Cubital Tunnel Syndrome

Cubital Tunnel Syndrome
Cubital Tunnel Syndrome: Causes, Symptoms, and Treatment

Cubital Tunnel Syndrome occurs when there is increased pressure on the ulnar nerve at the elbow. The ulnar nerve passes under a bony prominence on the inner part of the elbow (the medial epicondyle), commonly known as the “funny bone.” This area is particularly vulnerable to pressure, which can affect the nerve and cause pain, numbness, and tingling in the elbow, forearm, hand, and fingers.

What Causes Cubital Tunnel Syndrome?

Several factors can increase pressure on the ulnar nerve, leading to cubital tunnel syndrome:

  • Pressure on the elbow: Resting your arm on a table with the inner part of your elbow may cause temporary numbness. If this happens repeatedly, the discomfort may become persistent.
  • Elbow movement: Repetitive straightening and bending of the elbow can cause the ulnar nerve to click over the bony bump, irritating the nerve.
  • Sustained elbow bending: Keeping the elbow bent for prolonged periods, such as while sleeping or holding a phone, can stretch the nerve across the medial epicondyle.
  • Thickened connective tissue: In some cases, the tissue over the nerve may thicken, adding pressure on the nerve, or variations in the muscle structure around the elbow can also contribute.
Symptoms of Cubital Tunnel Syndrome

The most common symptoms include:

  • Pain, numbness, and tingling in the elbow, forearm, hand, and fingers, often in the ring and little fingers.
  • Symptoms typically occur when there is pressure on the nerve, such as when resting the elbow on an armrest or with repetitive bending or straightening of the elbow.
  • Weakness while pinching, clumsiness, and the tendency to drop things.
  • In severe cases, loss of sensation and muscle weakness or atrophy in the hand.
Diagnosis

A doctor will assess your symptoms, check for muscle weakness, and test the nerve’s response to tapping or bending the elbow. They may also evaluate other conditions, such as thyroid disease or diabetes, that could contribute to similar symptoms.

To confirm the diagnosis, your doctor may recommend an electromyography (EMG) and/or nerve conduction study (NCS) to assess nerve function and severity. These tests can also identify other nerve issues, such as a pinched nerve in the neck.

Cubital Tunnel Syndrome Treatment

In mild cases, non-surgical treatments can provide relief:

  • Avoiding pressure on the elbow by changing habits, such as not resting the elbow on hard surfaces.
  • Wearing an elbow pad over the ulnar nerve and “funny bone” for extra protection.
  • Keeping the elbow straight during sleep with a splint.
  • Physical therapy to learn strategies for reducing nerve pressure.

If symptoms persist or are severe, surgery may be necessary to relieve the pressure on the nerve. The surgeon may move the nerve to the front of the elbow or place it under a layer of fat, muscle, or within the muscle. In some cases, trimming the bony bump (medial epicondyle) may also be recommended.

Recovery and Post-Surgery Care

Your recovery after surgery depends on the procedure performed. Generally, you will need to avoid lifting or making certain elbow movements for a period. Therapy may be required to help regain full function.

If you are experiencing symptoms of cubital tunnel syndrome, contact South Florida Hand and Orthopaedic Center to schedule an appointment and begin treatment. Call us at (561) 241-4758.

Wrist Sprain

Wrist Sprain
Wrist Sprain: Diagnosis, Treatment, and Recovery

A wrist sprain is an injury to a ligament in the wrist. Ligaments connect bones together, and an injury to these ligaments can vary in severity. Wrist sprains are commonly caused by excessive force or strain, such as falling forward or backward onto an outstretched hand.

Types of Wrist Sprains

Wrist sprains are categorized based on their severity:

  • Grade I Injury: A stable injury with minimal damage to the ligament.
  • Grade II Injury: Partial tearing or stretching of the ligament.
  • Grade III Injury: A complete tear of the ligament or full detachment from the bone.
Diagnosis and Treatment of Wrist Sprains

If you have sprained your wrist, our doctors will perform a thorough examination to determine the severity of the injury, the cause, and whether further diagnostic tests are needed. An X-ray may be performed to rule out any fractures, and in some cases, an MRI or wrist arthroscopy may be used to examine the ligaments.

Once diagnosed, the treatment will be tailored to the severity of the sprain:

  • Milder sprains may be treated with splints or casts, along with protected activity.
  • Severe sprains with complete ligament tears may require surgical repair or reconstruction.
Chronic Wrist Sprains

If a wrist sprain goes untreated or unnoticed, it can lead to wrist instability and arthritis, limiting treatment options. Persistent or chronic sprains may be managed with:

  • Anti-inflammatory drugs
  • Steroid injections
  • Splinting for support

For a thorough evaluation and personalized treatment plan, contact South Florida Hand and Orthopaedic Center at (561) 241-4758.

