Carpal Tunnel Syndrome is the most common hand operation performed in the UK. It is a relatively straight forward procedure with good outcomes if managed appropriately.
Many thanks to Lynda Gwilliam, Senior Head Therapist, at Wrightington Hospital who provided much of the information and protocols here.
Please browse the following information for hand therapists:
Distal Radio-Ulna Joint replacement
Currently there are a number of different implants in use. The Herbert distal ulna replacement has been available for a number of years and is involves the replacement of the distal ulna.
Dupuytrens Disease can affect a single digit or multiple. Often multiple procedures are required and as the disease is not curable, there is more than one procedure on the same finger.
Hypersensitivity refers to a condition of extreme discomfort or irritability in response to a normally non-noxious tactile stimulation. It occurs at or near to the site of injury or surgical incision.
Metacarpal Phalangeal Joint Replacements
Traditionally MCPJ replacements have been of silicone construction inserted into patients with rheumatoid disease. However osteoarthritis (OA) either primary or secondary to trauma does occur.
Proximal Phalangeal Joint Replacements
PIPR is indicated in both osteoarthritis and rheumatoid arthritis. There are various types of implants that are currently used.
Total Wrist Arthroplasty
When deciding on post operative rehabilitation, the routine is determined by the operating surgeon at the time of surgery and should be documented in the notes.
Trapeziectomy / Carpal metacarpal Joint replacements of the thumb
Basal thumb arthritis is extremely common in the population secondary to osteoarthritis (OA) at the carpal-metacarpal joint (CMC). Traditionally procedures such as trapeziectomy with or without a ligament suspension have been performed.
Wrist arthrodesis (fusion) is currently used in patients whose radiocarpal joint has been damaged by trauma or arthritis, and where the patient has severe pain.
Cubital Tunnel Syndrome
Cubital tunnel syndrome occurs due to compression of the ulnar nerve at the elbow. It is the second most common nerve compression and causes tingling of the little and ulnar half of the ring finger with weakness of small muscles of the hand and/or the thumb.
De Quervain's Tenosynovitis
De Quervain’s syndrome is stenosing tenosynovial inflammation of the 1st dorsal compartment. This impairs gliding of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons and thumb function, and causes pain on the radial (thumb) side of the wrist.
Trigger finger is a disorder characterised by intermittent triggering or locking of the finger or thumb with or without pain, generally occurring in the palm at the level of the metacarpophalangeal (MCP) joint. In most cases it is due to a non-inflammatory thickening of the digit’s A1 pulley with secondary entrapment and/or sometimes thickening of the tendon(s)/ inflammatory nodules; however the exact aetiology remains unclear.