Diagnosis and

TREATMENTS

PATHOLOGIES OF THE UPPER LIMB: HAND AND ELBOW

Any problem that conditions the appearance of discomfort or pain when using the hand and elbow can lead to significant difficulties in performing many of the activities of our daily lives. These are two anatomical regions that participate in a coordinated way in the performance and development of precision tasks, whether they are work activities or activities of daily life. For this reason we must make an accurate diagnosis against the appearance of painful symptoms in order to plan a treatment focused on recovering or maintaining the functional level.

The treatments available today are: pharmacological, functional rehabilitation, infiltrations and surgery. Within the surgical section today highlights the advancement of arthroscopic techniques both in the elbow and wrist and hand that allow not only the direct visualization of the joint but also perform treatments without the need to make incisions.

The diseases that most frequently affect the hand and elbow can be grouped as follows depending on the origin of the pain and its location:

Peripheral nerve

STC Carpal Tunnel Syndrome (hand): the median nerve in its passage to the palm of the hand is located in an anatomical duct that for different reasons can be narrowed or hardened. This causes the appearance of discomfort of increasing intensity (from the thumb to the ring finger) in the form of tingling (predominantly nocturnal). It is then that the surgical decompression of the nerve path must be evaluated to prevent the progression of the lesion on it.

Ulnar Nerve (elbow) entrapment syndrome: N. Ulnar may be subjected to compression as it runs along the back of the elbow and up to the first 10 cm of the forearm when circulating between the muscles. When this happens, it typically causes the same pain in the form of tingling, but in this case,at the level of the ring finger and little finger; also in this situation, the need to practice surgical decompression must be assessed.

It should be noted that progressive compression of the peripheral nerves can eventually lead to a loss of muscle strength and skin changes that may be irreversible.

Bone and joints

Arthrosis

Osteoarthritis is a disease that can affect any joint in the body. In the hand, its most frequent location is at the base of the thumb (RIzarthrosis), everything and that is also very common in the interphalangic apticulations of the fingers. Qqirúrgico treatment may be indicated when nk a good control of pain is achieved with other therapeutic opcignes or when it derives dn a significant funcinnal involvement.

arthritis

Arthritis is an inflammatic process of one or more joints that usually requires the completion of a complete study for obtaining a precious diacnostic3o and the adoption of an appropriate treatment. For this reason it sometimes requires the collaboration of other specialties such as Rheumatology. The most common location of the upper extremity where these processes can appear are the interphalangic joints of the fingers.

Fractures

The most common fracture of the upper extremity is the fracture of the distal part of the radius in the wrist joint. It is a fracture that can alter the integrity of the joint and that increasingly tends to be treated surgically. The objective of the treatment is the recovery of the shape of the radan and its consolidation in order to recover the maximum functionality. In those cases in which the articular cartilage is affected by the fracture trace, it may be necessary to use the arthroscspica technique added to the co.vencional surgery.

Other prevalent fractures of the hand are that of the scaphoid bone, that of the fifth metacarpal and those of the phalanges of the desoc. Depending on the pattern of each of these fractures, the most appropriate type of treatment must be assessed.

Close monitoring of patients during the first four weeks is essential to control possible displacements.



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