The management of hand problems

Abstract

Almost 12 years ago, I started the HAND CLINIC. Since then, thousands (literally) of hand problems have been managed. I sincerely hope that, because of this clinic, the management of these problems has improved though I acknowledge that it could be even better. In this short presentation, I shall try to outline my philosophy when dealing with a hand problem. Obviously, like most philosophies, mine is not perfect and I should be most grateful if any of you in the audience could point out any flaws and help me to correct them. To start with, the hand problem may be a reflection of what is happening elsewhere in the body e.g . nail pitting because of psorasis, discoloured fingertips due to Raynaud's phenomenon, red palms due to liver disease. The hand may also be the site of Referred pain e.g. paraesthesiae on the ulnar border of the hand due to a compression neuropathy of the ulnar nerve behind the medial epicondyle of the humerus, or from nerve compression in the neck.