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The Hand

  • Patrick M. Foye
  • Debra S. Ibrahim
  • Michael J. Mehnert
  • Todd P. Stitik
  • Jong H. Kim
  • Mohammad Hossein Dorri
  • David J. Van Why
  • Jose Ibarbia
  • Lisa Schoenherr
  • Naimish Baxi
  • Ladislav Habina
  • Jiaxin J. Tran
Chapter

Abstract

Injections at the hand region are relatively common in musculoskeletal practice. Some of the more commonly performed injections are listed in Table 9.1, along with relevant references from the medical literature. These hand region injections encompass a spectrum of intra-articular joint injections for osteoarthritis and other arthritic conditions, tendon sheath injections, nerve blocks, etc.

Keywords

Joint Injection Nail Removal Flexor Tendon Sheath Diagnostic Injection Aspiration Syringe 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Taras JS, Raphael JS, Pan WT, Movagharnia F, Sotereanos DG. Corticosteroid injections for trigger digits: is intrasheath injection necessary? J Hand Surg [Am] 1998;23(4):717–22.CrossRefGoogle Scholar
  2. 2.
    Kazuki K, Egi T, Okada M, Takaoka K. Clinical outcome of extrasynovial steroid injection for trigger finger. Hand Surg 2006;11(1–2):1–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Fuchs S, Mönikes R, Wohlmeiner A, Heyse T. Intra-articular hyaluronic acid compared with corticoid injections for the treatment of rhizarthrosis. Osteoarthritis Cartilage 2006;14(1):82–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Coaccioli S, Pinoca F, Puxeddu A. Short term efficacy of intra-articular injection of hyaluronic acid in osteoarthritis of the first carpometacarpal joint in a preliminary open pilot study. Clin Ter 2006;157(4):321–5.PubMedGoogle Scholar
  5. 5.
    Kahan A, Mödder G, Menkes CJ, Verrier P, Devaux JY, Bonmartin A. 169Erbium-citrate synoviorthesis after failure of local corticosteroid injections to treat rheumatoid arthritis-affected finger joints. Clin Exp Rheumatol 2004;22(6):722–6.PubMedGoogle Scholar
  6. 6.
    Raza K, Lee CY, Pilling D, Heaton S, Situnayake RD, Carruthers DM et al. Ultrasound guidance allows accurate needle placement and aspiration from small joints in patients with early inflammatory arthritis. Rheumatology (Oxford) 2003;42(8):976–9.CrossRefGoogle Scholar
  7. 7.
    Posner MA, Langa V, Green SM. The locked metacarpophalangeal joint: diagnosis and treatment. J Hand Surg [Am] 1986;11(2):249–53.Google Scholar
  8. 8.
    Menkes CJ, Gô AL, Verrier P, Aignan M, Delbarre F. Double-blind study of erbium 169 injection (synoviorthesis) in rheumatoid digital joints. Ann Rheum Dis 1977;36:254–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Jalava S, Saario R. Treatment of finger joints with local steroids. A double-blind study. Scand J Rheumatol 1983;12(1):12–4.CrossRefPubMedGoogle Scholar
  10. 10.
    Reeves KD, Hassanein K. Randomized, prospective, placebo-controlled double-blind study of dextrose prolotherapy for osteoarthritic thumb and finger (DIP, PIP, and trapeziometacarpal) joints: evidence of clinical efficacy. J Altern Complement Med 2000;6(4):311–20.CrossRefPubMedGoogle Scholar
  11. 11.
    Low CK, Wong HP, Low YP. Comparison between single injection transthecal and subcutaneous digital blocks. J Hand Surg [Br] 1997;22(5):582–4.Google Scholar
  12. 12.
    Yin ZG, Zhang JB, Kan SL, Wang P. A comparison of traditional digital blocks and single subcutaneous palmar injection blocks at the base of the finger and a meta-analysis of the digital block trials. J Hand Surg [Br] 2006;31(5):547–55.Google Scholar
  13. 13.
    Hung VS, Bodavula VK, Dubin NH. Digital anaesthesia: comparison of the efficacy and pain associated with three digital nerve block techniques. J Hand Surg [Br] 2005;30(6):581–4.Google Scholar
  14. 14.
