FAQ Category: Hand


I was turned down flat for carpal tunnel surgery because of my age (87 years old). I am hale and hearty except for this terrible numbness in my left hand. I expect to live another 20 years and I do NOT want to live like this. How can I convince my doc to approve this procedure? I think it’s because I’m on Medicare and old enough to be his grandfather that I’m getting this kind of treatment.

The question of whether older adults can benefit from carpal tunnel release surgery has been studied with mixed results. Older adults (65 years old and older) seem to have a greater chance of developing carpal tunnel syndrome and with more severe symptoms. So finding an answer to the question is […]


Is is safe to take glucosamine for hand arthritis? All I ever see on the Internet is about hip or knee arthritis. Also, what are the side effects of these supplements?

Glucosamine and chondroitin sulfate are two alternative products used by many arthritis sufferers. Glucosamine and chondroitin sulfate are natural substances normally found in the articular cartilage. Articular cartilage lines the joints and makes for smooth sliding and gliding action while protecting the joint. When the joint has enough of these […]


Are there any alternatives to prescription drugs for the treatment of hand osteoarthritis? I’m not opposed to taking medications. But I’d like to explore all my options first before just swallowing a pill with the potential for bad side effects.

Two physicians from the Raleigh Hand Center (North Carolina) recently published an article reviewing current evidence on one alternative treatment for hand osteoarthritis. Their focus is on recent evidence concerning the use of glucosamine and chondroitin sulfate as an alternative treatment for hand osteoarthritis. Most of today’s modern treatment of […]


Over the weekend, I managed to dislocate my ring finger in the middle part when I fell out of a boat and grabbed at a rope as I lost my balance. I popped it back in place but now it’s all bent and swollen. Should I get one of those splints from the pharmacy or just tape the finger to the finger next to it?

Recently, three hand surgeons from well-known centers for reconstructive hand surgery presented a lecture on complications following dislocations of the proximal interphalangeal (PIP) joint. This is the joint you are describing. They offered some information about splinting that may be helpful. First, understanding a little bit about the injury is […]


Our son got his middle finger jammed during a wrestling match. The middle joint of the middle finger is dislocated. They are talking about doing surgery. How can we tell if this is really the right treatment? Can’t they just pull it back in place and put a splint on the finger? Why would surgery be needed?

Dislocations of the proximal interphalangeal (PIP) joint (middle joint of the finger) can be complex and challenging. Treatment is not always straightforward, especially when there is a fracture involved. Decisions are made based on the extent of damage, percentage of joint surface that is involved if there was a fracture, […]


I’m faithfully wearing a night splint the hand therapist made for me after I had surgery for Dupuytren finger contracture. I’m starting to have some serious questions about this splint. It holds my fingers straight but I’m stiff in the mornings. It takes a while to get my fingers to bend again. Is that normal?

Routine hand therapy following surgical release of Dupuytren contractures usually includes the fabrication of a finger extension orthosis or splint for each patient. This customized splint may affect each joint of the hand differently resulting in some stiffness when the splint if first removed. A review of studies focused on […]


I’m going to have surgery to remove tight cords in my palm from Dupuytren disease. The surgery is covered by insurance but the hand therapy and splinting afterwards is not. Can I get along without these treatments?

This is a good question and one that hand therapists are actively researching. With the new push for evidence-based outcomes, investigations are ongoing comparing different treatment approaches for various hand conditions including contractures caused by Dupuytren disease. Dupuytren contracture is a fairly common disorder of the fingers. In this condition, […]


It’s been six months since I got hit by a flying baseball and ended up with a permanently bent tip of the index finger (despite wearing a splint day and night since the accident). I’ve seen other people with bent finger tips but never knew this is how you get them. I’m wondering if there is some kind of surgery that could fix this — if for no other reason than cosmetics (I don’t like how it looks). What can you tell me?

Most mallet finger injuries are treated with splinting, which is what it sounds like you have already tried quite faithfully. Surgery is reserved for those patients who still have the mallet finger deformity (tip of the finger remains bent and cannot be straightened voluntarily) several months after splint immobilization. There […]


I am planning to get married in six-months. I have a mallet finger from a high school baseball injury. My fiance would like to have a photo taken of our hands with our wedding rings but there is the ugly mallet finger. Can anything be done to fix this?

With the mallet deformity, the end of the finger is bent and cannot be straightened voluntarily. The distal interphalangeal (DIP) joint (tip of the finger) can be straightened easily with help from the other hand. If the DIP joint gets stuck in a bent position and the proximal interphalangeal (PIP) […]


I’m a little bit bummed that the carpal tunnel release surgery I had done a few years ago can be done now without a visible scar. Do they get as good of results that way as with the kind I had with a full incision?

