Hand problems
Experiencing pain in the hand and fingers is common, as they are some of the body parts we use the most. Elit Ortopedi investigates, treats, and rehabilitates issues and injuries in the hands and wrists.
Ganglion
A ganglion is a fluid-filled cyst that typically appears near joints or tendons in the hand and wrist. These cysts are often round or oval and can vary in size. Ganglions can cause pain, discomfort, and limited mobility, depending on their location and size. They often arise without any apparent reason but can be related to overuse or injury to the hand or wrist.
Ganglion är en sorts cysta och består av en vätskefylld utbuktning som bildas i anslutning till en led. Det vanligaste är att ganglion uppkommer på ovansidan av handen, men de kan även uppstå på undersidan av handleden, i handflatan vid fingerbasen och längst ut på fingertopparna. Alla kan få ganglion och oftast beror det på att man har överansträngt leden. Cystor på ovansidan av handen är vanligast hos yngre kvinnor som idrottar och kan då ge ont i handen.
Leder och senor smörjs av en speciell gelatinös vätska, som kallas ledvätska, inuti ledkapseln eller senskidan. Ibland ökar produktionen av ledvätska i en led eller inuti en senskida. Detta kan vara förorsakat av förändringar i leden (arthros), inflammation (arthrit), skada, överbelastning eller annan orsak. På grund av det ökade trycket i leden eller senskidan läcker ledvätskan ut genom kapseln eller senskidan och det bildas en liten blåsa. Då ledvätskan innehåller speciella äggviteämnen som gör att den är trögflytande kan kroppen inte suga upp ledvätskan som läckt ut, utan endast vattnet i ledvätskan. Det kvarvarande blir som ballong fylld med gelé. Storleken och hårdheten på cystan beror på hur mycket vätska som finns i den.
The symptoms of a ganglion include a noticeable lump or bump under the skin, pain or discomfort that may worsen with movement or pressure, and sometimes numbness or tingling if the cyst presses on nearby nerves. The size of the ganglion can vary, and they can sometimes disappear on their own
At Elit Ortopedi, the diagnosis of a ganglion is made through a thorough evaluation that includes a detailed medical history and a physical examination of the hand and wrist. We sometimes use imaging techniques, such as ultrasound or MRI, to confirm the diagnosis and assess the size and location of the cyst
At Elit Ortopedi, we offer several effective treatment options to manage ganglions:
1. Biological Treatments:
Aspiration with Biological Injection: Aspiration involves using a needle to remove the fluid from the cyst. Following aspiration, a biological treatment such as Platelet-Rich Plasma (PRP) or Autologous Conditioned Plasma (ACP) Max can be injected into the area to promote healing and reduce the risk of recurrence. These injections use components from your own blood to facilitate tissue repair.
2. Surgery: If the ganglion causes significant pain, discomfort, or recurs after aspiration, surgical removal may be necessary. Surgery involves removing the entire cyst and its stalk to prevent it from coming back. This can be done through an open surgical procedure or arthroscopy, depending on the cyst’s location and size.
Rehabilitation is the cornerstone of all orthopedic treatment and is performed regardless of whether one chooses biological or surgical treatment, both before and after treatment at Elit Ortopedi. It is highly individualized as everyone has different resources, levels of motivation, and previous training experiences. The rehabilitation strategy includes weight control, work modification, and measures for well-being. In other words, rehabilitation is directly crucial for the treatment outcome.
Regain mobility
Carpal tunnel syndrome
Carpal tunnel syndrome is a common condition that occurs when the median nerve, which runs from the forearm to the hand through the carpal tunnel in the wrist, becomes compressed or pinched. This can lead to pain, numbness, and weakness in the hand and fingers. Carpal tunnel syndrome can be caused by repetitive movements, overuse, injury, inflammation, or anatomical abnormalities in the wrist.
Karpaltunneln är en bindvävstunnel på handflatesidan av handleden genom vilken fingrarnas böjsenor och medianusnerven passerar. Om vävnaderna runt karpaltunneln ökar i tjocklek kläms nerven och de typiska symptomen uppstår: .