    Brutus JP, Baeten Y, Chahidi N, Kinnen L, Ledoux P, Moermans JP. Single injection digital block: comparison between three techniques. Chir Main 2002;21(3):182–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Kollersbeck C, Walcher T, Gradl G, Genelin F. Clinical experiences and dosage pattern in subcutaneous single-injection digital block technique. Handchir Mikrochir Plast Chir 2004;36(1):64–6.CrossRefPubMedGoogle Scholar
  16. 16.
    Seaberg DC, Angelos WJ, Paris PM. Treatment of subungual hematomas with nail trephination: a prospective study. Am J Emerg Med 1991;9(3):209–10.CrossRefPubMedGoogle Scholar
  17. 17.
    Batrick N, Hashemi K, Freij R. Treatment of uncomplicated subungual haematoma. Emerg Med J 2003;20(1):65.CrossRefPubMedGoogle Scholar
  18. 18.
    Meek S, White M. Subungual haematomas: is simple trephining enough? J Accid Emerg Med 1998;15(4):269–71.PubMedGoogle Scholar
  19. 19.
    Joshi R. Intraarticular corticosteroid injection for first carpometacarpal osteoarthritis. J Rheumatol 2005;32(7):1305–6.PubMedGoogle Scholar
  20. 20.
    Saunders S. Wrist treatments. In Saunders S, ed. Injection Techniques in Orthopaedic and Sports Medicine. Second edition. London: WB Saunders; 2002:70–81, 60–61.Google Scholar
  21. 21.
    Waldman SD. Intra-articular Injection of the Carpometacarpal Joint of the Thumb. Atlas of Pain Management Injection Techniques. Philadelphia, PA: WB Saunders; 2000:125–7.Google Scholar
  22. 22.
    Kesson M, Atkins E, Davies I. Wrist and hand. In Kesson M, Atkins E, Davies I, eds. Musculoskeletal Injection Skills. New York: Butterworth Heinemann; 2002:86–88.Google Scholar
  23. 23.
    Tallia AF, Cardone DA. Diagnostic and therapeutic injection of the wrist and hand region. Am Fam Physician. 2003;67(4):745–50.PubMedGoogle Scholar
  24. 24.
    Furtado RN, Oliveira LM, Natour J. Polyarticular corticosteroid injection versus systemic administration in treatment of rheumatoid arthritis patients: a randomized controlled study. J Rheumatol 2005;32(9):1691–8.PubMedGoogle Scholar
  25. 25.
    Kesson M, Atkins E, Davies I. Wrist and hand. In Kesson M, Atkins E, Davies I, eds. Musculoskeletal Injection Skills. New York: Butterworth Heinemann; 2002:89–90.Google Scholar
  26. 26.
    Waldman SD. Intra-articular Injection of the Metacarpophalangeal Joints. Atlas of Pain Management Injection Techniques. Second edition. Philadelphia, PA: WB Saunders; 2007: 248–51.Google Scholar
  27. 27.
    Kumar S, Singh RJ, Reed AM, Lteif AN. Cushing’s syndrome after intra-articular and intradermal administration of triamcinolone acetonide in three pediatric patients. Pediatrics 2004;113(6):1820–4.CrossRefPubMedGoogle Scholar
  28. 28.
    Waldman SD. Intra-articular Injection of the Interphalangeal Joints. Atlas of Pain Management Injection Techniques. Philadelphia, PA: WB Saunders; 2000:141–3.Google Scholar
  29. 29.
    Kesson M, Atkins E, Davies I. Wrist and hand. In Kesson M, Atkins E, Davies I, eds. Musculoskeletal Injection Skills. New York: Butterworth Heinemann; 2002:89–91.Google Scholar
  30. 30.
    Williams JG, Lalonde DH. Randomized comparison of the single-injection volar subcutaneous block and the two-injection dorsal block for digital anesthesia. Plast Reconstr Surg 2006;118(5):1195–200.CrossRefPubMedGoogle Scholar
  31. 31.
    Castellanos J, Ramírez C, De Sena L, Bertrán C. Transthecal digital block: digital anaesthesia through the sheath of the flexor tendon. J Bone Joint Surg Br 2000;82(6):889.CrossRefPubMedGoogle Scholar
  32. 32.
    Scarff CE, Scarff CW. Digital nerve blocks: More gain with less pain. Australas J Dermatol 2007;48(1):60–1.CrossRefPubMedGoogle Scholar
  33. 33.
    Fitzgerald BT, Hofmeister EP, Fan RA, Thompson MA. Delayed flexor digitorum superficialis and profundus ruptures in a trigger finger after a steroid injection: a case report. J Hand Surg [Am] 2005;30(3):479–82.CrossRefGoogle Scholar
  34. 34.