Wrist Fracture

Wrist Fracture
Wrist Fracture: Diagnosis, Treatment, and Recovery

A wrist fracture refers to a break in one of the eight small bones of the wrist (such as the scaphoid) or the larger radius or ulna bones. These fractures often occur due to significant force, such as a fall onto an outstretched hand. The ulna bone is the most commonly broken bone in the wrist.

Types of Wrist Fractures

There are various types of wrist fractures, each with different characteristics:

  • Compound (Open) Fracture: The bone breaks through the skin.
  • Compression Fracture: The bone is crushed, often occurring in patients with osteoporotic bones.
  • Comminuted Fracture: The bone breaks into three or more pieces.
  • Spiral Fracture: Caused by excessive twisting of the bone, common in sports injuries.
  • Greenstick Fracture: The bone bends but does not break completely, similar to how a green twig breaks.
Treatment for a Wrist Fracture

If you have suffered a wrist fracture, one of our experienced doctors at South Florida Hand and Orthopaedic Center will conduct a thorough examination to assess the fracture. The doctor will determine the fracture pattern, whether it is stable or unstable, and if it is displaced or non-displaced.

Treatment options depend on the fracture type:

  • If the fracture is non-displaced or already set, treatment may involve a splint or cast.
  • If the fracture is unstable or displaced, surgical intervention may be necessary, including pins, screws, plates, or external fixation (a frame outside the body to stabilize the bone).
  • If parts of the bone are missing or crushed, a bone graft may be required.
Results of Treatment and Recovery

During the healing process, it is important to keep the fingers flexible to avoid stiffness, which can impede recovery. Recovery time will vary depending on the severity of the fracture, and additional treatments may be required. If you have suffered a wrist fracture, contact South Florida Hand and Orthopaedic Center at (561) 241-4758 to schedule an appointment and begin your treatment plan.

Scaphoid Non-Union

wrist pain
Scaphoid Non-Union: Diagnosis, Symptoms, and Treatment

The wrist consists of eight small bones arranged in two rows, and one of these bones, the scaphoid, spans both rows. Although crucial for wrist motion and stability, its unique position makes it vulnerable to fractures. Scaphoid fractures are particularly difficult to detect, and with its relatively low blood supply, the bone may fail to heal properly. This is known as scaphoid non-union.

What is Scaphoid Non-Union?

When a scaphoid fracture does not heal properly, it can lead to complications such as:

  • Loss of wrist motion
  • Arthritis
  • Avascular necrosis: This condition occurs when the bone loses its blood supply, causing it to die and collapse.
Symptoms of Scaphoid Non-Union

Scaphoid non-union often results from an untreated fracture and may show the following signs:

  • Pain along the side of the thumb
  • Pain along the wrist
  • Diminished wrist mobility
  • Diminished wrist extension

If you are experiencing these symptoms, it is crucial to seek a consultation with a hand specialist at South Florida Hand and Orthopaedic Center. The doctor will conduct an x-ray to confirm the injury, and if necessary, an MRI to check for avascular necrosis.

Treatment for Scaphoid Non-Union

Once a scaphoid fracture fails to heal, the pattern of degeneration is generally predictable, often leading to decreased mobility and arthritis. Treatment options depend on the stage of the fracture and the time since the injury occurred.

  • If arthritis has not developed, surgery and realignment of the bone is typically the preferred treatment.
  • If arthritis has set in or previous reconstructions have failed, the focus of surgery shifts to improving pain and preserving wrist function.

Our doctors at South Florida Hand and Orthopaedic Center will tailor your treatment plan to your specific needs to promote healing and restore optimal wrist function.

Thumb Sprain

Thumb Sprains
Thumb Sprains: Causes, Types, and Treatment

A thumb sprain is an injury to the ligament that connects the bones to the joint, often caused by a fall or a sports-related injury. In a sprain, the thumb is typically bent beyond its normal range of motion, which can result in swelling, pain, and bruising at the affected area.

Common Thumb Sprains

Two ligaments are commonly injured during a thumb sprain:

  • Ulnar Collateral Ligament (UCL): Located on the medial side of the thumb, the ulnar collateral ligament is the most commonly injured in thumb sprains. It is often associated with a condition known as “skier’s thumb”, as it is frequently seen in skiing accidents.
  • Radial Collateral Ligament (RCL): This ligament is located on the lateral side of the thumb and is less commonly injured compared to the UCL.
Treatment for Thumb Sprains

If you suspect a thumb sprain, it is essential to see one of the trained physicians at South Florida Hand and Orthopaedic Center. The doctor will perform an x-ray to rule out any bone fractures in the hand or thumb. Following the imaging, a physical examination will help assess the severity of the sprain.