Karpaltunnelsyndrom är den vanligaste orsaken till att handen och fingrarna domnar. Det är vanligast hos kvinnor men män drabbas också. Man vet inte alltid orsaken till inklämningen men reumatiker och diabetiker drabbas oftare och även de som skadat handleden eller arbetar manuellt med vibrerande verktyg får det oftare än andra. Det är också vanligt med besvär under och efter graviditeten.
Carpal tunnel syndrome is a common condition that occurs when the median nerve, which runs from the forearm to the hand through the carpal tunnel in the wrist, becomes compressed or pinched. This can lead to pain, numbness, and weakness in the hand and fingers. Carpal tunnel syndrome can be caused by repetitive movements, overuse, injury, inflammation, or anatomical abnormalities in the wrist..
At Elit Ortopedi, the diagnosis of carpal tunnel syndrome is made through a thorough evaluation that includes a detailed medical history and a physical examination of the hand and wrist. We also use diagnostic tests, such as nerve conduction studies and electromyography (EMG), to assess nerve function and confirm the diagnosis.
At Elit Ortopedi, we offer several treatment options to manage carpal tunnel syndrome, but in many cases, surgical treatment may be necessary to relieve symptoms and prevent permanent nerve damage:
Injections:
– Cortisone Injections: Cortisone injections can be used to reduce inflammation and swelling in the carpal tunnel, which can temporarily relieve symptoms.
Surgical Treatment:
– Carpal Tunnel Release: If conservative treatments do not provide sufficient relief, surgical intervention may be necessary. Carpal tunnel release is a surgical procedure where the ligament forming the roof of the carpal tunnel is cut to reduce pressure on the median nerve. This can be done through an open surgical procedure or endoscopic surgery, depending on the patient’s specific needs and the surgeon’s assessment
Rehabilitation is the cornerstone of all orthopedic treatment and is performed regardless of whether one chooses biological or surgical treatment, both before and after treatment at Elit Ortopedi. It is highly individualized as everyone has different resources, levels of motivation, and previous training experiences. The rehabilitation strategy includes weight control, work modification, and measures for well-being. In other words, rehabilitation is directly crucial for the treatment outcome
Wrist Osteoarthritis
Wrist osteoarthritis, also known as degenerative joint disease, is a condition where the cartilage that covers the ends of the bones in the joint gradually breaks down. This leads to pain, stiffness, and reduced mobility. Osteoarthritis can be caused by aging, genetic factors, previous injuries, or repetitive stress on the wrist.
I kroppens leder finns brosk som gör leden stadig och möjliggör att skelettets ben kan glida mot varandra. Artros innebär att brosket bryts ner snabbare än det byggs upp och att det därmed får sämre hållfastighet. I senare stadium påverkar artros inte bara ledbrosket utan även övriga vävnader i leden såsom skelett, ledband, ledhinna och ledvätska.
Artros med ont i händerna är vanligast hos personer över 50 år. Den kan också inträffa i yngre åldrar, särskilt om en led har blivit utsatt för en skada eller onormal belastning. Även ärftliga faktorer kan bidra till artros. De vanligaste ställena att få artros i handen är vid tumbasen eller i fingerlederna. Tummens basled är speciellt utsatt för förslitning, det vill säga artros, framförallt hos kvinnor efter klimakteriet. Vid tumbasartros uppträder artrosen i leden mellan tummens mellanhandsben och handledsbenet.
The symptoms of wrist osteoarthritis include pain that worsens with activity and is relieved by rest, stiffness and reduced mobility in the wrist, swelling around the joint, and a feeling that the hand is not functioning properly. In advanced cases, bone spurs (osteophytes) may be present and visible on X-rays.
At Elit Ortopedi, the diagnosis of wrist osteoarthritis is made through a thorough evaluation that includes a detailed medical history and a physical examination of the wrist. We also use advanced imaging techniques, such as X-rays, MRI, or ultrasound, to assess the degree of cartilage loss and rule out other possible causes of pain.
