A hand or forearm fracture occurs when one of the bones of the hand, wrist or forearm is broken or cracked. There are 29 bones that together make up the supporting framework of the hand and forearm.
Most hand and forearm fractures occur as a result of direct trauma. This commonly occurs after a fall on the hand or when the hand strikes an object. If a fracture is suspected, an X-Ray will be taken to determine if any of the bones are broken. If a fracture is seen a decision will be made to determine the appropriate treatment for the injury. This usually requires the broken bone to be immobilised for a period of time e.g. using a plaster or strapping to allow it to heal.
Hand and forearm fractures are one of the most commonly treated conditions at the Merivale Hand Clinic.

There are nearly 50 muscles that control the hand and forearm, half of which are situated in the hand (called the intrinsic muscles) and half which sit in the forearm (called the extrinsic muscles). They are responsible for controlling the finest and most intricate movements of the hand and the strongest of grips with heavy activity.
Injury to a muscle in the hand or forearm can result in inflammation, pain and reduced ability to use the hand. The hand therapists at the Merivale Hand Clinic can help assess the extent of the injury and develop a plan to help return you to your normal level of activity. This may involve the use of a soft support to rest the muscle for a short period of time while you continue with normal daily activities. A specific reconditioning program to regain strength and flexibility may also be included in the rehabilitation program.

The joints of the hand and wrist are highly susceptible to injury and are the most commonly treated condition at the Merivale Hand Clinic.
The bones of the hand are supported by ligaments that allow movement of the joints in specific directions. Injury to the ligaments can result in varying degrees of instability at the joint. This can make the joint painful and the hand difficult to use.
It is important to support an injured ligament to allow it to heal. There are various ways of doing this, ranging from simple strapping to custom made splints. Some ligament injuries need specific imaging or surgical opinions to determine the best approach to management due to possible complications. Your hand therapist can discuss management options for your particular injury to ensure the best possible outcome.

Muscles transmit force through tendons to produce movement at joints. The tendons of the hand can become painful from direct trauma or as a result of use over time. Anatomical tunnels in the wrist and hand are common sites where problems are experienced. Localised pain and swelling, clicking, triggering or graunching are symptoms experienced when tendons are irritated.
Treatment varies widely according to the tendon involved. Activity modification, supports and a graduated reconditioning program are important in the rehabilitation process.
If a tendon is cut, it will no longer be able to produce movement at a joint. Treatment of these injuries requires specialised input and an early review is essential. Surgery is often but not always required depending on the tendon involved. Splinting to protect the tendon as it heals is vital and a specific exercise program is required. A hand therapist is trained to manage these injuries and therapists work in close liasion with the surgeons involved.

There are many different types of arthritis. Osteoarthritis and rheumatoid arthritis are common types of arthritis seen in the community. Arthritis can affect the hand's natural curves formed by the joints and soft tissues with resultant deformities presenting in a number of ways. The degree of deformity or arthritic change and its effect on a person's symptoms and function can vary greatly. Joint protection principles, specific exercise and supports can all help make activity more achievable and sleep more comfortable. Your doctor can ensure optimal medical management and referral to a specialist can be made if appropriate. Support groups, such as Arthritis New Zealand have a wealth of information and are worthwhile contacting. Surgery for arthritis in the hand can be very effective and hand therapists work closely with the surgeons to ensure optimal recovery.

Injury to the nerves of the hand and forearm can have a significant impact on the ability to activate muscles, coordinate movements and to feel the environment we are in. The three main nerves in the hand (Radial, Median and Ulnar) all supply different muscles and different areas of the skin for sensation. A condition known as Carpal Tunnel Syndrome affects the median nerve and is the most common nerve compression condition in the hand. Tennis Elbow and De Quervains Tenosynovitis can be associated with radial nerve symptoms. The Ulnar nerve is commonly affected when people strike the inner side of their elbow resulting in a tingle in the little finger. People often describe this as pain from knocking their 'funny bone'.
Nerves can be injured by direct blow, postural strain or complete laceration and symptoms present in many different ways. Each problem requires a specific treatment approach. Your hand therapist will assess your injury and implement a specific program depending on your needs.

Hand surgery and the implementation of a post operative rehabilitation program is a very specialised field of therapy. Hand therapists are extensively trained to manage this care and have close contact with the surgeon involved to ensure optimal results. Merivale Hand Clinic therapists manage many post operative rehabilitation programs including joint replacements, releases, fusions, Dupytrens release, nerve and tendon releases and repairs, fracture stabilisations and ligament repairs to name a few.
Specific splinting, progressive exercises, scar management and swelling control are the basic components of post operative management in conjunction with patient education and advice. The combination of these specialised therapy skills contribute towards optimising a successful outcome for the patient.

The thumb and each finger have specific roles in activity. Amputation of a thumb and/or fingers impacts on the ability of the hand to perform normal hand activities, but with training and adaptation much of the functional loss can be overcome. Your hand therapist will help you with stump and scar management, pain issues (such as phantom pain) and provide you with an exercise program to help regain strength and movement. Protective gloves and supports can also be useful in helping people make a return to work, sport and other leisure pursuits.

The brain evaluates and interprets a variety of information both past and present with pain being one response to help protect us from a perceived threat to our body.
Managing acute and more persistent pain after injury or disease in the hand or forearm can involve many different strategies. Seeking treatment early is important. An individualised approach to the management of painful conditions to suit each person's lifestyle and particular goals can then be initiated and monitored. Your General Practitioner should be involved and referral to a specialist Pain Management Team may be appropriate.