Both ulnar and radial collateral ligament sprains are typically treated with a cast or splint to immobilize the thumb and promote healing. If the injury is severe or does not respond to conservative treatment, further intervention may be necessary.

Scaphoid Fracture

Scaphoid Fracture
Scaphoid Fractures: Causes, Diagnosis, and Treatment

A scaphoid fracture is a break in the scaphoid bone of the wrist, which is located between the forearm and hand. This bone spans both rows of carpal bones, making it more vulnerable to injury. The scaphoid bone is the most commonly fractured carpal bone due to its position and the forces it absorbs during certain types of wrist injuries.

How Do Scaphoid Fractures Occur?

Scaphoid fractures are most commonly caused by a fall onto an outstretched hand. While you may experience immediate pain, it often decreases after a few days or weeks. Bruising is rare, and swelling is minimal. Since there is usually no visible deformity, many people mistake the injury for a sprain and delay treatment. In some cases, individuals may not realize they have fractured the bone until months or even years later.

Diagnosis of Scaphoid Fractures

Scaphoid fractures are typically diagnosed through x-rays of the wrist. However, if the fracture is non-displaced, early x-rays may not show the break. This can lead to a misdiagnosis as a sprain. If you experience significant tenderness directly over the scaphoid bone (located on the thumb side of the wrist), this could indicate a fracture and should be treated with a splint.

If an initial x-ray doesn’t reveal the fracture, re-evaluation and additional imaging techniques may be necessary. Your doctor may recommend a CT scan, bone scan, or MRI if the condition is still suspected after initial treatments.

Treatment for Scaphoid Fractures

If the fracture is non-displaced, it can typically be treated with immobilization in a cast. The cast will usually cover the forearm, hand, thumb, and possibly the elbow during the first phase of healing. While some fractures heal in as little as six weeks, healing may be delayed, especially if blood supply to the bone is compromised. In such cases, a bone may even die due to the lack of circulation, particularly at the forearm side of the bone.

If surgery is required, the doctor may insert screws or pins and possibly use a bone graft to help stabilize and heal the fracture. This is often recommended even in non-displaced fractures to avoid prolonged casting and potential complications.

Complications from Scaphoid Fractures
  • Non-union: If the fracture doesn’t heal properly, it can result in a non-union. This can lead to abnormal motion, bone misalignment, and eventually arthritis.
  • Avascular Necrosis: Lack of blood supply can cause part of the bone to die, leading to collapse and, eventually, arthritis. Surgery may be needed to restore circulation.
  • Post-Traumatic Arthritis: If arthritis develops due to a scaphoid fracture, surgery may be necessary to remove degenerated bone or fuse the wrist joint.

If you suspect you may have a scaphoid fracture or are experiencing persistent wrist pain, contact South Florida Hand and Orthopaedic Center today. Our expert physicians can provide a comprehensive evaluation and recommend the best treatment options for your condition.

Repetitive Strain Injuries (RSI) of the Wrist

Repetitive Strain Injuries (RSI) of the Wrist
Repetitive Strain Injuries: Causes, Symptoms, and Treatment

Repetitive strain injuries (RSIs), also known as repetitive stress injuries, are common ailments that can cause continuous pain and inconvenience. These injuries are particularly common in sports, but they can also affect individuals in everyday work environments. The pain and discomfort caused by RSIs can interfere with daily activities, making it important to address the condition early. At South Florida Hand and Orthopaedic Center, our experienced doctors specialize in treating RSIs and developing personalized treatment plans to help you recover and return to your daily routine.

Types of Repetitive Strain Injuries

There are two main types of RSIs:

  • Type 1 RSI: These injuries are characterized by easily recognizable symptoms such as swelling or inflammation of the muscles and tendons. Common conditions associated with Type 1 RSIs include Carpal Tunnel Syndrome and Tenosynovitis.
  • Type 2 RSI: These injuries may not show any visible symptoms but are still accompanied by general pain and discomfort. Type 2 RSIs are harder to diagnose and are sometimes referred to as non-specific pain syndromes.
Symptoms of Repetitive Strain Injuries

The symptoms of RSIs can worsen over time if not addressed. Common symptoms include:

