Management of Pregnancy-related Hand and Upper-extremity Conditions and Trauma: Pain Control, Anesthesia, and Other Perioperative Considerations.

Abstract

Upper-extremity conditions, including carpal tunnel syndrome, de Quarvians disease, trigger finger, and joint laxity, are common during pregnancy and are related to hormonal fluctuations and fluid shifts. These conditions generally respond well to conservative management with medications, bracing, and corticosteroid injection. However, surgery should be offered during pregnancy if nonoperative treatment fails. Regional and local anesthesia decreases fetal anesthetic exposure, minimizes airway issues, and assists postoperative pain control. Pregnant patients with trauma should be evaluated for extremity injury, and appropriate imaging should be obtained while minimizing pelvic radiation exposure. Surgical management should include fixation techniques with minimal radiation exposure.