    Saunders S. Wrist treatments. In Saunders S, ed. Injection Techniques in Orthopaedic and Sports Medicine. Second edition. London: WB Saunders; 2002:70–81, 64–5.Google Scholar
  35. 35.
    Kesson M, Atkins E, Davies I. Wrist and hand. In Kesson M, Atkins E, Davies I, eds. Musculoskeletal Injection Skills. New York: Butterworth Heinemann; 2002:99–101.Google Scholar
  36. 36.
    Waldman SD. Trigger Finger Syndrome. Atlas of Pain Management Injection Techniques. Philadelphia, PA: WB Saunders; 2000:134–7.Google Scholar
  37. 37.
    Akhtar S, Burke FD. Study to outline the efficacy and illustrate techniques for steroid injection for trigger finger and thumb. Postgrad Med J 2006;82(973):763–6.CrossRefPubMedGoogle Scholar
  38. 38.
    Salter SA, Ciocon DH, Gowrishankar TR, Kimball AB. Controlled nail trephination for subungual hematoma. Am J Emerg Med 2006;24(7):875–7.CrossRefPubMedGoogle Scholar
  39. 39.
    Skinner PB Jr. Management of traumatic subungual hematoma. Am Fam Physician 2005;71(5):856.PubMedGoogle Scholar
  40. 40.
    Kaya TI, Tursen U, Baz K, Ikizoglu G. Extra-fine insulin syringe needle: an excellent instrument for the evacuation of subungual hematoma. Dermatol Surg 2003; 29(11):1141–3.CrossRefPubMedGoogle Scholar
  41. 41.
    Palamarchuk HJ, Kerzner M. An improved approach to evacuation of subungual hematoma. J Am Podiatr Med Assoc 1989;79(11):566–8.PubMedGoogle Scholar
  42. References 1.
    Tallia AF, Cardone DA. Diagnostic and therapeutic injection of the wrist and hand region. Am Fam Physician 2003;67(4):745–50.PubMedGoogle Scholar
  43. 2.
    Helm AT, Higgins G, Rajkumar P, Redfern DR. Accuracy of intra-articular injections for osteoarthritis of the trapeziometacarpal joint. Int J Clin Pract 2003;57(4):265–6.PubMedGoogle Scholar
  44. 3.
    Koski JM, Hermunen H. Intra-articular glucocorticoid treatment of the rheumatoid wrist. An ultrasonographic study. Scand J Rheumatol 2001;30(5):268–70.CrossRefPubMedGoogle Scholar
  45. 4.
    Grassi W, Lamanna G, Farina A, Cervini C. Synovitis of small joints: sonographic guided diagnostic and therapeutic approach. Ann Rheum Dis 1999;58(10):595–7.CrossRefPubMedGoogle Scholar
  46. References 1.
    Tallia AF, Cardone DA. Diagnostic and therapeutic injection of the wrist and hand region. Am Fam Physician 2003;67(4):745–50.PubMedGoogle Scholar
  47. 2.
    Raza K, Lee CY, Pilling D, Heaton S, Situnayake RD, Carruthers DM et al. Ultrasound guidance allows accurate needle placement and aspiration from small joints in patients with early inflammatory arthritis. Rheumatology (Oxford) 2003;42(8):976–9.CrossRefGoogle Scholar
  48. 3.
    Koski JM, Hermunen H. Intra-articular glucocorticoid treatment of the rheumatoid wrist. An ultrasonographic study. Scand J Rheumatol 2001;30(5):268–70.CrossRefPubMedGoogle Scholar
  49. 4.
    Grassi W, Lamanna G, Farina A, Cervini C. Synovitis of small joints: sonographic guided diagnostic and therapeutic approach. Ann Rheum Dis 1999;58(10):595–7.CrossRefPubMedGoogle Scholar
  50. References 1.
    Scott PM. Subungual hematoma evacuation. JAAPA 2002;15(3):63–5.PubMedGoogle Scholar
  51. 2.
    Pirzada A, Waseem M. Subungual hematoma. Pediatr Rev 2004;25(10):369.CrossRefPubMedGoogle Scholar
  52. 3.
    Batrick N, Hashemi K, Freij R. Treatment of uncomplicated subungual haematoma. Emerg Med J 2003;20(1):65.CrossRefPubMedGoogle Scholar
  53. 4.
