Hand Therapist Nigel Chua

Cold, discoloured ring and little fingers in one hand — with a normal thumb — in someone who uses their palm as a hammer. Why it is arterial, and what it is mistaken for.

Years of vibrating tools damage the nerves and vessels of the hand permanently. The two strands, how it is staged, and why stopping exposure is the only treatment that works.

Escalating pain far worse than the injury, with a tense forearm and agony on straightening the fingers, is compartment syndrome until proven otherwise. The signs, and the six-hour window.

Numbness over the back of the thumb with completely normal strength points at Wartenberg’s syndrome. Where the nerve gets pinched, what it is mistaken for, and why the fix is often a watch strap.

A quarter of perilunate dislocations are missed at the first visit because the front-on X-ray looks normal. What the lateral view shows, and why the first week decides the wrist.

A small firm bump near the fingernail with a groove down the nail is a mucous cyst — a ganglion driven by arthritis in the joint beneath. Why draining it fails, and when to act.

A finger forced sideways tears a collateral ligament. How it is graded, why moving it early matters more than splinting it, and why the swelling lasts a year.

A small cut on the hand can divide a tendon, a nerve and an artery. The four-question check to run before anyone closes it, and the wounds that are emergencies.

Elbow arthritis hurts at the ends of the range, not the middle, and takes your straightening first. Why bone blocks it before cartilage does, and what debridement actually gives back.

A hard, fixed lump on the back of the hand that never changes size is usually a carpal boss, not a ganglion. How to tell them apart, and why most need nothing done.