Clicking and locking of a finger or thumb is generally known as a “Trigger finger” or “Trigger thumb.” This is a common condition involving inflammation or thickening of the tendon that bends your fingers or thumb. The tendon passes through a pulley in the palm of the hand, however when the tendon is inflamed, it can catch or lock as you make a fist or grip items.
This can be due to poor technique or repetitive motions straining the forearm and wrist muscles. It can lead to multiple types of overuse injuries such as lateral epicondylitis or intersection syndrome.
A Distal Radius Fracture is a fracture of the end of the radius near the wrist, and is commonly referred to as a broken wrist. It mainly occurs when you fall on an outstretched hand.
An X-Ray is required to assess the severity of the fracture. Sometimes a CT or MRI is required.
An undisplaced or mildly displaced fracture can be managed by a hand therapist. Different immobilisation options are available including a waterproof fibreglass cast, EXOS brace and thermoplastic splint.
Your therapist will determine the appropriate for of immobilisation for you depending on the severity of the fracture, amount of swelling and whether the fracture is being managed non-operatively or after surgery. You will also be provided with:
Surgical review may be required if there is multiple fragments or any displacement. Your hand therapist will be happy to discuss with you and your GP whether referral to a hand surgeon is appropriate.
If you have any questions regarding a broken wrist or any other condition you have, or to book an appointment, feel free to contact us here. We’d be more than happy to help.
QUESTION: A 58 year-old right hand dominant admin officer complains of pain at the base of her thumb when opening jars, turning keys, writing and knitting. She is worried that she is developing arthritis, and remembers how debilitated her mother was with arthritis in her hands. Is there a role for hand therapy?
What is it?
Osteoarthritis at the base of the thumb is a degenerative condition, which may be associated with pain, stiffness, weakness and increasing deformity. Symptoms can be aggravated by activities requiring strong pinch or sustained gripping activities. The thumb may look swollen and be tender to touch, and ache after prolonged activities. Particular aggravating activities include opening jars, turning keys, writing, pinching pegs or leaning on an extended wrist.
Location of pain at the base of the thumb
Clinical Examinations
An X-Ray may be helpful to determine the degree of degenerative change, although symptoms don’t necessarily correlate with severity of X-ray change.
Treatment
Most people with arthritis at the base of the thumb will respond well to a custom made splint, and instruction in various self-help strategies with an appropriate exercise program. Your hand therapist will provide you with:
Push Brace
Neoprene thumb and wrist brace
Short opponents splint
Three point thumb splint
Surgical Treatment
Surgical review may be required depending on your response to conservative treatments. Your therapist will be happy to discuss with you and your GP whether referral to a hand surgeon is appropriate.
If you have any questions regarding a condition you have or to book an appointment, feel free to contact us here. We’d be more than happy to help.
A volar plate injury can occur when the finger is forced into hyperextension. It is very common in ball sports. The volar plate is a ligament which sits at the front of the proximal interphalangeal joint. It prevents the finger from hyperextending.
The volar plate is supported by a ligament on either side of the joint called the collateral ligaments, which prevent deviation of the joint from side to side. The ligaments can partially or fully tear and can avulse with a small fracture fragment when the finger is forced backwards into hyperextension. This can cause swan neck deformity of the finger.
Xray showing avulsion fracture of volar plate
Your hand therapist can assess the finger for stability, swelling and movement. An X-Ray or Ultrasound may be needed, your therapist will advise whether this is required.
Your hand therapist will fabricate a thermoplastic finger splint to help protect the ligament whilst it heals. This is sometimes needed for 3-6 weeks. You will also be provided with:
Dorsal splint for volar plate injury
Active flexion within limit of the splint
Figure of 8 extension block splint
Active flexion in the Figure of 8 splint
Buddy straps
A referral to a hand surgeon may be required for large avulsion fractures or where the joint is unstable. Your therapist can assess your finger and in discussion with you GP arrange a referral if necessary.
If you have any questions regarding volar plate injury, please feel free to give us a call.