Surgery of Louisville
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Conditions we treat

Wrist and Forearm

Patients with de Quervain's Tenosynovitis have painful tendons on the thumb side of the wrist.  Tendons are the ropes that the muscle uses to pull the bone.  You can see them on the back of your hand when you straighten your fingers.  In de Quervain's Tenosynovitis, the tunnel (the first extensor compartment; see Figure 1A-B) where the tendons run narrows due to the thickening of the soft tissues that make up the tunnel. Hand and thumb motion cause pain, especially with forceful grasping or twisting.

Treatments that can relieve symptoms include a splint that stops you from moving your thumb and wrist and Tylenol or aspirin type medications (e.g., ibuprofen).  Treatments that attempt to change the course of the disease include a cortisone-type of steroid injection into the tendon compartment. Surgical intervention is also an option to open the tunnel and make more room for the tendons.


A common fracture that involves the radius. Treatment of these fractures is crucial to protect range of motion and promote proper healing. Symptoms include pain, swelling and decreased motion.  A wrist fracture is a medical term for a broken wrist. The wrist is made up of eight small bones which connect with the two long forearm bones called the radius and ulna. Although a broken wrist can happen in any of these 10 bones, by far the most common bone to break is the radius. This is called a distal radius fracture. 

A padded splint might be worn at first in order to align the bones and support the wrist to provide some relief from the initial pain. If the fracture is not too unstable, a cast may be used to hold a fracture that has been set. Other fractures may benefit from surgery to put the broken bones back together and hold them in correct place. 


Lateral epicondylitis, commonly known as tennis elbow, is a painful condition involving the tendons that attach to the bone on the outside (lateral) part of the elbow.  Tendons anchor the muscle to bone. The muscle involved in this condition, the extensor carpi radialis brevis, helps to extend and stabilize the wrist. With lateral epicondylitis, there is degeneration of the tendon’s attachment, weakening the anchor site and placing greater stress on the area. This can then lead to pain associated with activities in which this muscle is active, such as lifting, gripping, and/or grasping. Sports such as tennis are commonly associated with this, but the problem can occur with many different types of activities, athletic and otherwise.

Treatments include a variety of conservative options including;  Activity modification, medication, bracing, physical therapy and steroid injections.  Surgery is considered when the pain is incapacitating and the patient has not responded to conservative care. Surgery involves removing the diseased, degenerated tendon tissue. 


A wrist fracture is a medical term for a broken wrist. The wrist is made up of eight small bones which connect with the two long forearm bones called the radius and ulna. A broken wrist can happen in any of these 10 bones. 

Some fractures are more severe than others. Fractures that break apart the smooth joint surface or fractures that shatter into many pieces (comminuted fractures) may make the bone unstable. These severe types of fractures often require surgery to restore and hold their alignment. An open fracture occurs when a fragment of bone breaks and is forced out through the skin. This can cause an increased risk of infection in the bone.


The scaphoid is one of eight small bones that make up the “carpal bones” of the wrist.  It connects two rows of these bones - the proximal row (closer to the forearm) and the distal row (closer to the hand). This connection puts it at extra risk for injury. 

If the fracture is non-displaced (bone has not moved out of place at the fracture), it usually can be successfully treated with a cast. Although the fracture may heal in as little as six weeks, it may take longer for some patients.  If the fracture is in a certain part of the bone or if the fracture is at all displaced (bone ends have shifted), surgery might be the best option. This might include the insertion of a screw or pins.