Hand Pathologies

Abstract

In most cases, the extensor tendon injuries affect long fingers, and partial disruptions (less than 50%) do not require surgical treatment if the patient can extend the finger against resistance. On the contrary, complete (or partial >50%) lacerations need to be treated with direct suture repair, but the postoperative rehabilitation depends on the zone of injury. The flexor tendon injuries have several common points regardless of the specific area of interest: they are commonly associated with neurovascular damage, and the examiner should test each digit for active DIP and PIP flexion. The stenosing tenosynovitis affects more frequently middle and ring finger of women over 50 and is often associated with diabetes and inflammatory arthropathy. De Quervain tenosynovitis involves the first compartment of the extenders, which includes the abductor pollicis longus and extensor pollicis brevis tendons of the thumb. The compression syndromes are a set of painful neuropathies due to the compression of a nerve. Those of the upper limb concern the median, ulnar, and radial nerve and the thoracic outlet, and they share some sensory and/or motor symptoms and signs, such as initially loss of light touch followed by pain and temperature sensitivity, paresthesia, weakness, dropping of objects, and clumsiness. Osteoarthritis commonly affects DIP joints and trapeziometacarpal of the thumb and is diagnosed by clinical features and classic radiographic findings. Dupuytren disease is a benign fibroproliferative disorder characterized by the progression of a nodule in the palmar fascia to pathological cords and MCP and/or PIP joint flexion contractures.