  • Dull, non-specific pain in the wrist
  • Numbness in the hand
  • Tingling in the hand and fingers
  • Tightness or difficulty bending the wrist
Causes of Repetitive Strain Injuries

RSIs are often caused by the overuse of muscles and tendons, particularly in environments where repetitive movements are common. Factors contributing to RSIs include:

  • Repetitive movements: Activities like writing, typing, or assembly line work can cause strain.
  • Vibrating equipment: The use of tools or machinery that vibrate can put stress on muscles.
  • Working in cold environments: Cold conditions can increase muscle stiffness and strain.
  • Poor posture: A non-ergonomically designed workspace can lead to strain on muscles and tendons.
  • Forceful activities: Engaging in forceful tasks can lead to overuse injuries.
  • Holding the same posture: Remaining in a fixed posture for long periods can cause strain.
  • Direct pressure: Pressure on specific areas can contribute to the development of RSIs.
  • Carrying heavy loads: Lifting or carrying heavy objects repeatedly can lead to muscle strain.
Get Help for Repetitive Strain Injuries

If you are experiencing any symptoms of RSI, it is important to seek treatment early to prevent further damage. At South Florida Hand and Orthopaedic Center, we can help diagnose and treat your injury, developing a plan to reduce pain and improve mobility. Don’t let RSIs interfere with your daily life—contact our office today for personalized treatment options.

Radial Tunnel Syndrome

South Florida Hand and Orthopaedic 20
Radial Tunnel Syndrome: Causes, Symptoms, and Treatment

Radial Tunnel Syndrome is a nerve compression condition caused by pressure on the radial nerve. It is often compared to carpal tunnel syndrome but is less commonly known. The radial nerve runs along the length of the arm, from the shoulder to the hand, passing through the radius (thumb-side of the forearm), which is why it is named after this area. The radial tunnel extends just below the elbow, where the nerve crosses over the bones of the forearm. When extra pressure is applied to this nerve, you may experience sharp pain in the forearm or back of the hand when trying to straighten your wrist and fingers.

What Causes Radial Tunnel Syndrome?

Radial tunnel syndrome is often caused by physical pressure on the radial nerve or repetitive strain on the related body part, similar to tennis elbow. Common causes include:

  • Injury: Trauma or damage to the radial nerve.
  • Tumors: Growths such as bone, fatty, or benign tumors can put pressure on the nerve.
  • Ganglion cysts: Fluid-filled sacs that may compress the nerve.
  • Swelling or fluid: Inflammation or swelling in the area can increase pressure.
  • Poor flexibility: Tight muscles or tendons can restrict space for the nerve.
Signs and Symptoms of Radial Tunnel Syndrome

The main symptom of radial tunnel syndrome is pain in the arm or hand. Unlike other nerve compression syndromes, radial tunnel syndrome typically does not cause numbness or tingling because the radial nerve affects muscles, not sensory nerves. Symptoms may include:

  • Sharp pain in the back of the hand
  • Stabbing pain at the top of the forearm
  • Muscle weakness
  • Unusual muscle fatigue

These symptoms are usually felt or become more noticeable when trying to straighten your wrist and fingers.

Diagnosis of Radial Tunnel Syndrome at South Florida Hand and Orthopaedic Center

Our expert hand doctors can diagnose radial tunnel syndrome through a physical examination. The doctor will check for any mass pressing on the radial nerve, such as a lipoma, tumor, or cyst, and assess any injuries. If repetitive motion is the cause, it may be harder to pinpoint the exact source, but your pain’s location and type will guide the diagnosis.

Radial Tunnel Syndrome Treatment Options

Non-surgical treatments often involve:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): To reduce pain and inflammation.
  • Corticosteroid injections: To decrease swelling and relieve pressure.
  • Splinting: To support the wrist and reduce strain on the radial nerve.

Physical therapy, including stretching, strengthening exercises, icing, heat therapy, and nerve-gliding exercises, may also be recommended. If conservative treatments do not work, surgery may be necessary. A radial tunnel release surgery involves making the tunnel larger to provide more space for the nerve, relieving pressure.

If you are experiencing symptoms of radial tunnel syndrome, contact the dedicated team at South Florida Hand and Orthopaedic Center. Our experts will review your condition and recommend the most suitable treatment plan for your needs.

Ganglion Cyst

Ganglion Cyst
Ganglion Cysts: Causes, Symptoms, and Treatment

Ganglion cysts are common lumps found in the hand and wrist, often developing adjacent to joints or tendons. These cysts can appear in various locations, including:

  • Top of the wrist
  • Palm side of the wrist
  • Base of the finger on the palm side
  • Top of the end joint of the finger

Ganglion cysts typically resemble a water balloon on a stalk, filled with clear fluid or gel. While the exact cause of ganglion cysts is unknown, they may form due to joint or tendon irritation or mechanical changes. They can occur in individuals of all ages and may fluctuate in size or even disappear completely over time. These cysts are non-cancerous and do not spread to other areas of the body.

