Colles' Fracture of Wrist
This is a fracture of the radius and ulna bones that is usually caused by a fall on an outstretched hand. It will need a plaster for 6 weeks followed by physiotherapy using mobilisation and exercise to regain movement and strength.
Carpal Tunnel Syndrom
This is a common problem where the large nerve into the wrist becomes compressed at the wrist level as it enters through a tight tunnel. Pins and needles tend to be felt in the thumb, index and middle fingers, particularly at night. Fine movements with the thumb and index finger become difficult. While splintage at night can be helpful, an operation to release the carpal tunnel may be advised and is usually very successful.
Ganglias
These are fluid filled sacs which come from either a tendon sheath or a joint lining. They appear as soft bumps around the wrist area and at times can be painful. These can often settle spontaneously but if troublesome the treatment is aspiration or surgical removal. Physiotherapy can be used following these procedures to reduce pain and regain movement using techniques such as ultrasound and exercise.
Tendonitis
Tendonitis is an inflamation of the tendons within the sheath that they run in. It is usually associated with overuse and causes pain on movement. The symptoms can be helped by splintage to rest the area and ultrasound to settle the swelling and pain. A cortisone injection can be helpful in more chronic cases where the above treatments have not fully resolved the problem.
TFCC (Triangular Fibrocartilaginous Complex)
This is a small cartilage which has a cushioning effect on the outer side of the wrist. It can tear due to forceful trauma to the wrist such as a fall. The symptom will usually be pain that is felt on the outer side of the wrist, especially on twisting. This can often settle spontaneously but, if troublesome, arthroscopy (which uses a small camera to look inside the wrist) may be required to locate and trim the tear. Physiotherapy techniques such as ultrasound can help to settle the post-operative pain.
Osteoarthritis at Base of Thumb
This is a natural wear and tear of the mobile joint at the base of the thumb. Pain tends to be felt on pinching or gripping. The problem can sometimes be helped with specialised splints or an injection. Otherwise an operation to remove the small bone called the trapezium can prove very effective, followed by physiotherapy to regain movement and settle pain, using ultrasound, massage and specific exercise programmes.
