FAQ Category: Hand


I am a professional card dealer in a large Las Vegas casino. Unfortunately, I fell on the ice and broke my hand. I’ve had surgery to pin two bones together and I’m in a cast. What can I expect for recovery (how long will it take? will I get full use of my hand again)?

Whether from sports-related activities, work injuries, car accidents, or falls, hand fractures can cause significant pain and disability. But most patients can expect that, in time, they can return to normal motion and use of the involved hand. An accurate and timely diagnosis is always the first step. With careful […]


I’m going to have the fingers on my hand that are permanently bent injected to release the tissue. The surgeon will straighten the finger after the injection and then I’m supposed to go to therapy for a splint and some exercises. Are these the kind of exercises I can just do on my own? I don’t have insurance coverage for hand therapy.

Dupuytren’s contracture is a fairly common disorder of the fingers. It most often affects the ring or little finger, sometimes both, and often in both hands. It occurs most often in middle-aged, white men. This condition is seven times more common in men than women. The condition commonly first shows […]


As my Aunt Loretta used to say, “Shoot a bean.” This means I can’t make up my mind about the best way to treat my two stuck fingers. The doc says I have a disease called Dupuytren. Middle joints of the middle and ring fingers of my dominant hand are stuck in a bent position. The choices for treatment are some kind of enzyme injection or surgery. Both sound simple and successful. Are there any tipping points to help me with this one?

You may be interested in the results of a study recently reported by a group of surgeons at the Philadelphia Hand Center at Thomas Jefferson Medical College. In this study, surgeons from the report on the effect of a three-part therapy treatment for severe Dupuytren disease. Patients enrolled included 19 […]


I am going to have surgery on my dominant (right) hand to replace a tendon that has worn through from my rheumatoid arthritis. It’s the tendon on the back of my index finger. How important is it to see a hand surgeon (specialist) rather than just a regular surgeon? I can’t seem to get a straight answer from my main doctor.

Serious injuries like tendon injuries often require treatment by an experienced hand surgeon. Surgeons know how complex and delicate the anatomic structures of the hand are. They understand the need for very careful surgical technique when repairing, reconstructing, transferring, or grafting a tendon. There are many potential complexities of surgery […]


Have you ever heard of people who think they can predict the weather by their aches and pains? I’m a little skeptical but whenever I want to know if it’s going to be a good day for fishing, I ask my Grandpa and he is always spot on. What do you think about this?

Like others who have relied on a family member with arthritis to predict an upcoming storm, you know there may be some kind of link between change in weather and joints. But what is that relationship? Is it real or imagined? Scientists have been studying this phenomenon for a while. […]


I am a long-distant bicyclist with a few typical problems with neck pain and wrist/hand pain and numbness. I’ve been told I have a “double crush syndrome.” Can you tell me a bit more about this and what to expect?

Neck pain, shoulder pain, thoracic outlet syndrome, carpal tunnel syndrome, and this diagnosis of neck pain and carpal tunnel syndrome (which together make up the double crush syndrome) are fairly common among bicyclists. In fact, in a recent study of just patients who were bicyclists, they found a high proportion […]


I am a physical therapist who subscribes to your service — it has been a great help to me. Tomorrow I will be seeing two patients who both received a pyrolytic carbon implant for osteoarthritis of the MCP joint. What tips can you offer me for designing the rehab program? What do other hand therapists do for these patients?

The implant is made by burning and separating hydrocarbon gas to make it chemically stable. The process makes the material biologically compatible (acceptable to the body). Pyrolytic carbon implants have been around and in use for finger joint replacements for 20 years or more. But the use of these devices […]


I saw a funny thing on the subway this morning. A woman was wiggling her fingers and talking out loud. Now, in New York City, that really isn’t so unusual but what she was saying caught my attention. She was memorizing the anatomy of just the tendons that pull the fingers back. It caught my attention so I’m checking your website for a little more about this myself. What should I look for?

You may want to start with our publication A Patient’s Guide to Hand Anatomy. You may find other Patient Guide topics of interest in the section on hand. We also recently reported on a review article just on the extensor tendons of the hand from The University of Illinois at […]


My wife and I were away over the weekend on a snowmobiling trip. Unfortunately, she was flipped off the snowmobile and got a badly broken and dislocated middle joint of the middle finger. We were out of town at the time. She had surgery there at the regional medical center and now sent home (we live about 200 miles from where she was treated). We have a referral to the hand center in our area. But what should we expect? Like what happens next?

