckle, mid-bone, or near the wrist. Signs and symptoms of a broken bone include: swelling, tenderness, deformity, inability to move the finger, shortened finger, depressed knuckle, or a finger crossing over its neighbor when you make a partial fist.

Hand Surgery
When your doctor or one of our physicians determines that surgery will benefit you, be assured that the doctors and staff at The Michigan Hand center are highly skilled and experienced in many types of hand, wrist, and arm surgeries, and are committed to making the experience as comfortable as possible.

Hand Therapy
Hand therapy provides exercises and activities designed to return your hand to normal use. Either in response to an ongoing ailment or after a surgery, therapy can help increase range of motion, strength, and function, and aid in wound healing. The surgeons at the Michigan Hand Center are dedicated to working as a team with you and your hand therapist to achieve the best results possible.

Joint Replacement (Arthroplasty)
Joint replacement (arthroplasty) in the upper extremity has advanced by leaps and bounds in recent years. Physicians at the Michigan Hand Center routinely perform these operations on the shoulder, elbow, wrist and finger joints. This surgery allows patients with end stage or severely painful arthritis to maintain functional motion, and may occasionally be necessary in cases of severe trauma or tumors.

Kienböck's Disease
Kienböck's disease is a painful condition of the wrist, first described by German scientist Robert Kienböck in 1928. Most individuals present with vague pain in the wrist that becomes progressively worse. This condition is caused by degeneration of the lunate bone, which causes pain and loss of function in the wrist. Kienböck's disease may affect young, active, and productive patients. Diagnosis is determined by a careful wrist evaluation and specialized radiographic studies. Treatment is dependent on the stage of the disease and individual considerations. The surgeons at Michigan Hand Center provide expert evaluation and treatment for wrist conditions such as Kienböck's disease.

Ligament Injuries
Ligaments are the fibrous bands that provide support to all joints. Ligament injuries, often classified as sprain injuries, are some of the most common forms of trauma the hand receives. Following an injury to a ligament, most patients will experience pain and swelling around a specific joint. Because x-rays are typically normal and these conditions are common and may seem minor, ligament injuries are often under-diagnosed and under-treated. It is essential that these injuries be evaluated properly as soon as possible because proper splinting and therapy provide the best opportunity for a return of normal function, while a delay in treatment often results in protracted stiffness, limited motion, and pain.

Nerve Injuries
Nerves are the "electrical wiring system" that carry messages from the brain to the rest of the body; some messages are sent to muscles to make the body move, while others provide information about pain, pressure, and temperature. Nerves are very fragile structures and can be damaged by pressure, stretching, or lacerations; an injury to nerves of the upper extremity can result in significant pain and dysfunction. The sooner these injuries are identified and treated, the better the prognosis is for recovery. Microsurgical techniques are often used for nerve repairs. During the recovery phase-when the nerve regenerates-hand therapy is an important part of achieving a good recovery.

Reflex sympathetic dystrophy
Reflex Sympathetic Dystrophy (RSD) is an uncommon but serious condition that may occur after an injury to the upper extremity. Usually it is the result of a significant nerve injury or crushing type injury, but may occur even with minor injuries or after routine procedures. For some individuals, the body responds to injuries with an abnormal pain "reflex" that causes significant, continuing pain, stiffness, and an inability to use the upper extremity for normal activities. The key to successful treatment of RSD is early recognition of the problem and aggressive intervention with therapy and often times referral to a pain specialist.

Replantation
Replantation is the reattachment of a severed part of the body using microsurgical techniques. This may include reattachment of fingers, hands, the arm, and even the scalp, ear, or nose. Many parts of the body can be successfully replanted if the damage to the particular part is not severe. The severed part should always be saved, placed in a clean gauze or paper towel, sealed in a bag and then placed in a mixture of ice and water. Cooling the tissue helps preserve it until it can be reattached. However, not all amputations are able to be replanted. Each case is carefully evaluated and patients are educated about the pros and cons of replantation. The doctor and patient often make a decision together about whether or not a part will be replanted based on several factors. The Michigan Hand Center physicians have extensive experience in microvascular surgery and replantation.

