Wrist

About the Wrist

The importance of the wrist is that it carries the hand which is the functioning part of the upper limb. A problem with the wrist may cause impairment of function, weakness or pain in the hand.

Carpal Tunnel Syndrome

The commonest complaint in this area is Carpal Tunnel Syndrome. (carpus from the greek for wrist). Although Carpal Tunnel Syndrome can be associated with conditions such as arthritis, diabetes, pregnancy or thyroid disease, most are called idiopathic or without specific identifiable cause. The condition is caused by entrapment of the median nerve in the carpal tunnel. Nerve conduction studies may be required to confirm the diagnosis. The affected person may complain of pain or tingling in the fingers in the half of the hand nearest the thumb. The symptoms are usually worse at night. If the symptoms cannot be relieved by injection or splinting then surgical release of the carpal tunnel is carried out. This is a day procedure and limited function of the hand can be allowed quite soon after surgery.

Fractures of the Wrist

Fractures of the wrist rarely result in long-term problems – however in the few that do, corrective surgery may be indicated. Of the fractures around the wrist perhaps the best known is the fracture of the scaphoid bone which usually occurs in young sports men. Scaphoid fractures are difficult to diagnose and not infrequently are overlooked as a sprain and therefore may never come to medical attention. Unfortunately some scaphoid fractures can develop arthritis and therefore should a fracture fail to heal, surgical fixation is indicated.

Arthritis of the Wrist

Osteoarthritis of the wrist is unusual and generally occurs in the over 65s. However secondary osteoarthritis, ie. arthritis that occurs after a cause such as injury can occur at any age and depends often on the severity of the original injury. Fractures are not always the cause, occasionally injuries to the ligaments can destabilise the wrist, causing chronic wrist pain, loss of grip strength and progressive arthritis. There is an arthritis which does occur with some frequency and mainly in females. It is common enough to have once been known as ‘Housewives arthritis’. This is arthritis at the base of the thumb. It has a very debilitating affect on hand function and can be very successfully treated surgically, often by joint replacement. Rheumatoid arthritis affects the wrist as it does many other joints. The the hand loses function because of pain, weakness and loss of bone. In some cases joint replacement is an option alternatively a fusion of the joint can relieve the pain and restore hand function.