    Skinner PB. Management of traumatic subungual hematoma. Am Fam Physician 2005; 71(5):856.PubMedGoogle Scholar
  54. References 1.
    Tallia AF, Cardone DA. Diagnostic and therapeutic injection of the wrist and hand region. Am Fam Physician 2003;67(4):745–50.PubMedGoogle Scholar
  55. 2.
    Taras JS, Raphael JS, Pan WT, Movagharnia F, Sotereanos DG. Corticosteroid injections for trigger digits: is intrasheath injection necessary? J Hand Surg [Am] 1998;23(4):717–22.CrossRefGoogle Scholar
  56. 1.
    Waldman SD. Neural blockade and neurolytic blocks. In Lampert R, Ross A, Ruzycka A, eds. Atlas of Interventional Pain Management. Philadelphia, PA: WB Saunders, 2004:202–4.Google Scholar
  57. 2.
    Phillips JS, Gillespie PH, Logan AM. Digital nerve blocks: a cadaveric study of an unrecognized trauma? J Trauma 2005;59(3):770–2.PubMedGoogle Scholar
  58. 3.
    Andrades PR, Olguin FA, Calderon W. Digital blocks with or without epinephrine. Plast Reconstr Surg 2003;111(5):1769–70.CrossRefPubMedGoogle Scholar
  59. 4.
    Wilhelmi BJ, Blackwell SJ, Miller JH, Mancoll JS, Dardano T, Tran A et al. Do not use epinephrine in digital blocks: Myth or truth? Plast Reconstr Surg 2001;107:3937.Google Scholar
  60. 5.
    Krunic AL, Wang LC, Soltani K, Weitzul S, Taylor RS. Digital anesthesia with epinephrine: an old myth revisited. J Am Acad Dermatol 2004;51(5):755–9.CrossRefPubMedGoogle Scholar
  61. 6.
    Bartfield JM, Ford DT, Homer PJ. Buffered versus plain lidocaine for digital nerve blocks. Ann Emerg Med 1993;22(2):216–9.CrossRefPubMedGoogle Scholar
  62. 7.
    Chiu DT. Transthecal digital block: flexor tendon sheath used for anesthetic infusion. J Hand Surg [Am] 1990;15-A:471–3.Google Scholar
  63. 8.
    Castellanos J, Ramirez C, De Sena L, Bertran C. Transthecal digital block: digital anaesthesia through the sheath of the flexor tendon. J Bone Joint Surg [Br] 2000;82(6):889.CrossRefGoogle Scholar
  64. 9.
    Whetzel TP, Mabourakh S, Barkhordar R. Modified transthecal digital block. J Hand Surg 1997;22A(2):361.Google Scholar
  65. 10.
    Hung VS, Bodavula VK, Dubin NH. Digital anaesthesia: comparison of the efficacy and pain associated with three digital nerve block techniques. J Hand Surg [Br] 2005;30(6):581–4.Google Scholar
  66. 11.
    Sarhadi NS, Shaw-Dunn J. Transthecal digital nerve block. An anatomical appraisal. J Hand Surg [Br] 1998;23(4):490–3.Google Scholar
  67. 12.
    Thomson CJ, Lalonde DH. Randomized double-blind comparison of duration of anesthesia among three commonly used agents in digital nerve block. Plast Reconstr Surg 2006;118(2):429–32.CrossRefPubMedGoogle Scholar
  68. 13.
    Waldbillig DK, Quinn JV, Stiell IG, Wells GA. Randomized double-blind controlled trial comparing room-temperature and heated lidocaine for digital nerve block. Ann Emerg Med 1995;26(6):677–81.CrossRefPubMedGoogle Scholar
  69. 14.
    Brutus JP, Baeten Y, Chahidi N, Kinnen L, Ledoux P, Moermans JP. Single injection digital block: comparison between three techniques. Chir Main 2002;21(3):182–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Patrick M. Foye
  • Debra S. Ibrahim
  • Michael J. Mehnert
  • Todd P. Stitik
    • 1
  • Jong H. Kim
  • Mohammad Hossein Dorri
  • David J. Van Why
  • Jose Ibarbia
  • Lisa Schoenherr
  • Naimish Baxi
  • Ladislav Habina
  • Jiaxin J. Tran
  1. 1.Department of Physical Medicine and RehabilitationNew Jersey Medical SchoolNewarkUSA

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