COMMON CONDITIONS

Expert diagnosis and management of common upper limb conditions

The Wrist

Distal Radius Fractures

The radius is the larger of the two bones of the forearm.  The end toward the wrist is called the distal end.  A fracture of the distal radius occurs when the area of the radius near the wrist breaks.

Distal radius fractures are very common.  In fact, the radius is the most commonly broken bone in the arm.

 

The link below provides very helpful information about Distal Radius Fractures:

https://orthoinfo.aaos.org/

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De Quervain's Tenosynovitis

De Quervain's TSV is a painful condition affecting two tendons at the base of the thumb as they travel side by side along the inside of the wrist. They pass through a soft tissue channel or sheath, with the inner walls of the channel producing a slippery fluid to lubricate the tendons as they slide back and forth. 

Repetitive or excessive movements may cause the lubrication system to malfunction allowing friction to develop between the tendons of the thumb and the soft tissue sheath. The friction leads to thickening and constriction of the sheath, which interferes with the smooth gliding of the tendons. 

 

Pain over the thumb side of the wrist is the main symptom, and this pain can also radiate down the thumb or up to the forearm. As the friction persists the tendons can start to 'squeak' as they move through the constriction, and is called crepitus. Other specialised tests can be performed by your physiotherapist to confirm the diagnosis, and an ultrasound scan can also provide additional confirmation.

Treatment initially consists of splinting to support the wrist and thumb and allow the tendons to rest and heal. Anti-inflammatory medications, massage, ultrasound and laser may be used to help control the swelling, and as the symptoms settle the splint may be taken off the do light pain-free activities as tolerated. Stretches for the thumb may also be introduced to ensure good glide of the affected tendons, as well as other conditioning exercises.

If symptoms persist, you doctor may suggest a cortisone injection into the irritated tunnel to reduce swelling of the tendons. If conservative measures do not provide a satisfactory outcome, surgery may be necessary.

 

Scaphoid Fracture

The scaphoid is the most frequently fractured wrist bone and is located on the thumb side of the wrist. It occurs after a fall onto an outstretched hand. Diagnosis is made with imaging and treatment can be operative or non-operative.

Non-operative treatment involves the application of a fiberglass cast or Exos splint. Once the fracture has healed exercises to restore mobility are commenced until normal function has returned

Treatment of fractures around the wrist can sometimes require complicated surgical intervention.  Other times however, cast immobilisation is insufficient.  Most casts these days are made of fibreglass however the next level of convenience in cast immobilisation would be the removable thermoplastic splinting.  Staff are expert in custom fitting and managing all these splints and, if necessary, will work closely with your treating doctor.