Iowa Ortho's Hand and Upper Extremity Division provides patients with a comprehensive, multidisciplinary approach to care for the evaluation, treatment, and management of hand and upper extremity disorders. Our board-certified, fellowship trained, team of hand and upper extremity physicians assist patients in achieving success for a broad range of common hand conditions to severe hand and upper extremity injuries and disease.

Hand and Upper Extremity Treatments include:

Left untreated, some minor hand, wrist, and elbow problems can become major, chronic conditions. Regardless of the origin, when hand, wrist, or elbow pain interferes with daily activities an evaluation should be performed to determine what treatment options are available that may reduce or eliminate pain. IOC’s Hand and Upper Extremity Division physicians provide the latest state-of-the-art procedures and technology, allowing us to provide superior care to our patients.

Common Injuries

Ganglion Cysts
Ganglion cysts are the most common mass or lump in the hand. These are most common on the back of the wrist. These noncancerous, fluid-filled cysts arise from the ligaments, joint linings, or tendon sheaths when they are irritated or inflamed. They may disappear or change size quickly.

Many ganglion cysts do not require treatment. However, if the cyst is painful, interferes with function or the patient does not like the appearance, your orthopaedic surgeon can remove the fluid, inject steroids, or remove it surgically.

Carpal Tunnel Syndrome
Common symptoms of carpal tunnel syndrome are numbness and tingling in the hand, especially at night; pain with prolonged gripping such as holding a steering wheel; or clumsiness in handling objects. Sometimes the pain can go all the way up to the shoulder.

These symptoms are caused by pressure on the median nerve as it enters the hand through a tunnel in the wrist. The tendons that bend your fingers and thumb also travel in this tunnel.

Mild cases can be treated with a splint or brace to rest the wrist. Steroid injections into the carpal canal to decrease swelling may be used in more severe cases. Those cases that do not respond to nonsurgical treatment and those that are diagnosed late may require surgery. This is generally done in an outpatient setting under local anesthesia.

Tendonitis of the Wrist
DeQuervain's stenosing tenosynovitis is most common in adult women ages of 30 and 50. It is an irritation and swelling of the sheath or tunnel which surrounds the thumb tendons as they pass from the wrist to the thumb. Pain when grasping or pinching and tenderness over the tunnel are the most common symptoms. Sometimes a lump or thickening can be felt with the thumb "tucked in" and bent towards the little finger, and the pain gets worse.

Tendonitis may be caused by overuse and also can be seen in association with pregnancy or inflammatory arthritis such as rheumatoid disease.

If treated early, many cases improve with rest in a splint, injection with steroids and/or taking anti-inflammatory medications. More severe cases or those that do not respond to other treatment may require surgery. Modification of the activities which caused the symptoms initially also may be required.

"Wear and Tear" Arthritis of the Hand
Wear and tear arthritis is very common at the base of the thumb. Pain localized to the base of the thumb, particularly with use, is a very common early symptom. Early disease can be treated with anti-inflammatory medication, steroid injections into the joint, or splinting.

As the wear and deformity progresses, surgery is frequently required. There are many procedures to relieve pain and improve function.

Heberden nodes are "bumps" which occur at the last joint of the finger or thumb due to wear and tear arthritis (osteoarthritis). As the joints deteriorate, small bone spurs form over the back of the joints and make them appear "lumpy".

Since most Heberden nodes are not painful and seldom interfere with function, no specific treatment is usually required. Patients with pain can be treated with anti-inflammatory medications. All patients should continue moving their hands; disuse frequently results in stiffness.

Dupuytren's Contracture
A Dupuytren's Contracture is a hereditary thickening of the tough tissue called fascia that lies just below the skin of your palm. This condition may vary from small lumps or bands to very thick bands which may eventually pull the fingers into the palm.

The only treatment is surgical and is recommended if there is progressive contracture drawing the fingers into the hand. Small nodules or lumps in the palm do not need treatment until they are very large and interfere with hand function. Even with successful surgical removal, the bands may reappear or occur in other fingers.

Trigger Finger
Trigger finger is an irritation of the digital sheath which surrounds the flexor tendons. When the tendon sheath becomes thickened or swollen it pinches the tendon and prevents it from gliding smoothly. In some cases the tendon catches and then suddenly releases as though a "trigger" were released.

Sometimes the swelling can be treated with rest, activity modification, oral anti-inflammatories, or steroid injections. The tendon sheath will then return to its normal, pain-free condition. More severe cases may require surgery to release the tendon. This can be done as an outpatient procedure. Normal activity can be resumed as pain allows.

Because we rely on our hands and upper extremities to do so much, they are subject to injury and overuse causing wear and tear and arthritis.  When you select Iowa Ortho as the provider of your hand and upper extremity care, you can expect to receive the highest level of orthopaedic care available.  Iowa Ortho provides patients with exceptional orthopaedic care, board certified fellowship trained physicians, and state-of-the-art diagnostic tools for a comprehensive evaluation, accurate diagnosis, and development of a treatment plan that places you on the road for success.

Your hands… they help you to feel and discover your world.  You can have confidence you’ve selected the best in orthopaedic care, when you place your hands….in ours.  Call the experts at Iowa Ortho at 515-247-8400, or toll free 800-642-6381.