Interactive anatomy
Explore the hand.
Where is the problem?
Select where you’re experiencing a problem. We’ll show conditions that can affect that area - with plain-English explanations of each.
Wrist
Eight small bones, nine tendons and the median nerve pass through a small space at the wrist.
Conditions that may affect this area include
- Carpal Tunnel SyndromePressure on the median nerve where it passes through a narrow tunnel at the wrist, which can cause numbness, tingling and weakness in the hand.
- De Quervain’s TenosynovitisIrritation and narrowing around two tendons on the thumb side of the wrist, causing pain with gripping, lifting or moving the thumb.
- Ganglion CystsA fluid-filled lump around a wrist or hand joint or tendon that may cause pain, tenderness or discomfort with movement.
- Wrist FracturesBreaks involving the end of the forearm bones or the small bones of the wrist, most often after a fall onto an outstretched hand.
- Wrist ArthritisWear or inflammation in the joints of the wrist that can cause pain, stiffness, swelling, weakness and reduced motion.
- Tendon InjuriesCuts, ruptures or damage to the cords that connect muscle to bone and make the fingers and thumb move.
- Peripheral Nerve InjuriesDamage to the nerves that carry signals between the brain and the hand, causing numbness, weakness or pain in the territory that nerve supplies.
- Thumb-Base ArthritisWear of the joint at the base of the thumb, where the thumb meets the wrist, causing pain with pinching, gripping and twisting.
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Advanced anatomy
What structure is affected?
What it does
Carries sensation from the thumb, index, middle and half of the ring finger, and controls several of the muscles that move the thumb.
General symptoms when it is affected
- Numbness or tingling in the thumb, index and middle fingers
- Symptoms that are worse at night
- Weakness of the thumb, particularly moving it away from the palm
- In long-standing cases, thinning of the muscle at the base of the thumb
How a hand surgeon evaluates it
A hand surgeon maps sensation in the median territory, tests the specific thumb muscles the nerve supplies, and examines the whole course of the nerve from the neck to the hand - because compression can occur at more than one level. Nerve conduction studies are used where they will change the plan.
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A different approach to reconstruction
The hand is more than bone.
Complex upper-extremity problems can involve skin, soft tissue, tendon, nerve, blood vessels and bone - often all at once. Treating one layer well is not the same as restoring a working hand.
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01
Surface
What you can see is the outer covering. Palm skin is thick and anchored for grip; the skin on the back of the hand is thin and mobile so a fist can close. Both matter to how a hand works.
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Structure
Twenty-seven bones give the hand its frame - eight in the wrist, five in the palm, and fourteen in the fingers and thumb. Their alignment matters more here than almost anywhere else in the body.
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Movement
The muscles that move the fingers largely sit in the forearm. Tendons transmit their power across the wrist and into each digit - and they have to glide freely to do it.
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Sensation & control
Three nerves serve the hand. They carry sensation back to the brain and instructions out to the muscles. Each supplies a distinct territory, which is why the pattern of numbness tells a surgeon a great deal.
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Reconstruction
A serious injury rarely respects these boundaries. It damages several systems along the same line - and putting a hand back together means addressing all of them, in the right order.
Complex problems can involve skin, soft tissue, tendon, nerve, blood vessels and bone.
Dr. Champagne’s background spans plastic surgery, hand surgery and microsurgical reconstruction. That combination shapes how a problem is assessed: not as one damaged structure, but as a system that has to work together again.
Hand surgery is practised by surgeons from several backgrounds, each bringing a different emphasis. This describes Dr. Champagne’s, not a comparison with anyone else’s.
Discuss your symptoms and options
Consultations begin with understanding your symptoms, what you can no longer do comfortably, and what has already been tried.