What joints are in the hand?

The hand is made up of a variety of different muscles, bones, and ligaments that give it the high level of dexterity that allows us to perform a variety of tasks. The human hand has three main bone types:

  1. Phalanges are the 14 bones located in the fingers. There are two joints and three bones for each finger, while the thumb only has one joint and two bones.
  2. Metacarpal bones are the five bones found in the middle of the hand.
  3. Carpal bones are the two rows of small bones that make up the wrist and are connected to bones in the arm (radius and ulna).

The ligaments in the hand hold the bones together, while the muscles are connected to the bones via tendons. The muscle contract and expand when the hand is activated. Each finger in the hand is surrounded by a tubular sheath that works as a form of elastic pulley to help transmit forces from the muscles.

Common Hand Conditions And Injuries

Because of how frequently the hand is used, this part of the body is regularly exposed to injury either through wear and tear or sudden trauma. Hand conditions and injuries can range from mild sprains to broken fingers and a loss in the ability to grip and lift objects. Hand injuries can also often involve damage to the nerves that impact muscle operation and sensitivity.

Common hand injuries and conditions include:

  • Hand tendonitis – Irritation or inflammation of tendons in the hand, causing pain and restriction in motion. Pain is more noticeable when trying to grip objects.
  • Trigger finger – Narrowing of the space within a finger sheath that causes the finger to be stuck in a bent position. It can also occur in the thumb.
  • Finger fractures – One or more bones in the finger are broken due to sudden impact, most often a fall onto an outstretched hand.
  • Carpal tunnel syndrome – Compression of the hand’s median nerve that is typically associated with repetitive motion. It causes pain that worsens without treatment.
  • Dupuytren’s contracture – A thickening of the fascia underneath the skin that causes fingers to be pulled towards the palm (contracture). It can vary in severity.
  • Hand arthritis – Breakdown of the cartilage that separates the bones in the hand, causing them to rub together, causing pain and loss of function.

How Can A Hand Injury Be Diagnosed?

X-rays are the main diagnostic tool used for fractures and dislocations. Soft tissue problems can be diagnosed at the time of consultation. Sometimes CT scans or MRI scans are required to help in diagnosis or for operative planning.

Other means of diagnosing hand injuries include arthrography, bone scintigraphy, videofluoroscopy, electromyography, and ultrasound. Arthrography and bone scintigraphy involves the injection of dyes to allow doctors to more easily observe the condition of joints, tissues and structures.

What Are The Treatment Options For Hand Injury?

There are a variety of surgical and non-surgical treatment options for hand injuries. Non-surgical treatments include rest, application of ice, compression bandaging, and non-steroidal anti-inflammatory medications. More severe injuries may require the application of a brace, cast, or splint and physical therapy.

Surgical intervention may be necessary if these non-surgical treatments fail to provide adequate relief and restore hand function.

Types of Hand Surgery

Carpal Tunnel Surgery

Also called carpal tunnel release or carpal tunnel decompression, carpal tunnel surgery involves cutting the ligament around the carpal tunnel to relieve pressure from the median nerve. This surgery can either be performed open or arthroscopically.

Trigger Finger Release Surgery

Trigger finger release surgery, also called tenolysis, involves releasing the A1 pulley (a tubular sheath) that keeps the flexor tendon in place as the finger is moved. This release allows the flexor tendon to pass more easily through the sheath, removing the pressure that causes symptoms of trigger finger.

Finger Arthritis Surgery

Finger arthritis surgery, called finger joint fusion, involves removing damaged ends of bone in a finger joint. This is followed by the installation of a prosthesis to reattach (fuse) the bones together.

Finger Fracture Surgery

Finger fracture fixation surgery involves the realignment of bones using wires, screws, or pins to put them back in the correct position. The surgery is performed under local anaesthesia, and a cast or splint is applied afterwards to ensure the bones heal correctly.

Dupuytren’s Contracture Treatment

Dupuytren’s contracture surgery is known as a partial fasciectomy. The surgeon makes an incision in the hand and removes the thickened tissue to straighten out the affected fingers.

Thumb Joint Arthritis Surgery

Several different procedures can be used to treat thumb arthritis. Bones in the joint can be fused together (this will limit movement, however). Another procedure involves removing the damaged part of the joint and reconstructing it with a prosthetic or tendon graft.

Hand Surgery: FAQs

What to expect during and after hand surgery?

During hand surgery, you can expect to be administered with local or general anaesthesia, depending on the invasiveness of the procedure. After surgery, mild to severe pain can be expected, but pain medications will be prescribed to offset these effects. A splint or bandage may also immobilise your hand after surgery, and you may be instructed not to perform certain activities like work or driving for a certain period.

How long does hand surgery recovery take?

The time it takes to recover from hand surgery depends on the procedure you had and what aftercare instructions you have been given. The time it takes between hand strength and full hand function returning will also vary.

Can I drive after hand surgery?

You will not be able to drive for 24 hours after receiving anaesthesia or sedation. After those 24 hours, if your hand surgery impacts your ability to firmly grip the steering wheel and operate other vehicle functions, you should not drive. Make sure you check with your surgeon regarding when you can safely drive again.

What is the average cost of hand surgery?

Depending on the complexity of the procedure, you could expect to pay between $500 to $1000 for hand surgery. Costs will vary depending on your private health insurance, and you will need to factor in other charges for physiotherapy needed post-treatment.

Matthan Mammen

Mr. Matthan Mammen

MS, FRACS (Orth)

Matthan is an internationally qualified orthopaedic surgeon, who is a Fellow of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association.

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