Athletes’ Hand Injuries
This is a review of the more frequent sports injuries I treat in athletes. Many others exist that are too numerous to place here.
Fractures of the Scaphoid bone of the wrist are the more frequent. They can result from falling down, contact with other players, the ball hitting the hand etc.
They can often be unrecognized. Treatment must be aggressive, as even after surgery scaphoid fractures may not heal well. (Scaphoid nonunion)
Avulsion of the profundus tendons. Our fingers receive two tendons that allow us to flex and hold things. One tendon is the profundus which means deep and the other tendon is the superficialis which means superficial. Avulsion of the profundus tendons is common in football players.
Fracture of the hook of the hamate bone is common injuries. The diagnosis can often be missed. Treatment is simple and entails surgical removal of the fractured piece. If left untreated the patient will experience continuous chronic pain at the base of the wrist.
Detachment of the lunar collateral ligament of metacarpal phalangeal joint of the thumb.
A classic injury in Skiers. Treatment may be by splinting if addressed very early or by surgery.
Fracture of the neck of the 5th metacarpal. Is often described as Boxers fracture. Treatment may be either splinting or surgery.
Damage to the flexor tendon sheaths and trigger finger. Treatment is either steroid injections or surgery.
Nerve injury and tendinitis of the ulnar aspect of the thumb. Treatment is by rest and splinting.
Racing cyclists distribute much of their total body weight on their handlebars. This places much pressure on the hypothenar muscles of the hand and the ulnar nerve that is underneath. This may cause nerve paresthesias and muscle weakness. Treatment is usually rest and splinting.
Intersection syndrome. In this condition the thumb extensor tendons rub over the wrist extensor tendons and inflammation is caused. Treatment is usually by rest. If it does not resolve simple surgical treatment can correct this condition.
The more common injury is a tear of a ligament between the triquentrum bone of the wrist and the end of the ulnar bone of the forearm. Treatment varies per individual patient. It may range from rest and splinting to endoscopy and fibrocartilage debridement or to ulnar shortening.
Fracture dislocation of the proximal interphalangeal joints. These injuries result from excessive hand/finger extension.
These are the more common injuries I see and their treatment varies by patient:
- Facial injuries
- Swimmer’s ear (otitis externa)
- Thrower’s elbow (elbow pain)
- De Quervain’s syndrome ( first dorsal compartment tendinitis)
- Groin pain-athletic pubalgia