At Elit Ortopedi, we offer several effective treatment options to manage wrist osteoarthritis. Biological treatments, such as PRP (Platelet-Rich Plasma), ACP Max, and stem cell therapies, can also be used to promote healing and reduce inflammation. These biological treatments are scientifically proven and have studies that show good results.
Platelet-Rich Plasma (PRP) Injections:
– PRP injections use concentrated platelets from your own blood to promote tissue repair and reduce inflammation. Platelets contain growth factors that stimulate the healing of damaged tissues. PRP can help improve symptoms and slow the progression of osteoarthritis. The treatment involves a simple blood draw, followed by centrifugation to isolate the concentrated platelets, which are then injected into the affected area.
Autologous Conditioned Plasma (ACP) Max:
– ACP Max is an advanced form of PRP treatment that uses a higher concentration of platelets and growth factors from your own blood. The process is similar to PRP treatment but involves additional steps to maximize the concentration of bioactive molecules. ACP Max can be particularly effective for managing osteoarthritis and other degenerative joint conditions by promoting the regeneration and repair of joint tissue.
Angel ACP:
– Angel ACP is another advanced biological treatment that uses a sophisticated centrifugation technique to isolate and concentrate platelets and growth factors from your blood. The Angel system allows for a higher degree of precision and customization of the concentration of platelets and growth factors, which can be tailored to the patient’s specific needs. This treatment can enhance tissue repair and reduce inflammation in the affected joint.
Cortisone Injections:
– Cortisone injections can be used to reduce inflammation and relieve pain in the wrist. By administering cortisone directly into the affected joint, we can quickly reduce inflammation and improve symptoms. Cortisone injections offer rapid relief but are typically a temporary solution.
What sets Elit Ortopedi and Dr. Ferm apart is his super specialization in ultrasound and ultrasound examination. This allows him to precisely locate the injury and deliver biological treatments exactly where they are needed to maximize effectiveness. Additionally, Elit Ortopedi has expertise in determining the right quantity, frequency, and treatment protocol to ensure optimal healing. This expertise ensures that each treatment is tailored and optimized for the best possible outcome.
At Elit Ortopedi, our specialists will conduct a thorough examination to determine the most appropriate treatment plan for your specific condition. You will be informed about all available options and guided through each step of the process to ensure the best possible outcome.
Rehabilitation is the cornerstone of all orthopedic treatment and is performed regardless of whether one chooses biological or surgical treatment, both before and after treatment at Elit Ortopedi. It is highly individualized as everyone has different resources, levels of motivation, and previous training experiences. The rehabilitation strategy includes weight control, work modification, and measures for well-being. In other words, rehabilitation is directly crucial for the treatment outcome.
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De Quervain’s syndrome
De Quervain’s syndrome is a painful condition that affects the tendons on the thumb side of the wrist. This condition occurs when the two tendons running through the first dorsal compartment of the wrist become inflamed or irritated. De Quervain’s syndrome can be caused by repetitive movements, overuse, or injury to the wrist.
De Quervain’s syndrom beror på en inflammation i en senskida i handleden. Senskidor är rörformade kanaler av bindväv runt en eller flera senor. Senskidorna skyddar vävnad på utsatta ställen genom att dess glidyta minskar friktionen mellan senor och muskler mot benvävnad. Den inflammerade senskidan sitter på handledens tumsida och blir förtjockad.
De Quervain’s syndrom är vanligt. Orsaken till inflammationen är inte känd men ovana, upprepade och ensidiga rörelser med handen och tummen, som vid trädgårdsarbete eller snickrande är förmodligen några av anledningarna. En annan orsak tros vara hormonförändringar i kroppen. Många får även åkomman efter att ha fött barn. Ibland skrivs syndromet som Mb Quervain’s syndrom eller Morbus de Quervain’s syndrom.