Restoring Hand Function after Spinal Cord Injury
A patient with a spinal cord injury may have paralysis that affects how they use their hands. In cases where paralysis causes weak hand function, surgery can be performed that may restore partial strength and motion to the fingers. This type of surgery requires specialized therapy afterwards, but it can be incredibly rewarding, restoring abilities that had been lost due to the paralysis.

Scaphoid (wrist bone) Fracture
The scaphoid or navicular bone is the most commonly fractured wrist bone. It is usually the result of a fall onto the outstretched hand. Often, these fractures are initially missed on routine x-rays or ignored by the patient as a "sprain." If not treated appropriately, a scaphoid fracture may not heal, resulting in eventual collapse and arthritis of the wrist many years later. The scaphoid bone takes longer than most bones to heal. Sometimes surgery is recommended to place a screw across the fracture for better healing.

Skiier's Thumb
The skier's thumb is a serious injury to the strong ulnar collateral ligament of the thumb. It is usually the result of falling onto the hand while holding a ski-pole, causing the thumb to be bent outwards. It can result from common falls around the house as well. This injury needs to be diagnosed early and is usually treated surgically by reattaching the torn ligament. If left untreated, it can result in a painful, weak, and unstable thumb.

Shoulder Injury or Disorder
Patients with aching pain in the top or front of the shoulder, perhaps extending into the outer arm or neck, may be suffering from shoulder injury or disorder.

Sports Injuries
Sports can cause a variety of finger, hand, and wrist injuries. These injuries can be minor, such as a sprain, or major including broken bones. To treat these injuries properly, they need to be diagnosed early. Successful treatment depends on the type of injury and may require splints, therapy, and/or surgery. The ultimate goal is to return the athlete, be it weekend warrior or professional, back to their sport.

Sprained Thumb
The thumb is a commonly injured digit of the hand. The thumb may be considered the most important digit, and injuries to the thumb are very disabling. While sprains are common, more serious injuries to the thumb may be misdiagnosed as simple sprains. A sprained thumb should be promptly examined by a doctor to determine the best course of treatment.

Sprained Wrist
A sprained wrist is a common injury, usually caused by a fall or sudden twist. The injuries can vary from mild, causing brief pain, to major injury resulting in damage to a ligament, or even a broken bone. Early diagnosis of the problem is the key to treatment and very often x-rays or other tests are needed. Treatment can include splints, therapy, and surgery, including arthroscopic wrist surgery.

Thumb Fractures
The thumb is commonly fractured (broken), as the thumb is separate from the fingers and is therefore prone to injuries. To ensure the best outcome, these injuries are best seen to early; they may require a cast, protective splint, or surgery for optimum healing.

Trigger Finger
Trigger finger (also known as stenosing tenosynovitis) is characterized by pain at the base of the finger or locking, clicking, or catching of the finger. This occurs when tendons in the palm of the hand thicken or swell, impeding correct hand movement. Treatment ranges from medication, splinting and massage to surgery.

Ulnar Tunnel Syndrome
Ulnar Tunnel Syndrome (UTS) is a common disorder where the ulnar nerve loses blood-flow as it courses around the inner bony part of the elbow. This is the spot that people refer to as the "funny bone." UTS can result in numb fingers (usually the ring and pinky) as well as weakness of the hand muscles. It often bothers patients while sleeping, driving, working or other times when the elbow is bent.

Work Injuries
The Michigan Hand Center physicians see patients with work related injuries of all sorts. Commonly we care for traumatic injuries (cuts, fractures, crush injuries, amputations, etc.) as well as repetitive trauma types of problems such as Carpal Tunnel, Tennis Elbow, hand, wrist, elbow and shoulder pain, etc. We provide back-to-work rehabilitation, strengthening and work-hardening programs.

Conclusion
We hope that this web page has been helpful in sharing the information about common problems of the hands, wrists, and upper extremities. The physicians at The Michigan Hand Center can develop a tailored treatment program to help you recover from your condition. If you have further questions or concerns, please do not hesitate to contact one of our physicians or nursing staff.

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