The hand can become structurally deformed for several reasons. This deformity could originate from bone or joint injury, nerve damage or it could be present at birth (congenital deformities). The severity of each type of deformity varies as does the treatment option.
Congenital Deformities of the Hand
Although rare, congenital deformities such as fused fingers or duplication of the finger can occur. These deformities can sometimes limit the movement of the hands. Surgical reconstruction can improve the function and appearance of the deformity.
Deformities of the Bones of the Hand
Fractures of the hand and fingers can result in a displacement of the bone, causing the bone to become deformed. The radial part of the wrist is frequently affected; a fall on an outstretched hand will usually cause an injury. The deformity, in this case, is called a ‘dinner fork’ deformity because of its appearance. Surgical repair of the fractured bone along with bone grafting is usually the treatment of choice.
When the fingers are fractured, they can cause a similar kind of deformity as well. Deformed fingers make it difficult to perform certain actions such as making a fist. The best treatment option in this case is a surgical correction as well.
Sometimes a forward compression injury to the finger can cause it to bend inwardly, so-called the ‘mallet finger’. In this type of deformity, splinting usually helps but surgery is preferred in severe cases for a speedier recovery.
Deformities of the Joints of the Hand
The joints can be affected in a number of conditions such as rheumatoid arthritis and degenerative joint disease. In advanced stages, these joint problems can cause them to become permanently deformed.
In inflammatory arthritis such as RA, a typical ‘swan-neck’ deformity develops. In this condition, the fingers become crooked, stiff and painful. Rheumatoid arthritis can also cause the ulnar side of the wrist to protrude and become painful. This can sometimes be associated with a finger drop.
Although the deformities in RA can be severe the good news is that they can be managed if medications are given at an early stage. Surgical reconstruction and repair of the damaged tendons will help correct the deformity.
Degenerative joint disease or osteoarthritis can also cause permanent deformities of the hand if left untreated. Typically the distal joints are affected.
Deformities Caused By Nerve Damage
When a nerve or group of nerves of the hand is damaged, the muscle it supplies lose their functioning. This can cause a range of various deformities. Once the underlying pathology is identified, a surgical repair or decompression of the nerve can be the treatment of choice.