The symptoms of De Quervain’s syndrome include pain and tenderness on the thumb side of the wrist, swelling, and difficulty moving the thumb and wrist. The pain can worsen with activities such as gripping, twisting, or lifting objects.
At Elit Ortopedi, the diagnosis of De Quervain’s syndrome is made through a thorough evaluation that includes a detailed medical history and a physical examination of the hand and wrist. A common test used is the Finkelstein test, where the patient bends the thumb across the palm and then covers the thumb with the fingers, followed by bending the wrist toward the little finger. Pain during this test often indicates De Quervain’s syndrome.
At Elit Ortopedi, we offer several effective treatment options to manage De Quervain’s syndrome:
1. Platelet-Rich Plasma (PRP) Injections:
– PRP injections use concentrated platelets from your own blood to promote tissue repair and reduce inflammation. Platelets contain growth factors that stimulate the healing of damaged tissues. PRP can help improve symptoms and promote healing in the affected area. The treatment involves a simple blood draw, followed by centrifugation to isolate the concentrated platelets, which are then injected into the inflamed area.
2. Cortisone Injections:
– Cortisone injections can be used to quickly reduce inflammation and relieve pain in the affected area. Cortisone is a powerful anti-inflammatory medication that can provide rapid symptom relief. By administering cortisone directly into or around the inflamed tendons, we can quickly reduce inflammation and improve functionality.
3. Surgical Treatment:
– Surgical intervention may be necessary. Surgery for De Quervain’s syndrome involves releasing the first dorsal compartment to give the inflamed tendons more space. This can reduce pressure on the tendons and alleviate pain.
Rehabilitation is the cornerstone of all orthopedic treatment and is performed regardless of whether one chooses biological or surgical treatment, both before and after treatment at Elit Ortopedi. It is highly individualized as everyone has different resources, levels of motivation, and previous training experiences. The rehabilitation strategy includes weight control, work modification, and measures for well-being. In other words, rehabilitation is directly crucial for the treatment outcome.
Dupuytren´s Contracture
Dupuytren’s contracture is a condition that affects the connective tissue in the palm of the hand and fingers. The condition causes the tissue under the skin of the palm to thicken and tighten, which can lead to one or more fingers being pulled towards the palm and becoming bent. This can affect hand function and make everyday activities more difficult
Vid Dupuytrens kontraktur får man en förändring i ämnet kollagen som finns i handflatans bindvävsplatta. Kollagenet ger fasthet och styrka åt kroppens vävnader, och vid Dupuytrens kontraktur blir bindvävsplattan kortare och tjockare.
Åkomman är förmodligen ärftlig och relativt vanlig (cirka 20 procent av befolkningen drabbas). Den beror på en ärrbildning i handflatan, men man vet inte helt vad som utlöser åkomman, dock verkar skador och nötningar påverka. Dupuytrens kontraktur är vanlig hos personer som har diabetes. Sjukdomen brukar även kallas “vikingasjukan”.
Dupuytren’s contracture is a condition that affects the connective tissue under the skin of the palm and fingers, causing the tissue to thicken and contract. The symptoms typically develop gradually and may include:
– Nodules: Small, firm lumps or nodules under the skin of the palm. These nodules are often painless but can be tender or sensitive to touch.
– Pitting: The skin on the palm may become dimpled or pitted due to the underlying tissue thickening.
– Cord Formation: Thickened tissue may form into cords that can extend from the palm into the fingers. These cords can gradually tighten, pulling the fingers toward the palm.
– Finger Contracture: As the condition progresses, one or more fingers (usually the ring and little fingers) may be pulled into a bent position. This contracture can make it difficult to straighten the fingers completely.
– Loss of Function: The contracture can impair hand function, making it challenging to perform everyday tasks such as gripping objects, shaking hands, or putting hands in pockets.
