Damaged thumb, wrist, and carpa tunnel. Dr. Stone
The Doctors
I recently fell at work holding a mug and have done damage
to my
wrists. My symptoms are numbness in my hands, fingers,
wrists and sometimes legs. Other symptoms are limited
thumb dexterity.
I am an artist of clay and use my hands alot which has
been very limiting as of late. My doctor says that I have
corpal tunnel
and my chiropractor says it is tissue and nerve damage.
There was an x-ray done 2 weeks after the accident when I
was admitted
into the emergency room because the pain in my
wrist was so bad that I could not grab things or hold things.
The
hospital told me to take aspirin and that I was going to
develop corpal tunnel. I am confused and afraid because I
am getting
different diagnosis from different doctors. The x-ray
showed possible damage to the upper left wrist bone. There
is swelling
in my right wrist and the thumb that I was holding the
mug in. Can you give me some guidance on how to go
about curing this
ailment so I can resume my artistic endeavors?
Answer by Aaron Stone MD
Aesthetic & Reconstructive Plastic Surgery
It doesn't sound like you fractured the bone as this should
have been
picked up on x-ray. Sometimes a small bone in the wrist
(scaphoid) can
be fractured & not show up on regular x-rays thereby
needing CAT scans
or MRI to show the fracture. The treatment for this is a cast
&
sometimes surgery. Any trauma to the hand can cause carpal
tunnel
syndrome in addition to any other fractures or injuries. The
common
factor causing the carpal tunnel syndrome is swelling in the
carpal
tunnel.
Carpal tunnel syndrome
The carpal tunnel is a passageway through the wrist carrying
tendons
and one of the hand's major nerves. Pressure may build up
within the
tunnel
because of disease (such as rheumatoid arthritis), injury,
fluid
retention during pregnancy,
overuse, or repetitive motions. The resulting pressure on the
nerve
within
the tunnel causes a tingling sensation in the hand especially
the thumb,
index and middle
fingers, often accompanied by numbness, aching, and
impaired hand
function.
This is known as carpal tunnel syndrome.
In some cases, splinting of the hand and anti-inflammatory
medications
will relieve the problem. If this doesn't work, however,
surgery may be
required.
In the operation, the surgeon makes an incision from the
middle of the
palm to the wrist. He or she will then cut the tissue that's
pressing on
the nerve, in order to release the pressure. A large dressing
and splint
are used after surgery
to restrict motion and promote healing. The scar will
gradually fade and
become barely visible.
The results of the surgery will depend in part on how long
the condition
has existed and how much damage has been done to the
nerve. For that
reason,
it's a good idea to see a doctor early if you think you may
have carpal
tunnel
syndrome.
The most important thing is that you see a qualified hand
surgeon, have
appropriate diagnostic studies to make a proper diagnosis &
then have
the appropriate treatment. If you vary from this path you
may end up
with irreversible damage.
=========
DISCLAIMER: The material contained here should not be
considered a substitute for your physician. These are only
general guidelines to help you think about the medical
possibilities. You are encouraged to consult your own health
care provider with any questions or concerns you may have
regarding your condition. To find other suggested answers to
your question, refer to the Ask the Doctors Web site which
includes a complete index of questions and answers at
http://www.flora.org/ask-doctor/.
___________________________________________