Hand Injuries

Just in North America alone, over 260,000 Carpal Tunnel Release operations are performed each year, and over 47% of these cases are reported as being work-related!

 

The costs due to CTS are substantial – both for the patient and for the employer.

When does Carpal Tunnel Syndrome occur?

The increased use of computers, and their accompanying flat, light-touch keyboards that allow for high-speed typing, have resulted in an epidemic of injuries to the hands, arms, shoulders, and neck. The increased use of pointing devices like the computer mouse and trackball (which require repeated subtle movements) add to these injuries.

The thousands of repeated keystrokes and long periods of clutching and dragging with the mouse causes chronic irritation to soft-tissue (nerves, muscles, ligaments, fascia, and tendons). This irritation creates friction and pressure, which eventually leads to small tears within the soft-tissue. These in turn cause inflammation, decreased circulation, and swelling (edema).

 

CTS injuries are aggravated by:

  • Poor posture and body positions.

  • Poor ergonomics (positioning of the chair, mouse, monitor, keyboard, assembly line, and so on).

  • Decreased strength due to poor conditioning or injury.

  • Insufficient relaxation/rest time away from the stresses that cause the problem.

  • Excessive force that is required to perform an action.

  • Muscle imbalances.

All these factors place unnecessary, repeated stress upon all the soft-tissues of the neck, shoulders, arms, wrists, and hands.

 

Dupuytren’s contracture, occasionally called Dupuytren’s disease, is a thickening and contraction of the palmar fascia, the fibrous bands on the palms of your hands. With Dupuytren’s contractures, the connective tissue in your hands becomes extremely thick, causing your fingers to curl inward; especially your ring finger and little finger.

 

This condition usually begins as a tender lump or nodule in the palm of your hand. Over time, months or years, this area thickens, restricting motion and function. As the condition progresses the individual’s fingers will bend inward towards the palm of the hand.

 

After the initial stage, Dupuytren’s contracture is not typically painful. Functional impairment becomes the main problem. The degree of the contracture will vary from mild to disabling.

Causes of Dupuytren’s Contractures

The exact cause (etiology) of Dupuytren’s contracture is often not known. Dupuytren’s is more predominant in smokers, diabetics, epileptics, liver cirrhosis patients, vascular disease patients, and alcoholics. There are also indications of a genetic factor, this condition is more predominant in certain families. Men are also more prone to this condition than women, and persons of European descent have higher incidences (Scandinavian, Irish, or Eastern European ancestry).

 

From a biomechanical perspective an increase in Dupuytren’s contraction is seen in some individuals who have experienced physical trauma or after performing tasks that require repetitive motion.

 

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