A broken finger is not something trivial. Even though the individual bones that make up each finger are small, a fracture (and especially a fracture with dislocation) can result in a painful, unstable, nonfunctional finger. And the “middle” joint of the finger (called the proximal interphalangeal (PIP) joint is important […]


I have been having very painful thumbs for months now. It hurts when I press underneath the base of the tip of my thumbs (right where it bends). I have trouble picking things up with my thumb and fingers pinched together — just hurts like the dickens. How can I figure out what’s wrong and what to do about it?

You may be experiencing a problem known as sesamoiditis. But to know for sure (and to find out the best way to treat whatever is wrong), you will need an evaluation by your primary care physician or an orthopedic physician. Sesamoiditis refers to an inflammatory process affecting the sesamoid bones […]


I have been diagnosed with sesamoiditis of the thumbs (both thumbs). It’s probably because I’ve worked as a seamstress my whole life and the thumbs are getting worn out. The hand surgeon I’m seeing suggested trying a steroid injection. But everyone says, OH! Don’t do that — those are dangerous! I don’t know what to think. What do you advise?

Sesamoiditis is usually treated effectively with conservative (nonoperative) care. But when pain relievers, antiinflammatory medications, a thumb splint and hand therapy do not help, then steroid injection into the sesamoid joint is advised and can be very effective. But please know that a good period of conservative care (at least […]


I am a band leader for a swing band that plays at weddings and entertainment events. My drummer has developed something called Dupuytrens disease of his fingers. He’s going to try and bypass surgery by having some kind of injections. We have a lot of gigs scheduled this month. How long will recovery take?

Dupuytren’s contracture is a fairly common disorder of the fingers. It most often affects the ring or little finger, sometimes both, and often in both hands. It occurs most often in middle-aged, white men. This condition is seven times more common in men than women. The condition commonly first shows […]


I understand Xiaflex injections for Dupuytren’s hasn’t been around very long. From what you know that has been reported so far, what are they saying about results after a year or two?

You are correct that the use of this collagenase enzymatic product known as Xiaflex is a relatively new treatment for Dupuytren’s contracture. By injecting an enzyme directly into the cords formed by the disease, the tissue dissolves and starts to weaken. Then the patient can stretch the fingers and break […]


I had some special enzyme injections into the palm of my hand to help me straighten my fingers. It worked great for the main joints (my knuckles aren’t so bent up) but not for the middle joint. How come? Is this what happens to other people or just me?

It sounds like you have been treated with collagenase enzymatic injection for Dupuytren’s contracture. This type of hand problem is a fairly common disorder of the fingers. The condition usually shows up as a thick nodule (knob) or a short cord in the palm of the hand, just below the […]


I have started to develop pain in my right thumb that the doctor calls osteoarthritis. I’ve had carpal tunnel in that hand for several years. Could the thumb joint be breaking down now that the carpal tunnel has been there so long?

A recent study of 300 patients treated for trigger finger and carpal tunnel syndrome was done looking for a direct link between the two. In fact, they found that patients with more than one trigger finger were three times more likely to develop carpal tunnel syndrome in the same hand […]


Do you have any idea how the decision is made to do surgery for a skier’s thumb? Our 18-year-old daughter is away at college. She went skiing, had a skiing accident and ended up with skier’s thumbs (both sides). She’s far away and couldn’t come home for treatment and ended up having surgery there. I keep thinking if she were here, we could have avoided surgery. We had to go with the doctor’s recommendation there but I still wonder.

You may have seen a flowchart meant to help someone make an important or difficult decision. Physicians use this same idea when examining patients and determining the best treatment approach. For example, they might think “if this symptom is present, then I will order this test — or if the […]


What’s the difference between gamekeeper’s thumb and skier’s thumb? My husband has been to two different surgeons for thumb injuries after a skiing accident. One called it one thing and the other called it the other. Are they two different things or what?

Skier’s thumb (also known as gamekeeper’s thumb). The names skier’s thumb and gamekeeper’s thumb refer to the same injury: tear or rupture of the ulnar collateral ligament (UCL) of the thumb. In the case of skier’s thumb (obviously the result of a skiing accident), the UCL is damaged when a […]