Causes of pain in the wrist and hand

Dupuytren's contracture. In this case, there is a progressive thickening and fibrosis of the palmar (palmar) fascia. This condition can occur with family predisposition (autosomal dominant inheritance), alcoholism, with antiepileptic drugs, with Peyronie's disease (fibroplastic penile induction) and with congenital nodulation of the fingers. Most often, ring fingers and little fingers are amazed. As a rule, Dupuytren's contracture is bilateral and symmetric. The plantar fascia may also be affected. With thickening of the fascia, flexion occurs in the metacarpal joints. If the pathological process involves interphalangeal joints, the function of the brush can be completely broken. The goal of surgical intervention is to remove the affected palmar fascia and, consequently, to prevent the progression of the disease. There is a tendency to relapse after the operation. Strongly affected little fingers can be amputated.

Ganglia. These multilocal swellings (ganglion - protrusion of the tendon sheath) often arise around the wrist joint. They communicate with either the joint capsule or the tendon sheath and look like smooth spherical swellings containing a viscous transparent liquid. Patients require treatment because ganglia cause local symptoms of compression (eg, squeezing the median or ulnar nerves in the wrist area or the lateral nerve of the patella in the knee joint area). A strong blow to such an education can eliminate it (traditionally hit the family Bible). It can also disappear after it is aspirated with a wide-diameter needle. And, finally, the ganglia can be excised surgically, however, their relapse is observed for a fairly long time.

The de Cervin syndrome. The pain is felt above the styloid process of the radius bone, there is also a thickening of the tendons of the long muscle that leads to the thumb and the short extensor of the thumb. The pain increases with the tension of these tendons (for example, when lifting the kettle). Pain can also be caused by forced flexion or drawing of the thumb of the hand. The exact cause of the disease is not known, but it often occurs after an increased load on these muscles (for example, after squeezing the laundry). The initial treatment consists of injecting hydrocortisone around these tendons, as well as into the tendon sheaths. If, after treatment, rest and injection of hydrocortisone does not improve, then surgical decompression of these tendons is performed by "removing the roof" from their tendon sheath using a long incision.

The trigger finger. In this case, the constriction at the base of the tendon sheath causes a narrowing of the underlying tendon. Most often, the ring finger and middle finger are affected, as well as the thumb (especially in infants). Full extension of these fingers can not be achieved with the help of the muscles of the hand, and if at the same time help the other hand, then at the moment of reaching the full extension of the said fingers, the patients feel a kind of "click". In the initial period of the disease, hydrocortisone injection can be used. In surgical treatment, the narrowed part of the affected tendon sheath of the flexor muscles is expanded.

Völkmann's ischemic contracture. It occurs when impaired patency of the brachial artery in the elbow area (for example, after supracondylar fracture of the humerus). Muscular necrosis (especially of the long flexor of the thumb and deep flexor of the fingers) causes the contraction of the corresponding muscles and their fibrosis, which leads to flexion deformation in the wrist and elbow joints. Suspicion of this pathology can occur when the injured hand is cyanotic, the pulse on the radial artery is not probed, and the extension of the fingers is painful. In such cases, it is necessary to dilute bone fragments that cause the constriction of the artery, warm all limbs, which contributes to vasodilatation. If the pulse on the radial artery is not restored after 30 minutes, it is necessary to examine the brachial artery.

[1], [2], [3], [4], [5]