Hand Injuries and Syndromesby Dr Jeffrey Budoff Top Houston Hand Surgeon

Carpal Tunnel Syndrome

Symptoms typically include numbness, tingling, or pain in the thumb and fingers, particularly at night or during repetitive hand activities. If untreated, CTS can lead to hand weakness and reduced grip strength, significantly impacting daily activities.

Cubital Tunnel Syndrome

Common symptoms include tingling, numbness, and discomfort in the ring and little fingers, especially when the elbow is bent for extended periods. If untreated, cubital tunnel syndrome may lead to persistent hand weakness, decreased grip strength, and difficulty performing tasks requiring finger dexterity.

Pronator Syndrome

Symptoms often include aching pain and discomfort in the forearm, accompanied by numbness, tingling, or weakness in the thumb, index, and middle fingers. Pronator syndrome frequently results from repetitive movements involving rotation or gripping motions, leading to difficulty performing everyday tasks.

Ulnar Tunnel Syndrome

Symptoms typically include numbness, tingling, or weakness in the little finger and part of the ring finger, sometimes accompanied by discomfort in the wrist or palm. Common causes include repetitive hand motions, trauma, or prolonged pressure on the wrist area.

Trigger Finger / Trigger Thumb

It’s caused by inflammation and narrowing of the tendon sheath, making smooth movement difficult. Common symptoms include stiffness, popping sensations when moving the finger, pain at the base of the affected digit, and sometimes a visible bump.

Retinacular Cysts

Although usually painless, retinacular cysts can sometimes cause discomfort or interfere with finger movement if they grow larger or press against nerves and tendons. Treatment may include observation, aspiration, or surgical removal, especially when they cause pain or limit normal hand function.

Mucous Cysts

are small, fluid-filled growths typically found near the end joints of the fingers, close to the fingernail. Often associated with underlying arthritis, these cysts can cause discomfort, deformities in the fingernail, or limit joint movement. They usually appear translucent or slightly bluish, and may rupture, releasing a thick, jelly-like fluid.

Dupytren’s Contracture

Over time, this thickening can form cords that pull the fingers—typically the ring and little fingers—into a bent position, limiting hand function and making everyday tasks challenging. Although painless, Dupuytren’s contracture progressively restricts finger movement.

Flexor Tendon Lacerations

Often resulting from sharp injuries, these lacerations can severely affect finger and hand function, making it difficult or impossible to bend the affected digit. Prompt diagnosis and treatment—typically involving surgical repair followed by dedicated hand therapy—are essential to restore movement, prevent stiffness, and ensure optimal hand function. Delays in treatment can lead to permanent limitations in finger mobility and strength.

Extensor Tendon Lacerations

Extensor tendon lacerations occur when the tendons responsible for straightening the fingers or thumb are cut or damaged, typically due to sharp injuries on the back of the hand or fingers. This injury often results in an inability to fully straighten the affected digit, causing significant limitations in hand function. Immediate medical attention, including precise surgical repair and specialized hand therapy, is essential to achieve optimal healing, restore normal finger movement, and prevent long-term complications such as stiffness or deformity.

Mallet Finger

Mallet finger is a common injury characterized by the inability to fully straighten the fingertip due to damage to the extensor tendon at its insertion point. Often resulting from forceful impacts or sudden trauma, this injury typically causes the fingertip to droop downward. Immediate and appropriate treatment—usually involving splinting the affected finger—is crucial for restoring normal function and preventing permanent deformity. In more severe cases, surgical intervention may be necessary to ensure full recovery and proper alignment.

EPL Tendon Rupture

Commonly caused by trauma, repetitive stress, or underlying conditions such as rheumatoid arthritis, this injury leads to an inability to extend the thumb fully, significantly affecting hand functionality and grip strength. Early diagnosis and surgical repair, followed by targeted rehabilitation, are essential to restore thumb movement, prevent permanent disability, and regain optimal hand use.

Extensor Tendon Subluxation

This condition often presents as snapping, popping sensations, or visible shifting of the tendon during finger or thumb movements, leading to pain, discomfort, and reduced hand function. Prompt assessment and treatment, which may include splinting, physical therapy, or surgical intervention, are crucial to reposition the tendon, stabilize the joint, and prevent ongoing issues such as persistent discomfort or functional impairment.

