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Sports-Related Hand and Wrist Injuries and Recommended Treatments

Posted on: 11/30/1999
Different types of sports place different forces on the hand and can cause significant injury to an athlete. Ball sports, such as basketball or football, can result in a "jammed finger," which can range from damage to the ligament to a fracture. Contact sports can result in fractures from falls or the contact itself; gymnastics places a strong burden on the wrists; rock climbers exert unusual force on the flexor system of the hands; and combat sports often can result in fractures.

Treatment of these injuries vary and the right choice is vital not only for proper healing, but for the athlete to be able to return to his or her sport.In the case of "jammed fingers," treatment options range from surgery to plate implantation. The "mallet finger," a common baseball or basketball injury, has seen various techniques used for treatment, with none apparently being better than another. Although surgery may be an option, splinting the displaced fracture to the neighboring finger remains a common treatment.

In contact sports, the "jersey finger" usually requires surgery within seven to ten days of the injury, This time frame is vital to prevent tendon damage. The scaphoid fracture is usually treated with a long-arm cast, with good results. Traction may be used if needed. Another injury, the scapholunate ligament rupture is difficult to treat. The goal is to repair the ligament as much as is possible, but this doesn't have a high success rate. In one study, the findings showed that only one out of eight athletes who use their wrists extensively were able to return to their preinjury function. The issue becomes even more difficult to treat if the injury is a chronic one.

Gymnastics poses another problem for the hands and wrists because of the repetitive loads placed on the wrist. Diagnosis is also not easy as the gymnast may have complaints of vague wrist pain when tumbling or vaulting, but the x-rays may appear normal. This should be further investigated because non-treatment of this injury can result in a total physical shut down of the wrist, along with angular deformity and shortening of the wrist.

Rock climbers face a different type of hand injury because of the strain in their flexor system, due to the sustained and sudden pull force while climbing. Called a pulley disruption, this injury is associated with the "crimp-grip" hand position that the climber needs to use to grab on to small ledges.

In combat sports, the injuries can be more obvious. In boxing, for example, the "boxer's knuckle" is an injury in the third metacarpal head, sometimes from a single punch, but most often from repetitive punching.

The authors of this article conclude that if athletic injuries of the hand are not well assessed and treated, the function of the hand can compromise not only the patient's athletic career, but also the normal activities of daily living.

References:
Dan A. Zlotolow and Craig Bennett. Athletic injuries of the hand and wrist. In Current Orthopedic Practice. March/April 2008. vol. 19. No. 2. Pp. 206-210.

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