The carpal tunnel is a space in the wrist that is formed by wrist bones on the three sides and a ligament on top. Nine tendons and the median nerve travel through this space. The median nerve provides sensation to the thumb, index finger, middle finger, and half of the ring finger.
It also controls movement in the thumb. If there is increased pressure in this space, the median nerve will be compressed and develop symptoms of carpal tunnel syndrome.
The most common symptoms are numbness and tingling in the thumb, index finger, middle finger, and half of the ring finger. Symptoms are often worse at night and can disrupt sleep.
Symptoms may worsen during activities such as holding a cell phone or gripping the steering wheel of a car. There may be weakness or clumsiness of the hand, and in severe cases, the thumb may lose strength. The doctor may recommend a nerve conduction study to help determine the severity of carpal tunnel syndrome.
Treatment includes work modification, wrist splint, or anti-inflammatory medication. In moderate or severe cases, it may be necessary to surgically release the carpal tunnel. Dr. Liu is skilled in performing endoscopic carpal tunnel release, which is a minimally invasive approach through a 2-cm incision in the wrist as an outpatient procedure.
Dupuytren’s contracture is abnormal curling of the fingers. It is a genetically inherited condition with varying degrees of severity. Connective tissues under the skin of the palm and fingers become diseased and thick, forming nodules and cords.
The abnormal position of the fingers may interfere with activities such as golf, tennis, and bicycle or motorcycle riding or even with basic gestures such as shaking hands, laying hands flat on a tabletop, and putting hands in pockets.
Dupuytren’s contracture can be treated effectively with Xiaflex injection or with a surgery called palmar and digital fasciectomy. Xiaflex injection is minimally invasive and non-surgical with a short recovery time. Palmar and digital fasciectomy is the complete surgical removal of all the diseased tissues, offering lower rates of recurrence.
Dr. Liu is skilled with both treatments and will discuss the risks and benefits to help patients choose the most appropriate option. Most patients can expect to regain near-normal movement of the affected fingers.
Tendons glide through a pulley system in each finger, similar to fishing wire through the loops on a fishing pole. Trigger finger is tendonitis that interferes with smooth gliding through the pulleys during bending or straightening of the finger. Treatment includes steroid injection and surgical release.
Dr. Liu is skilled with both treatments and will discuss the risks and benefits to help patients choose the most appropriate option. Patients can expect to regain near-normal movement of the affected fingers almost immediately.
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