Hand & Wrist Specialists of the Palm Beaches
Laura Kolshak, M.D.
Board Certified Orthopaedic Hand Surgeon, Fellowship-Trained
Palm Beach County, FL
To Schedule An Appointment
Call (561) 508-7066
Fax (561) 508-5738
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Basilar Joint (Thumb) Arthritis
Basilar Joint Arthritis is also known as Arthritis of the Thumb or Carpal-metacarpal (CMC) Arthritis. This is a common form of arthritis because of the repeated wear and tear of this joint due to pinching, and is seen most frequently in women, over the age of 40. Arthritis DOES NOT cause numbness or tingling so further evaluation is warranted if you have this symptom.
These small wounds can lead to aggressive infections due to organisms found in human and animal saliva. Dog bites are the most common type of bites, but cat and human bites are more likely to result in infection. The dental anatomy of cats cause puncture-type wounds which often enter deep into the joint, while clenched fist or “fight bite” injuries inoculate the joints because it is prominent when the fist is clenched. These require urgent evaluation due to the potentially devastating consequences.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome (CTS) is a common condition affecting the wrist and hand, affecting approximately 0.1-10% of the population. Typically the result of irritation and swelling, CTS causes compression within the narrow carpal tunnel, located at the wrist. When this is compressed, a major nerve becomes damaged, temporarily or permanently, usually causing numbness, pain, tingling and weakness in the thumb, index and middle fingers.
Cubital Tunnel Syndrome
Cubital Tunnel Syndrome is another common condition affecting the hand and forearm. This is the result of compression placed on the ulnar nerve at the bony part of the elbow (medial epicondyle). It typically occurs when resting on the elbow for extended periods of time or by bending the elbow excessively. It can cause numbness and tingling at the ring and little fingers.
Dupuytren’s Disease is primarily a genetic condition affecting the hand. Most often seen in men, this disease usually result in contractures of the fingers known as Dupuytren’s Contracture. The condition causes excessive thickening of the “fascia” - the tough, fibrous tissue located between the tendons and the skin in the palm of the hand. It may prevent full extension of the fingers, eventually hindering movement of some fingers and function of the affected hand.
One of the newer developments in non-surgical treatment includes an injectable enzyme called XIAFLEX. XIAFLEX injection is a Collagenase, which is an enzyme derived from the bacterium Clostridium histolyticum. This hydrolyzes the collagen cords, causing them to rapidly dissolve/degrade. XIAFLEX is currently the only FDA-approved collagenase on the market. During treatment with XIAFLEX, collagenase is injected directly into the diseased cords.
This type of arthritis affects the small joints of the fingers. It may be the result of osteoarthritis (wear and tear), rheumatoid arthritis (inflammatory) or post traumatic arthritis (injury related).
Rheumatoid Arthritis (RA) is an inflammatory type of arthritis. It is generally associated with a genetic predisposition rather than an injury or wear and tear of the joints. Affecting nearly 1.3 million Americans, RA is most commonly seen in women, and results in the rapid degeneration of joints, then subsequent bone damage.
Tendon Lacerations are often the result of trauma to the flexor or extensor tendons of the hand or fingers.
Trigger Finger/Trigger Thumb
"Trigger Finger," also known as Tenosynovitis, is a tenderness and painful nodule or swelling at the base of the finger that limits bending of the thumb and fingers. This occurs when flexor tendons become irritated, they no longer move smoothly through the narrow tunnel. They become briefly “stuck” upon entry, causing a sensation of catching and popping free when the finger is straightened (which is how the condition was named.) Trigger Finger is caused by inflammation or degenerative changes of the flexor tendon sheath most commonly associate with diabetes and Rheumatoid Arthritis (RA).