It’s true that open incision carpal tunnel release is being replaced by the endoscopic (minimally invasive) approach. But open incision surgery is still in use and the jury is still out, so-to-speak, on the comparative results. Now for the first time, results of a long-term study on open incision carpal […]


Ten years ago, I had carpal tunnel surgery the “old-fashioned way”. In other words, I had the open-incision kind of surgery. I guess now everyone is having the kind without a big incision. I seem to be doing okay all these years later. How does that compare with other people who had the same kind of surgery I had back in the day?

According to a study from Harvard Medical School, your experience may be fairly typical. In fact, many studies have been done on patients who have had open incision carpal tunnel release surgery. The results have shown that symptoms improve right away but it can take months for patients to recover […]


I am a prep chef in a large New York City restaurant while trying to make it as an actor. I am easily replaced so I don’t want to lose my job. But I’m having a problem gripping objects because of what the doc calls a “swan-neck” deformity. Is there anything I can do to hold the finger so I can use it? I’ve tried taping it but that doesn’t look good in the kitchen (like I cut myself or something).

Successful nonsurgical treatment is based on restoring balance in the structures of the hand and fingers. The proximal interphalangeal or PIP joint must be supple (not stiff). This is the middle knuckle of each finger. Aligning the PIP joint and preventing hyperextension should help restore distal interphalangeal or DIP extension […]


I have just been diagnosed with rheumatoid arthritis of the hands. The physician says I have an “early” swan neck deformity of the middle finger that could get worse over time. I’d like to do whatever I can to keep this from getting worse and/or prevent any other fingers from going bad. What do you suggest?

You can find a more thorough discussion of swan neck deformity of the finger in our publication A Patient’s Guide to Swan Neck Deformity of the Finger. Swan neck deformity sounds elegant but as you have discovered, it can be very limiting. To the rest of the world, it just […]


I am a hand therapist looking for a little information. I’ve had a patient referred to me with a mallet thumb. I have never treated this condition before. What kind of help can you offer me?

In a continuing education publication from The Journal of Hand Surgery (June 2013), you can obtain a quick, but thorough review of this condition known as mallet thumb. This evidence-based continuing education activity provides updated information on indications for the treatment of mallet thumb (both surgical and nonsurgical approaches), methods […]


Our 17 year-old son got a summer job roofing. Today, one of the other workers had to go to the hospital for putting a nail through his hand using a high-powered nail gun. Naturally, now we are concerned about our son. Is this a common occurrence? Anything we can tell him that might help him avoid the same fate?

Penetrating trauma to the hand from nail gun injuries are on the rise due to increasing numbers of housing starts and, of course, home remodeling. But only 3.9 per cent of these injuries are attributed to industrial (worker compensation) injuries. The majority occur in residential carpentry. Roofing companies are usually […]


We just transported our nephew to the hospital with a nail embedded into his hand. Unfortunately, it is also attached to the piece of board he was putting the nail into. He was using a high-powered nail gun so it is well and truly connected to him now. What is the usual treatment for this? Will he have to have extensive surgery? We are beside ourselves with worry while waiting.

Once the individual has driven a nail with a nail gun into the hand, careful evaluation by the hand surgeon is required. Treatment can range from simple wound care to major microvascular surgery. The decision on how to manage the case depends on multiple factors. One important aspect of treatment […]


How long does it take nail crush injuries to heal? I have a deep crush injury to the tip of my ring finger. The surgeon treated it by removing the nail, sewing up the gash underneath, cleaning and draining the wound, and putting me all back together again. I’m very grateful I didn’t lose the fingertip but still anxious to get back to normal.

Nail plate injuries that also affect the nail matrix can be complicated. The nail plate covers the nail matrix, which is divided into two matrices: germinal and sterile. The nail matrix (also known as matrix unguis) is formed by these two layers of cells at the base of the fingernail […]


My buddy and I do team calf roping in local rodeos and county fairs where we live. He recently got himself a lasso rope injury and ended up with a funny, bent tip-of-the thumb. Think he could get this motion back with a little therapy? He’s trying to figure out a way to rustle them doggies and tie them up on his own but so far, it’s not working too good.

It sounds like your partner may have an injury known as a mallet thumb. A mallet injury usually affects the distal interphalangeal or DIP joint of the finger. More rarely, the interphalangeal joint of the thumb is involved. This joint is commonly injured during sporting activities such as baseball but […]


My husband was involved in a bar fight and ended up with a broken little finger. He thinks it’s nothing and a popsicle stick to hold it together is all that’s needed. I’m wondering if he should see a hand specialist before it heals in a bad or wrong position. What do you think?

According to orthopedic experts at the George Washington University Medical Center in Washington, D.C., the solution may lie somewhere in-between. In a recently published update on the treatment of hand fractures, they suggested that many (if not most) hand fractures are adequately cared for by emergency room physicians, general orthopedic […]