Hand and wrist injuries could happen to anyone. Fortunately, an orthopedic hand specialist in Kansas City offers the expertise needed for accurate diagnoses and effective treatments. Regardless of whether you sustain an acute injury such as a fracture, tendon, or ligament injury, arthritis, or develop a chronic condition such as carpal tunnel syndrome, it’s important to understand how a specialized physician can help.
Our hand and wrist doctor at APEX Orthopedics & Sports Medicine, Dr. Valerie Deardorff, has years of experience treating patients of all ages—from childhood to the elderly. She believes educating her patients helps them understand their problem and find the right treatment to allow them recover from their hand and wrist issues.
Read on to learn more about conditions hand specialists treat and our most frequently asked questions.
Common conditions orthopedic hand and wrist specialists treat
Orthopedic hand and wrist physicians treat a wide range of tendon, bone, muscle, and nerve conditions that affect the hand and wrist (and sometimes the elbow). However, congenital issues that developed before birth, such as extra fingers, require further specialization at a tertiary care center such as a children’s hospital.
While you should never try to diagnose yourself, here are a few common hand and wrist conditions that lead people to an orthopedic hand physician.
Carpal tunnel syndrome
Carpal tunnel syndrome is a type of nerve compression involving the median nerve (one of two major nerves in the hand). In an ideal anatomical course, nerves travel in smooth tunnels cushioned between muscles, ligaments, and bones. When those spaces around a nerve narrow, it can cause nerve compression and irritation, leading to pain, numbness, and weakness.
The median nerve runs through the carpal tunnel, a narrow passage inside the wrist. When the tunnel narrows or surrounding tissues swell, the median nerve gets compressed, leading to symptoms such as pain, tingling, and/or numbness. If untreated, continuous pressure on the nerve can cause more severe long-term damage.
Carpal tunnel syndrome may come from:
Specific anatomy: Your body may naturally have narrower tunnels that affect the traveling nerve.
Trauma: Acute trauma can cause nerve damage (i.e. a displaced bone fracture pressing on a nerve).
Repetitive activities: Forceful repetitive wrist and hand movements can irritate the surrounding tendons, which may add pressure to the median nerve.
Osteoarthritis: Bony enlargement from arthritis occasionally narrows the carpal tunnel.
Trigger finger (also known as stenosing tenosynovitis) happens when a finger gets stuck in a bent position; in some cases the finger may snap straight again.The underlying causes can vary. Tendon inflammation could also lead to trigger fingers.
If you visit an orthopedic hand specialist for trigger fingers, diagnosis typically does not require advanced testing and studies. Often, a physician can determine whether or not you have the condition based on a physical examination, history, and symptoms. Trigger finger symptoms may include:
- Tenderness in the palm at the base of the finger
- Stiffness (may be more noticeable in the morning)
- Clicking or popping of the finger
- Nodules at the base of the finger
Wrist and hand fractures
Fractures involve one or multiple broken bones and can range in severity. As with other areas of the body, fracture-causing injuries may come from anything—falling, sports, car accidents, jammed fingers, even yard work. Treatment typically involves casting for a designated time period. Here’s why:
A broken bone creates a gap at the fracture site. Bone healing cells have to jump across the gap to knit the bone together, but if the bone constantly moves, those cells can’t cross and heal the fracture. A cast (or even a splint in some cases) holds the bones together so healing can continue properly. Without a cast or splint, bone healing cells will build bone everywhere due to too much motion. As a result, healing could take a lot longer.
While most fractures heal through conservative treatment options, some patients may require surgery based on two main factors:
- Abnormal bone alignment that cannot heal
- Deformities that would affect a patient’s ability to use the hand/wrist optimally
During a visit, your physician can better understand the extent of your fracture and help you understand your treatment options.
Hand and wrist osteoarthritis causes wear and tear of the cartilage around bones, which leads to inflammation, pain, and even joint degeneration. One of the biggest differences between the hand and wrist and other joints is the number of bones.
The hip joint, for example, is created by the ball-shaped head of the thigh bone (femur) articulating with the hip socket (acetabulum)—two pieces to create movement on various planes. On the other hand, the hand and wrist are a collection of joints; you can imagine this as a cluster of small bones working in harmony, which can make arthritis pain more complex.
