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YOUR BODY / KATHLEEN DOHENY

Give Your Hands a Hand--and Some TLC

September 21, 1993|KATHLEEN DOHENY

They are the body's workhorses, unappreciated parts that are crushed, jammed, overused and neglected.

When you consider the complexity of their anatomy, it's easy to understand why hands are potential minefields of disaster, says Dr. Charles T. Resnick, a hand surgeon at Orthopaedic Hospital and a USC assistant clinical professor of orthopedics.

Together, the hands and wrists include 10 digits and 54 bones plus tendons, nails, cuticles, nerves and blood vessels covered with sometimes sensitive skin.

Over the years, Resnick has seen a laundry list of hand problems and lots of patient denial, even when a finger hangs by a thread or a hand swells to twice its normal size.

Knowing when to rely on Mother Nature and when to see a doctor is often a tricky but vital judgment call. And as those who make a living with their hands already know, preventive measures--hand creams and exercises, for instance--are worth the time.

In a Jam?

During a lively game of football, basketball or baseball, a finger suddenly "jams," an entirely unscientific term to describe everything from a dislocation to a fracture.

Look first to see if there is a deformity, Resnick advises. "If the finger is going off into a direction it doesn't normally go, I would assume there is a major problem. If the finger does not go off into the wrong direction and you can still feel everything and move it in the right direction, probably things are going to be OK." But it's often a tough call.

It's best to leave a jammed finger alone and seek medical help, he says. "But it is hard to resist (unjamming) because the finger hurts so bad."

There's an old saying about a mangled finger: "If you can move it, it's not broken." Not true, says Resnick. Even if you can move it, it might still be fractured.

If fingers or other parts of the hand are swollen, painful, black and blue--or all of the above--apply ice to relieve the pain, Resnick says. If a finger looks awry, consider using a drugstore splint to immobilize it until you can get to a doctor.

Carpal Tunnel Syndrome

Typists, checkout people and others who use their hands in repetitive motions on the job risk getting carpal tunnel syndrome, in which pressure increases on the median nerve where it passes into the hand via a space called the carpal tunnel.

"Falling-asleep of the fingers and/or the hand is often the first symptom," Resnick says. "Then all of a sudden you get the numbness during more activities. It becomes more noticeable."

If the symptoms don't go away within a reasonable period--four to 12 weeks--seek medical help, Resnick says.

Nails Aren't So Tough

False-fingernail fans should be especially alert to symptoms of infection.

"Your own fingernail can become soft, thin and flimsy," Resnick says. "You can develop infections beneath them."

Whether nails are fake or home grown, fungal infections beneath them can be difficult to shake, sometimes requiring months of anti-fungal drugs. Often people treating their athlete's foot contract the same fungus on their fingernails.

After soaking cuticles, push them back gently but never clip them, advises Dr. Carl Korn, a Sherman Oaks dermatologist and USC assistant clinical professor of medicine. After hand-washing, lubricate with petroleum jelly or shortening, he says.

Beware of Eczema

Then there are dermatologic problems. One of the most common is eczema, Korn says. Symptoms include tiny blisters and redness. Often eczema results from irritation by household cleaners or other substances but can appear with no apparent trigger.

Ice-water soaks can relieve the itching, Korn says, and should be followed by the use of skin lubricants or a hydrocortisone cream.

"If that doesn't work, see a dermatologist," Korn advises. Stress reduction can't hurt, either, he says.

Skeletal Structure of the Hand and Wrist

Four of the eight wrist bones, or carpals, are joined to the radius and ulna. The rest are connected to the five bones of the palm, or metacarpals, each of which is joined to a phalanx. * Phalanges Metacarpals Ulna Radius Carpals: Trapezium bone, Trapezoid bone, Capitate bone, Hamate bone, Scaphoid bone, Pisiform bone, Lunate bone, Triquetral bone.

Source: American Medical Association Encyclopedia of Medicine.

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