Hand Therapist Nigel Chua A fracture at the very base of the thumb runs into the joint and has a muscle pulling it out of place, which is why it usually needs fixing rather than casting. The goal is a smooth joint surface, not just a healed bone.
A fingertip crushed in a door or under a hammer. The tuft fracture heals on its own; the nail bed underneath is the part with a deadline, and whether the nail is split or lifted is what decides it.
The check that matters after a broken finger isn’t on the X-ray. Make a loose fist: if a finger crosses over its neighbor, the bone is rotated, and rotation is the one deformity a finger can’t work around.
Sore and swollen four to eight centimeters above the wrist on the back of the forearm, sometimes with a squeak you can feel. Routinely mistaken for De Quervain’s, and separated from it by location alone.
Little-finger side wrist pain that sits on the surface rather than deep in the joint, and sometimes snaps when you turn your palm up. Caught fresh, the snapping version is treated in a cast. Left late, it needs surgery.
A small wrist bone losing its blood supply and collapsing, usually in a younger manual worker with no injury to explain it. Early X-rays are normal, which is exactly the problem.
Most wrist arthritis under 60 is the ending of an old injury: a missed scapholunate tear or a scaphoid that never healed. The wear follows a predictable route, and every surgical option trades movement for pain relief.
Back-of-wrist pain in a young gymnast is a growth plate injury from weight-bearing on the hands. Ridden out, the radius can stop growing while the ulna keeps going, and that mismatch causes wrist pain for decades.
In a child’s arm the growth plate is weaker than the ligament, so throwing damages it first. Inner elbow pain usually means rest. Outer elbow pain, catching or lost straightening means imaging, and it’s the one that causes permanent damage.
Inner elbow pain in a thrower is a ligament problem, not a tendon one. The first sign is usually lost velocity rather than pain, and Tommy John surgery does not make anyone throw harder.