Diagnosis for hand and wrist osteoarthritis requires an examination from a physician along with tests such as X-rays or ultrasounds. But you may have an idea on whether you have osteoarthritis based on these symptoms:
- Reduce range of motion/stiffness
- Difficulty writing or typing
- Grinding or clicking when you move
- Difficulty gripping objects
Keep in mind the above three conditions are only a few examples, so it’s often best to visit a hand and wrist specialist before you assume you have an untreatable condition. In many cases, a hand specialist also treats:
- Ganglion cysts
- Tendon injuries
- Cubital tunnel syndrome
- Nerve injuries
- Mallet finger
- Ligament injuries
- And more
What to expect at APEX Orthopedics: Frequently Asked Questions
What are common signs I have a hand and/or wrist problem?
Common signs of a hand and/or wrist problem depend on the condition itself. However, you could watch for:
- Crooked fingers/deformity
- Loss of motion/stiffness
- Abnormal finger rotation when making a fist
If I have symptoms, do I need to see an orthopedic specialist right away?
If you have an acute problem that results from an injury, you should see an orthopedic specialist right away. For example, a fracture that is not treated appropriately shortly after it occurs could heal wrong, and the doctor would have to rebreak the bone. In other cases, tissues could become too tight, affecting the physicians ability to correct the issue. For more chronic conditions, it’s best to see an orthopedic surgeon to determine the correct diagnosis and treatment plan.
How do you assess orthopedic hand and wrist conditions?
Assessment depends on the injury. Your physician will start with obtaining a history and perform a physical examination. Often, we will obtain an X-ray, then an MRI or ultrasound if needed. If you have a tendon or nerve laceration, we normally won’t require those diagnostic tests. Ligament injuries sometimes require an MRI, but often a physical examination and X-ray are enough.
What are the differences between treating a child and an adult?
The first big difference between treating a child and an adult are the growth plates in children, which presents a problem and an advantage.
The problem: A growth plate injury could cause the plates to asymmetrically or even completely close down. In many cases, there is no concrete way to know whether or not the plates will close, so Dr. Deardorff makes sure these fractures heal in the best alignment possible.
The advantage: Children’s bones remodel. This means that the bone does not have to heal in a perfect position since it will straighten with time. One side of bone will grow faster than the other to compensate. This greatly reduces the need for surgery.
With older adults, we can sometimes accept mild deformities depending on lifestyle factors. For example, one 70-year-old patient may live a fairly sedentary lifestyle while another may bike every day. At the end of the day, Dr. Deardorff treats the patient based on physiological age/activity rather than the actual age.
What should I know before my initial appointment at APEX?
First, you should make sure you have filled out all of your paperwork and have your medical history prepared. If you have previous diagnostic tests, bring them so we can review and better understand your condition.
During your appointment, you will sit with Dr. Deardorff to discuss your problems, pain levels, exacerbating factors that increase or decrease pain, previous treatments, and more. From there, she will perform a physical exam and other important diagnostic studies. With all of the necessary information, Dr. Deardorff explains your diagnosis and treatment options, including which treatments will alleviate which conditions.
People often come in with multiple diagnoses, so Dr. Deardorff delineates each problem, giving patients a good understanding of their symptoms. For instance, if you come in for carpal tunnel surgery, she will highlight that it won’t resolve thumb arthritis pain. She thinks it is important for patients to have an understanding of which symptoms are related to each diagnosis and the treatment expected to resolve those issues.
Get to know Dr. Deardorff at APEX Orthopedics & Sports Medicine
Dr. Valerie Deardorff is our only wrist and hand specialist at APEX, and she completed a Hand and Upper Extremity fellowship at the University of Miami. She specializes in chronic and acute conditions of the elbows, forearms, wrist, and hands. Her practice centers around her patients, and she believes being an educator is her most important role as a physician.
With the help of the APEX’s private practice model, Dr. Deardorff ensures each patient receives the most value that doesn’t involve hidden fees or outlandish pricing.
The core of her success lies in proper diagnosis. An appointment with Dr. Deardorff includes the highest quality technology to pinpoint a patient’s underlying musculoskeletal conditions. From there, she can better understand which treatment will work best for you.
For a thorough evaluation with Dr. Deardorff, call us at 913-642-0200 or schedule an appointment today.