1. Carpal tunnel syndrome
Carpal tunnel syndrome, which is the pressure of the median nerve inside the carpal tunnel, is the most common peripheral neuropathy. The ossicles of the wrist thus form the carpal tunnel, through which the flexor tendons pass, running from the forearm to the palm and the median nerve. The transverse ligament of the wrist has a width of 2 to 5 cm and a thickness of 5 to 7 mm and is one of the strongest ligaments of the body.
Early symptoms of nausea, vomiting, hallucinations and heartburn (burning pain). In the initial stage the clinical picture is characterized by pain at the point of pressure that reflects in the distribution area of the median nerve. In addition, there is numbness and paraesthesia in the fingers I - III. We often have night pain attacks and in the morning difficulty in conceiving.
The advanced intermediate symptoms of the atrophy of the tenor muscles and the impossibility of fine and rough conception, as well as corresponding alterations in the Neurography.
The advanced final symptoms of dry, cold and discolored skin, with possible ulcers and trophic lesions. The middle finger is the most commonly affected, followed by the thumb and forefinger.
The surgeries are performed as day surgeries, and the patient returns home the same day.
2. Wrist ganglion
It is a bag of fluid that comes out of an adjacent joint or from a tendon sheath of the wrist and hand. The ganglion is usually located on the dorsal surface of the phalangophalangeal joint of the fingers, on the back of the wrist, on the lumbar and palmar side of the wrist, at the base of the fingers, on the bones of the wrist (intraosseous).
The ganglia affect the movement of the joints with which they are adjacent. Respectively they cause pain due to the pressure it causes on the adjacent soft molecules. When these ganglia are large, they also cause an unsightly effect.
3. De Quervain disease
Tendonitis is a painful inflammation of certain tendons that extend to the thumb. The swollen tendons and their coverings cause friction in the narrow tunnel or sheath through which they pass.
The result is pain that can extend from the forearm (the part from the elbow to the wrist) to the base of the thumb.
4. Ejecting finger
Ejection Finger occurs when the movement of the tendon that opens and closes the finger is restricted. Ectopic Finger is more common in people with certain medical problems, such as diabetes and rheumatoid arthritis.
This phenomenon is most commonly due to tendonitis of the flexor tendons which creates thickening in their sheath corresponding to the point of the first pulley in the palm. It develops slowly, causing mild pain and when the stenotic effects become more intense The finger "locks" in a bending position and for its extension requires special effort, or even help from the other hand.
A small lump at the base of the finger is usually palpated. The condition can affect more than one finger at a time.
For the final treatment, surgical rehabilitation is recommended. The operation is performed under local anesthesia, a small incision is made in the skin, about 2 cm long in the palm, and the movement of the tendons of the affected finger is released.
5. Dupuytren disease
Dupuytren's disease or palpation of the palmar nerve is due to progressive fibrosis of the subcutaneous tissue of the palm resulting in flexion of the fingers.
Men are affected more often and in fact at a rate of 10/1. Patients are usually in the 5th to 7th decade of life and the onset of the disease before the age of 40 is rare. The etiology is not known but there is an inherited predisposition and it is associated with alcohol abuse or chronic taking antiepileptic drugs. The damage in half of the cases affects both hands.
Patients at first have difficulty greeting and later as the injury progresses they can not self-medicate with this hand.
Treatment is percutaneous needle fasciotomy, Xiapex injection and partial neuronectomy.