2023-04-24 08:30:00
Even a minor injury or strain on the wrists, hands and fingers can make every movement a torture. Here hand surgeon Dr. Claus Deglmann, what you should pay attention to:
“Hand surgeons don’t just operate. We offer the entire range of treatments with all proven methods of conservative therapy,” explains Dr. Claus Deglmann, founder of the Munich Hand practice at Marienplatz. The specialist in surgery, hand surgery, plastic and aesthetic surgery has already performed more than 10,000 procedures. He is also part of the team of experts at the German Center for Upper Extremities at the ATOS Clinic in Bogenhausen. The most common hand problems and how to treat them:
Carpal Tunnel Syndrom
Symptoms: Hands that have fallen asleep (often at night), tingling, numbness and abnormal sensations from the thumb to the middle finger are typical symptoms of carpal tunnel syndrome (nerve congestion syndrome): On the inside of the wrist, the median hand nerve is constricted in the wrist tunnel. “The ball of the thumb can also regress. This threatens further impairments up to and including the loss of fine motor skills,” says Dr. Deglmann.
Treatment: Anti-inflammatory medication and wearing an individually fitted wrist splint at night will help initially. If you are unsuccessful, a small operation can help. A band is severed. The carpal canal widens and creates space for the stressed nerve. “Carried out in time, permanent damage to the metacarpal nerve is avoided and the patient is relieved of his symptoms,” emphasizes Dr. Deglmann.
Flicking finger
symptoms: If the flexor tendon of a finger can no longer slide freely through the ring ligament system, the finger gets caught during flexion. It can only be stretched with force – until it comes to a painful snapping or snapping. “The cause are inflammatory processes, mostly due to overload. As a result, the flexor tendon can become knotty,” explains Dr. Deglmann.
Treatment: In many cases, occupational therapy or a small outpatient procedure under local anesthesia helps to eliminate the tightness. “We have had good experiences with a new endoscopic surgical variant. Wound threads are no longer necessary. The small accesses heal within a few days with very little scarring.”
wrist ganglion
Symptoms: If a bulging, elastic or hard bulge forms on the hand or wrist, a harmless cyst is usually hidden behind it – the ganglion. It arises from a joint capsule or tendon sheath. This cyst is also popularly known as a ganglion bone, although neither cartilage nor bone is involved in its formation.
Treatment: As long as a ganglion causes no symptoms, no treatment is necessary. “If it’s pressing on nerves or causing pain when exerted, I recommend arthroscopic or open removal of the entire cyst,” recommends Dr. Deglmann.
disc damage
Symptoms: Wrist pain on the little finger side – e.g. B. when supporting the hand – indicate damage to the wrist meniscus. This triangular cartilaginous disc (discus triangularis) is part of a ligament complex. Like the meniscus in the knee, it acts as a pressure pad between the carpal and forearm bones. This cartilage intervertebral disc can wear out prematurely as a result of chronic incorrect strain on the wrist. People whose ulna is longer than their spoke are particularly at risk.
Treatment: Ideally, it is sufficient to smooth the damaged triangular disc minimally invasively during a joint reflection (arthroscopy). An overly long cubit can also be ground down in certain cases. Important to know: “Arthroscopy in a very small, complicated wrist requires a lot of experience. It should therefore only be carried out by proven specialists,” recommends Dr. Deglmann.
Rhizarthrose
Symptoms: The most common form of arthrosis in the hand affects the saddle joint of the thumb. Practically all grips involving the thumb hurt – in extreme cases so badly that objects fall out of the patient’s hands, keys cannot be turned and bottles cannot be opened. “Unfortunately, rhizarthrosis has a pronounced inflammatory component. This is why acute pain episodes are common,” says the specialist.
Treatment: Occupational therapy, anti-inflammatory painkillers, a thumb orthosis and sometimes arthroscopy help with milder forms. In the advanced stage with pronounced symptoms, open surgery is usually necessary to restore function.
Four tips from the experts:
1. Strengthening: Hands are also happy about a little workout. Let them rotate daily, spread your fingers vigorously, clench a fist. Also strengthen fine motor skills – e.g. B. with a small ball. You can also open and close small buttons.
2. Schutz: When doing rough work, you should always wear hard-wearing work gloves to prevent injury.
3. Relief: Use wrist rests, ergonomic keyboards and mice when working on the computer.
4. Expert Advice: Do you have pain in your hands and fingers or notice visible or palpable changes? Go to the hand surgeon quickly. Many problems can be solved conservatively if they are diagnosed in good time.
Patient Elke S: “I could no longer stretch my little finger”
The little finger curled further and further into the palm of the hand and could not be straightened. “At first I thought I should just put up with such a handicap. But then the limitations in everyday life became more and more stressful,” reports patient Elke S. (78).
Her problem is called Dupuytren’s disease
from dr Deglmann, she learned that this widespread problem is called Dupuytren’s disease. The cause is not a shortened tendon, but a benign growth in the connective tissue of the palm of the hand – recognizable by palpable knots and hardening under the skin. As long as the nerves are not directly affected, it does not hurt. And yet it is extremely annoying because even simple movements are becoming increasingly impossible.
Rapid therapeutic success with minimally invasive methods
dr In professional circles, Deglmann is regarded as a proven expert in the field of Dupuytren’s disease: “With minimally invasive methods, rapid therapeutic success can usually be achieved. But these are by no means suitable for all patients.” Not even for Elke S., who followed her doctor’s advice and underwent an open operation with microsurgical technology to remove the knots and strands. She survived the outpatient procedure very well “and even almost pain-free.”
Consistent follow-up care is important
However, that alone is not enough: Without consistent follow-up treatment, there is a high risk that adhesions will form again. Elke S. was given a plan for daily exercises and regularly goes to her occupational therapist Carina Deglmann on Residenzstrasse. She specializes in hand rehabilitation. The fact that they have the same name is no coincidence: Carina and Claus Deglmann are a married couple and complement each other professionally. Elke S. is making good progress thanks to her consistent exercises.
This article only contains general information on the respective health topic and is therefore not intended for self-diagnosis, treatment or medication. In no way does it replace a visit to the doctor. Unfortunately, our editorial team cannot answer individual questions about clinical pictures.
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