There are both intrinsic and extrinsic muscles of the hand. The intrinsic muscles are in the hand itself, while the extrinsic muscles are in the forearm and control things such as your ability to grip an object. The intrinsic muscles include:
- Interossei: Located between the bones of the hand
- Hypothenar: Located in the palm
- Lumbricals: Each of the four lumbrical muscles are associated with a finger.
- Thenar: Located at the base of the thumb
Dr. David J. Bozentka answers your questions about wrist fractures, commonly known as a distal radius fracture.
Q: What is a distal radius fracture?
A: The radius is the forearm bone on the thumb side of your wrist. When you break the radius bone about an inch from the wrist it is considered a distal radius fracture. These are the most common fractures of the wrist and occur most often when you fall on an outstretched hand. You will notice pain, swelling, and sometimes a deformity after the injury. The fracture can range in severity from very mild (requiring a splint for treatment) to a more severe injury in which the bone is shifted out of position and might need surgery.
Q: What should I do if I believe that I have broken my wrist?
A: You should support your wrist with a splint, apply ice, and elevate it. You should have an evaluation by a hand surgeon as soon as possible. The hand surgeon will often obtain an x-ray and place you in a well-molded, supportive splint or cast. You may need to have the wrist placed in a better position; this is called “reducing” the fracture. You will be asked to follow-up with your hand surgeon.
Q: What studies are performed in treating a distal radius fracture?
A: X-rays are performed in all patients to evaluate the extent of the injury. A CT scan might be needed to better evaluate the number of fragments and displacement. X-rays might be repeated every week or few weeks if you are treated without surgery to determine if the fracture has shifted out of alignment. A final set of x-rays are also taken to confirm that the fracture has healed, which occurs at six weeks or longer after the injury. If you are over 50 years of age, whether you are a male or female, ask your doctor about an evaluation for osteoporosis. A DEXA scan is often performed in the workup in the evaluation.
Watch this touching story about Zion and his journey to receive new hands through a bilateral hand transplant, a 14-hour surgery that required an entire team of surgeons, nurses and anesthesiologists. Learn more about hand surgery at www.handcare.org.
Cubital tunnel syndrome: Hand numbness and tingling is not always carpal tunnel syndrome.
I have a funny tingling in my small and ring fingers while holding my cell phone to my ear or while holding a book when reading in bed. Why?
That “funny” sensation could be compression of the ulnar nerve at the elbow. The path of the ulnar nerve runs just behind the boney part on the inside of the elbow. The nerve is close to the skin and runs through a boney ridge without any substantial padding. The nerve must slide and stretch through this cubital tunnel with elbow movement.
Wait a minute! What does the nerve at my elbow have to do with the funny sensations in my hand?
Good question! The job of the ulnar nerve is to facilitate communication from your brain to your hand. This communication operates the muscles that help you perform coordinated movements with your fingers. Another job of the ulnar nerve is to take information about sensation at the ring and small fingers back to the brain. If the nerve is compressed or irritated, it can’t do its job. This condition leads to difficulty manipulating objects with your hand, feelings of weakness and sensations of tingling, numbness, burning or tightness in your fingers.
That doesn’t sound good. What can I do?
There is good news. There are some things you can try that might calm the nerve. Nerves do not like to be crowded. The ulnar nerve becomes crowded at the elbow with direct pressure over its path or when the elbow is held in a bent position for an extended period of time.
Here are a few tips:
— Harvard Health (@HarvardHealth) July 17, 2015
We all love the warm summer weather and the fun activities that come with it, but the summer season is a peak time for many injuries. Here are some common summer injuries and how to prevent them:
- Wrist sprains: Falls are extremely common during the summer. Many activities such as skateboarding, rollerblading, bike riding or riding a scooter can result in a wrist sprain. To protect your wrists, wear wrist guards during these activities.
- Lawnmower injuries: Each year, 25% of hand and foot lawnmower injuries result in amputation. Keep children away from the lawnmower and always keep hands and feet away from the blades. For more information, read these safety tips.
- Burns: Barbecuing and relaxing around a fire pit during the summer is always enjoyable, but the open flames can be dangerous. Keep your distance from the grill and/or fire pit and always keep an eye on children that are nearby. Always use long tongs when grilling to protect your hands.
- Golfing injuries: Golfing can be tough on your hands, arms and wrists. Warming up and stretching before playing is important for injury prevention.
- Jammed finger: Many sports become more active in the summer, and jammed fingers are some of the most common sports injuries. Learn more about how to treat a jammed finger.
Scars are normal after an injury or surgery. It is how the body heals. Your hand surgeon or hand therapist may recommend a variety of scar treatments after your injury is healed, cut is healed, or stitches are removed. Here are some treatments that may help the look and feel of your scar:
- Massage: Gently massaging your scar can help reduce sensitivity and make it more smooth and movable.
- Rubbing with textures: Exposing your scar to different textures can also help reduce its sensitivity, making it more used to the normal forces of daily life. Desensitizing a scar can take up to four months. You should begin as soon as you are done healing.
- Exercise: An early exercise program can prevent stiffness of the joints near your scar.
- Silicone gel: This gel can be placed on your scar in the form of gel or sheets, often at night. Wrapping the scar can reduce swelling and tension.
- Injections or surgery: For special scar problems such as burns, an injection or surgery may be recommended by your surgeon.
Some scars take up to a year to complete the healing process, which is complete when the scar is light in color, smooth, and no longer sensitive to touch. During the healing process, be sure to protect your scar from the sun. Learn more about scar treatment at www.handcare.org.