If you notice any of these symptoms, it is important to seek medical advice for proper diagnosis and treatment. Early intervention can help manage the condition and maintain hand function
At Elit Ortopedi, the diagnosis of Dupuytren’s contracture is made through a thorough clinical examination and a detailed medical history. Once the diagnosis is established, we offer two main treatment options: surgery and needle fasciotomy.
Surgery is a common treatment method for Dupuytren’s contracture, especially in more advanced cases. During the surgery, the thickened tissue is removed to release the fingers and restore hand function. The surgery typically requires a period of rehabilitation and physical therapy to ensure the best possible recovery and improved hand function.
Needle fasciotomy is a less invasive treatment option that may be suitable for some patients. During this procedure, a fine needle is used to cut through and break up the thickened tissue. The procedure is often performed under local anesthesia and involves a shorter recovery time compared to traditional surgery. Needle fasciotomy can be an effective way to improve hand mobility and function without the need for major surgery.
Rehabilitation is the cornerstone of all orthopedic treatment and is performed regardless of whether one chooses biological or surgical treatment, both before and after treatment at Elit Ortopedi. It is highly individualized as everyone has different resources, levels of motivation, and previous training experiences. The rehabilitation strategy includes weight control, work modification, and measures for well-being. In other words, rehabilitation is directly crucial for the treatment outcome.
Trigger finger
Trigger finger, also known as stenosing tenosynovitis, is a condition that affects the tendons in the fingers or thumb. When a tendon in a finger or thumb becomes inflamed or irritated, it can no longer move smoothly through its sheath. This can cause the finger to get stuck in a bent position and then suddenly straighten with a “popping” or “snapping” sound. The condition can be painful and lead to stiffness and a sensation of locking during movement.
Triggerfinger, eller Tendinitis nodosa, är en vanlig åkomma. Triggerfinger beror på att det bildas en vätskefylld utbuktning vid senan, en så kallad senknuta, på fingrets böjsena så att senan inte längre kan glida fritt i sin skida. Senknutan fastnar under ett ligament i handflatan och fingret låses fast. Alla fingrar kan drabbas, även tummen.
Det är oklart vad som orsakar fenomenet. Det kan bero på överansträngning efter intensiv, upprepad och ensidig användning av handen. Reumatisk sjukdom och diabetes vet man ökar risken för triggerfinger. Triggerfinger kan också vara medfött.
Symptoms of trigger finger include pain at the base of the affected finger or thumb, stiffness, especially in the morning, a “popping” or “clicking” sound when bending or straightening the finger, tenderness or a lump at the base of the affected finger, and a locking of the finger in a bent or straight position that suddenly releases.
The diagnosis of trigger finger is typically made through a thorough clinical examination and a detailed medical history. The doctor will examine the hand and fingers, feel for tenderness and lumps at the base of the finger or thumb, and ask the patient to bend and straighten the fingers to evaluate the range of motion and note any “popping” or “clicking” sounds..
At Elit Ortopedi, we offer two main treatment options for trigger finger: corticosteroid injection and surgery.
Corticosteroid injections are an effective and less invasive treatment method for trigger finger. Corticosteroids are powerful anti-inflammatory medications that can be injected directly into the tendon sheath to reduce swelling and inflammation. This can help alleviate pain and improve mobility in the affected finger or thumb. Corticosteroid injections can provide rapid relief and reduce symptoms for several weeks or months.
If corticosteroid injections do not provide sufficient relief, or if the trigger finger is severe and affects hand function, surgery may be necessary. During the surgery, known as release surgery, the tight portion of the tendon sheath is cut to create more space for the tendon to move freely. This procedure is typically short and performed under local anesthesia. After the surgery, the patient can expect a quick recovery and improved function in the finger or thumb
Rehabilitation is the cornerstone of all orthopedic treatment and is performed regardless of whether one chooses biological or surgical treatment, both before and after treatment at Elit Ortopedi. It is highly individualized as everyone has different resources, levels of motivation, and previous training experiences. The rehabilitation strategy includes weight control, work modification, and measures for well-being. In other words, rehabilitation is directly crucial for the treatment outcome.