The hand is the tool of tools ~Aristotle

As Aristotle so aptly puts it, the hand is the tool of tools. Try living your life without the use of your hands and you will find that you not only lose the ability to perform simple self-care tasks such as eating, wearing your clothes, showering and brushing your teeth. Work activities are largely done by our hands as well, be it the mechanic who uses hand tools to repair machinery, or the office worker who has to write and operate the computer. Even leisure activities (such as playing racquet sports, baking, craftwork) and housework are often unachievable without the use of your hands. With such extensive use of the upper limbs, it is not surprising that they are also subject to frequent injury.

Injury can occur to different anatomical structures present in the upper limbs, and can be either traumatic or cumulative in nature. Wrist fractures are one of the most common upper limb fractures, accounting for approximately 25% of these fractures, and often occur as a result of trauma, such as falling onto an outstretched hand. Upper limb function is usually affected after a fracture, with reduced range of movements and decreased strength being some of its potential long-term effects. Cumulative injuries to the upper limb on the other hand, tend to take the form of repetitive strain injuries and often affect soft tissues such as tendons, muscles and ligaments. Examples of repetitive strain injuries include carpal tunnel syndrome, trigger finger, tennis elbow and De Quervain’s tenosynovitis. Pain, inflammation and loss of strength are the main symptoms of these injuries, and individuals often experience difficulty in performing their daily activities as a result (e.g. a cook/chef finding it hard to grip and carry a frying pan while cooking due to pain arising from a trigger finger, a laboratory worker finding it hard to do pipetting work due to pain over the wrist/thumb arising from De Quervain’s tenosynovitis).

The debilitating nature of upper limb injuries and its huge impact on an individual’s productivity and finances means that early diagnosis and treatment are of the utmost priority so that the recovery process can be as fast as possible. Medical and surgical treatment approaches aside, therapeutic and rehabilitative interventions, such as exercises, splinting, therapeutic modalities and appropriate patient education, are important contributors to a timely recovery following any upper limb injury. In the upcoming posts, we will discuss in more detail the common injuries that tend to afflict the upper limb.


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