Common Hand Conditions: A Review.

Area of Science:

• Hand and wrist conditions
• Orthopedic surgery
• Rheumatology

Background:

• Carpal tunnel syndrome, trigger finger, de Quervain tenosynovitis, and thumb carpometacarpal joint arthritis are common causes of hand and wrist disability.
• These conditions disproportionately affect certain demographics and are linked to specific occupational or lifestyle factors.

Purpose of the Study:

• To review the clinical presentation, diagnosis, and treatment of common disabling hand and wrist conditions.
• To evaluate the efficacy of conservative and surgical interventions for these conditions.

Main Methods:

• Review of diagnostic criteria and physical examination maneuvers for carpal tunnel syndrome.
• Discussion of electrodiagnostic testing for suspected neuropathies.
• Overview of first-line conservative treatments (steroid injection, immobilization) and surgical options for each condition.

Main Results:

• Carpal tunnel syndrome diagnosis can be aided by physical exam (Durkan maneuver) and electrodiagnostic testing.
• Trigger finger affects up to 20% of adults with diabetes; steroid injection is first-line, with surgery for persistent cases.
• De Quervain tenosynovitis is more common in women and mobile phone users; steroid injection with immobilization is effective, with surgery for recurrence.
• Thumb carpometacarpal arthritis affects postmenopausal women; conservative treatments manage pain, while surgery is for refractory cases.

Conclusions:

• Carpal tunnel syndrome, trigger finger, de Quervain tenosynovitis, and thumb carpometacarpal joint arthritis can lead to significant patient disability.
• Initial management for these conditions typically involves steroid injections and/or immobilization.
• Surgical intervention provides a safe and effective treatment for patients who do not respond to conservative therapies or have progressive disease.