A hand injury or finger injury can be very debilitating for an athlete or active person. Overhead sports like baseball or tennis are almost impossible to play until the injury heals. Some types of exercise, like lifting weights, can be very difficult without use of the hand. In this article, I discuss some of the common hand injuries that athletes and active people can suffer.
Hand injury #1: Ulnar collateral ligament injury of the thumb
This injury is often nicknamed “skier’s thumb” due to the frequency it occurs in skiers. In the past, it was often called “gamekeeper’s thumb.” Essentially, this is an injury to the ulnar collateral ligament (UCL) of the thumb. This ligament is located at the MCP joint at the base of the thumb. It stabilizes the MCP joint against valgus stress.
An athlete can injure this ligament with a sudden force that pulls the thumb away from the other four fingers. A skier might fall, and her thumb gets pulled away from the other four fingers by the ski pole.
For many UCL thumb injuries, treatment consists of the patient wearing a thumb spica cast or splint. Often the ligament displaces outside of one of the thumb tendons, a finding called a Stener lesion. This type of UCL injury requires surgery to repair or reattach the UCL.
Hand injury #2: Jersey finger
This is an injury to the flexor tendon that bends the finger. Orthopaedic surgeons often call it a “jersey finger” due to a consistent mechanism of injury. A football player can pull the tendon off of the bone at the tip of the finger when he grabs the uniform of an opponent. The finger forcefully extended when the player tries to get away, rupturing the tendon. Treatment options depend on the location of the avulsed tendon. The tendon often retracts down into the base of the finger or palm. A hand surgeon often reattaches the tendon during a short outpatient surgery.
Also read: Jersey finger
Hand injury #3: Boxer’s fracture
A person might punch a wall, another hard object, or another person and break this bone. A boxer might punch an opponent and suffer the injury as well. The bone breaks just proximal to the metacarpophalangeal (MCP) joint at the base of the finger. X-rays show the fracture and how well the bone lines up. If the fracture is minimally angulated, a splint or cast might be sufficient. If the fracture is significantly angulated, then surgery to reduce the fracture and hold it in place is recommended.
Hand injury #4: Mallet finger
This is an injury to the extensor tendon of the finger. An athlete can suffer this injury when a hard object hits his or her fingertip. For example, a basketball might hit the player on the tip of his finger. The extensor tendon that normally straightens the joint at the tip of that finger pulls off the bone or take a small portion off with it. If it is a simple tendon avulsion or only a small bony avulsion, nonsurgical treatment is usually effective. Keeping the distal interphalangeal (DIP) joint of the finger splinted in full extension or even slight hyperextension for 6-8 weeks often successfully fixes the injury.
Hand injury #5: PIP or DIP dislocation of the finger
This is a dislocation of the joint at the tip of the finger (distal interphalangeal joint – DIP) or closer to the base of the finger (proximal interphalangeal joint – PIP). In sports, these dislocations can often be reduced on the sidelines or in the training room by the athletic trainer or team doctor. X-rays can be helpful to determine if a fracture occurred at the joint.
Many of the hand injuries in sports and exercise can be treated without surgery. Still, proper evaluation by an orthopaedic surgeon or hand surgeon can help athletes start proper treatment quickly and minimize the risk of long-term problems.
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