Understanding Your Hand & Wrist

Clear information about carpal tunnel, TFCC tears, fractures, and hand conditions — written for patients.

Anatomy

How Do the Hand & Wrist Work?

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Bones

27 Bones in One Hand

The hand contains 27 bones: 8 carpal (wrist) bones, 5 metacarpals (palm), and 14 phalanges (fingers). The scaphoid is the most commonly fractured carpal bone — often missed on initial X-rays.

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Nerves

3 Main Nerves

The median, ulnar, and radial nerves control hand sensation and movement. The median nerve passes through the carpal tunnel — compression here causes the most common nerve problem: carpal tunnel syndrome.

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TFCC

The Wrist Stabilizer

The triangular fibrocartilage complex (TFCC) stabilizes the ulnar side of the wrist and the distal radioulnar joint. Tears cause ulnar-sided wrist pain — common in gymnasts, tennis players, and after wrist fractures.

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Tendons

Flexors & Extensors

Flexor tendons run along the palm side, pulling fingers to bend. Extensor tendons run along the back of the hand. Both can be injured by lacerations, sports trauma, or overuse (De Quervain's tenosynovitis).

Common conditions

What Could Be Wrong?

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Carpal Tunnel Syndrome

Tingling, numbness, and weakness in the thumb, index, and middle fingers — especially at night. Caused by median nerve compression. Very common in pregnancy, diabetics, and those doing repetitive hand work.

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Trigger Finger

A catching, locking, or clicking of the finger when bending, caused by tendon sheath inflammation. The finger may get stuck in a bent position. Treated with corticosteroid injection or a minor surgical release.

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De Quervain's Tenosynovitis

Pain and swelling at the base of the thumb, aggravated by pinching and gripping. Common in new mothers (from lifting babies), gamers, and musicians. Splinting, physiotherapy, and steroid injection are effective treatments.

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Scaphoid Fracture

A wrist fracture after a fall onto an outstretched hand — often missed on initial X-ray. Requires MRI or CT for diagnosis. Delayed treatment risks avascular necrosis (bone death). May require surgical fixation with a headless screw.

Treatment

Your Treatment Journey

Diagnosis

X-rays are first-line but miss many injuries. MRI is essential for scaphoid fractures, TFCC tears, and soft tissue injuries. CT scans detail fracture patterns. Nerve conduction studies confirm carpal tunnel syndrome.

Splinting & Conservative Care

Many hand and wrist conditions respond to splinting, activity modification, and hand therapy. Steroid injections are highly effective for carpal tunnel, trigger finger, and De Quervain's.

Minimally Invasive Procedures

Endoscopic carpal tunnel release is performed through tiny incisions with rapid recovery. Arthroscopic wrist surgery treats TFCC tears and cartilage problems. Percutaneous scaphoid fixation uses small screws without large incisions.

Reconstructive Surgery

Tendon repairs, nerve repairs, ligament reconstructions, and joint replacements are performed for more significant injuries. Hand surgery requires exquisite precision — often performed under loupe magnification or microscope.

Hand Therapy & Rehabilitation

Specialist hand therapists are essential for recovery after hand and wrist surgery. Custom splinting, scar management, desensitization, and graded exercises restore strength, sensation, and fine motor function.

FAQ

Your Questions, Answered

Night tingling in the thumb, index, and middle fingers is a classic sign of carpal tunnel syndrome. Wrist splints worn at night often provide immediate relief. A nerve conduction study confirms the diagnosis. Most mild-moderate cases respond to conservative treatment; surgery is very effective for persistent cases.

Yes — any wrist pain after a fall should be evaluated. X-rays are the first step, but scaphoid fractures are often invisible on initial X-ray. If there is tenderness in the anatomical snuffbox (base of thumb), further imaging (MRI or CT) should be requested even with a normal X-ray.

Carpal tunnel release can be done open (small palm incision) or endoscopically (through tiny incisions). Both divide the transverse carpal ligament to relieve pressure on the median nerve. It is usually done under local anesthesia as a day procedure. Most patients notice symptom improvement within days to weeks.

The TFCC (triangular fibrocartilage complex) stabilizes the small bones on the pinky side of the wrist. Tears cause ulnar wrist pain — especially with loading, rotation, or pushing. Diagnosis requires MRI arthrography. Arthroscopic repair or debridement is effective for symptomatic tears.

Questions about your hand or wrist?

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