Skier's Thumb

Typically caused by a sudden, forceful movement pushing the thumb away from the hand, it frequently occurs in skiing accidents or during sports. Symptoms include pain, swelling, instability, and difficulty gripping or pinching. Early evaluation and appropriate treatment—ranging from immobilization and splinting to surgical repair in severe cases—are essential for regaining thumb strength and function while preventing chronic instability or arthritis.

MP Joint & PIP Joint Arthroscopy

Are minimally invasive surgical procedures used to diagnose and treat conditions affecting the finger joints, such as arthritis, cartilage damage, or joint stiffness. By inserting a small camera and specialized instruments into the joint, surgeons can visualize and address problems with minimal disruption to surrounding tissues. Arthroscopy allows for faster recovery, reduced scarring, and improved joint function compared to traditional open surgery, making it an effective option for restoring mobility and relieving pain in the fingers.

Hand Fractures

These injuries often result from falls, direct trauma, or sports-related accidents and can cause pain, swelling, bruising, and difficulty moving the affected fingers or hand. Proper diagnosis with imaging and timely treatment—ranging from splinting to surgical fixation—is crucial to ensure the bones heal correctly, restore function, and prevent long-term complications such as stiffness, deformity, or loss of grip strength.

PIP Joint Injuries

These injuries can range from sprains and dislocations to fractures, often resulting in pain, swelling, stiffness, and difficulty bending or straightening the finger. Because the PIP joint is critical for fine motor function, proper evaluation and treatment—such as splinting, physical therapy, or surgery in more severe cases—are essential for restoring motion, reducing pain, and preventing long-term joint instability or deformity.

The Stiff Finger

The stiff finger refers to a condition where one or more fingers lose their normal range of motion, making it difficult to fully bend or straighten the joint. It can result from injury, surgery, prolonged immobilization, or underlying conditions like arthritis. Stiffness may be accompanied by pain, swelling, or joint tightness, significantly impacting hand function. Early intervention with hand therapy, stretching, and sometimes surgical release is key to improving flexibility, restoring motion, and preventing permanent loss of function.

Finger Nail Injuries

These injuries often cause pain, bleeding, and visible deformity. Treatment depends on severity and may include draining blood under the nail, repairing the nail bed, removing damaged nail tissue, or splinting if the underlying bone is fractured. Prompt care is essential to prevent infection, promote proper healing, and minimize long-term nail deformities or loss of nail growth.

Basilar (Basal) Thumb Arthritis

Occurs when the cartilage in the joint wears down, leading to pain, swelling, stiffness, and difficulty with gripping or pinching activities. This condition is especially common in women over 40 and those with a history of repetitive thumb use. Treatment options range from splinting, anti-inflammatory medications, and corticosteroid injections to surgical reconstruction in more advanced cases to relieve pain and restore thumb function.

Basilar Thumb Pain in Young Individuals

Arthritis commonly affects the base of the thumb. Older patients, or those with more advanced arthritis, are well-treated by the LRTI procedure, which is well-covered in the ‘Basilar Thumb Arthritis’ section of this website. While the LRTI is extremely effective, it is not right for every situation

Swan-Neck Deformity of the Thumb

Can result from ligament imbalance, joint laxity, trauma, or underlying conditions like rheumatoid arthritis. This deformity can impair thumb function, making it difficult to grasp or pinch objects effectively. Treatment depends on the severity and underlying cause and may include splinting, hand therapy, or surgical correction to restore alignment and improve hand mechanics.

Finger Arthritis

The fingers can be affected by osteoarthritis (‘wear and tear’ arthritis), rheumatoid (inflammatory) arthritis, or arthritis that occurs because of joint injury (post-traumatic arthritis). Any of the three finger joints can be affected. The distal interphalangeal (DIP) joint is the smallest joint.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic disease (i.e. it affects multiple systems of the body). The primary treatment for RA is medical, and there are many new excellent drugs that can decrease pain and greatly slow the progression of RA. Surgery is used mainly to prevent and correct deformities

Tetraplegic (Quadriplegic) Reconstruction

Spinal cord injury resulting in tetraplegia is a devastating, life-changing injury. Life becomes a battle for independence when even the smallest activity of daily living becomes a challenge. The human mind and the human hand are wonderfully adaptable. Many determined tetraplegics can accomplish

Hand Pain

Hand Pain is very common. There are many things that can cause hand pain. By far, the person most qualified to diagnose and treat the source of hand pain is a Hand Surgeon. Hand surgeons have specialized training in the diagnosis and treatment of common and uncommon hand conditions.