How Are Ganglion Cysts Diagnosed?

Diagnosis is often based on the appearance and location of the bump. Ganglion cysts are typically oval or round in shape and may be soft or firm to the touch. To investigate any underlying issues in the adjacent joints, the doctor may request an x-ray. Cysts located at the end joint of the finger are sometimes associated with an arthritic bone spur.

Treatment Options for Ganglion Cysts

In many cases, ganglion cysts do not require surgical intervention and can be managed conservatively. Treatment options include:

  • Observation: Many ganglion cysts resolve on their own without the need for treatment.
  • Splints and anti-inflammatory medication: Used to reduce pain and limit swelling.
  • Aspiration: The fluid within the cyst may be removed using a needle, which can help decompress the cyst.
  • Surgery: If the cyst is painful, limits activity, or recurs after aspiration, surgical removal may be recommended. This involves removing the cyst along with the portion of the joint capsule or tendon sheath. Traditional and arthroscopic techniques are commonly used for wrist ganglion cysts.

Your doctor will discuss the best treatment options based on the location, size, and symptoms of the cyst during your appointment.

De Quervain’s Tendonitis or Wrist Tendonitis

de Quervain’s Tendonitis or Wrist Tendonitis
De Quervain’s Tendonitis: Causes, Symptoms, and Treatment

De Quervain’s tendonitis (first dorsal compartment tendonitis) occurs when the tendons at the base of the thumb become irritated or inflamed. This inflammation causes the compartment (a tunnel or sheath) around the tendon to swell and enlarge, leading to pain with thumb and wrist movement. Activities such as making a fist, grasping, or holding objects often trigger pain in this condition.

What Causes De Quervain’s Tendonitis?

This condition is often caused by repetitive activities that place strain on the tendons. Specific factors that may contribute include:

  • Repetitive activity: Taking up a new repetitive activity can stress the tendons, leading to inflammation.
  • New mothers: The act of caring for an infant often leads to awkward hand positioning, making new mothers especially prone to this tendonitis. Hormonal changes during pregnancy and nursing may also contribute.
  • Wrist fractures: A history of wrist fractures may predispose individuals to de Quervain’s tendonitis due to increased stress across the tendons.
Signs and Symptoms of De Quervain’s Tendonitis

The primary symptom of De Quervain’s tendonitis is pain on the thumb-side of the wrist. This pain can appear suddenly or gradually and is located at the first dorsal compartment at the wrist. Other signs and symptoms include:

  • Pain radiating: The pain may radiate down the thumb or up the forearm.
  • Worsening pain with movement: Thumb and hand motion, especially forceful grasping or twisting, increases the pain.
  • Swelling: There may be noticeable swelling at the base of the thumb, sometimes with a fluid-filled cyst.
  • Catching or snapping: Occasionally, you may feel a “catching” or “snapping” sensation when moving the thumb.
  • Numbness: Irritation of the nerve over the tendon sheath can cause numbness on the back of the thumb and index finger.
Diagnosis of De Quervain’s Tendonitis

Your doctor will likely ask you to make a fist with your fingers clasped over your thumb, and then bend your wrist in the direction of your little finger. This maneuver will be very painful if you have de Quervain’s tendonitis, helping your doctor confirm the diagnosis.

Wrist Tendonitis Treatment

The goal of treatment is to relieve the irritation and swelling causing the pain. Treatment options may include:

  • Rest: Wearing a splint to rest the thumb and wrist and prevent further strain.
  • Anti-inflammatory medication: Oral anti-inflammatory medications to help reduce pain and swelling.
  • Cortisone injections: Steroid injections into the tendon compartment to reduce inflammation.

These non-operative treatments often provide relief by reducing swelling. In some cases, simply stopping the activities causing the irritation can allow symptoms to resolve on their own.

Surgical Treatment for Severe De Quervain’s Tendonitis

If symptoms are severe or do not improve with conservative treatment, surgery may be recommended. The procedure involves opening the compartment to create more room for the inflamed tendons, thus relieving the pressure and breaking the cycle of irritation. Following surgery, you can resume normal hand use once comfort and strength have returned.

If you are experiencing symptoms of De Quervain’s tendonitis, consult with South Florida Hand and Orthopaedic Center to discuss your treatment options and find relief from pain.