Finger

Trauma to fingers: Broken Finger and Hand Injuries: Symptoms and Care

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Acute Finger Injuries: Part I. Tendons and Ligaments

The severity of acute finger injuries is often underestimated, which can lead to improper treatment. Basic knowledge of the anatomy of the finger and a thorough evaluation of the patient can ensure proper diagnosis and treatment. Part I of this two-part article focuses on common tendon and ligament injuries of the finger. Part II1 discusses common finger fractures, dislocations, and thumb injuries.

Family physicians can manage most finger injuries; however, knowledge of referral criteria is important to ensure optimal outcomes. Treatment should restrict the motion of injured structures while allowing uninjured joints to remain mobile. Patients should be counseled that it is not unusual for an injured digit to remain swollen for some time and that permanent deformity is possible, even after treatment. Table 1 summarizes the evaluation and treatment of common ligament and tendon injuries.

Basic Anatomy of the Finger

The anatomy of the finger is complex, but a basic knowledge is necessary to properly treat acute injuries. The index, middle, ring, and fifth digits have proximal, middle, and distal phalanges and three hinged joints: distal interphalangeal (DIP), proximal interphalangeal (PIP), and metacarpophalangeal (MCP). The thumb has a distal and proximal phalanx as well as an interphalangeal and MCP joint. The joints sit in volar plates (collateral ligaments attached to dense fibrous connective tissue), which provide joint stability.2,3

The dorsal extensor tendon divides into a central slip that extends the PIP joint and then into two lateral bands that extend the DIP joint. The volar tendons include the flexor digitorum superficialis and the flexor digitorum profundus. The flexor digitorum superficialis tendon attaches to the base of the middle phalanx and flexes the PIP joint. The flexor digitorum profundus tendon is located under and splits the flexor digitorum superficialis tendon. It attaches to the base of the distal phalanx and flexes the DIP.4 Figure 1 illustrates the basic anatomy of the finger, including joints, ligaments, and tendons.

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Figure 1.

Anatomy of the finger. (A) Joints and ligaments. (B) Tendons.


Figure 1.

Anatomy of the finger. (A) Joints and ligaments. (B) Tendons.

Evaluation

Neurovascular and active flexion/extension testing will reveal clues to tendon and ligament injuries as well as subtle rotational abnormalities. The neurovascular evaluation should include two-point discrimination and capillary refill assessments. The physician should evaluate active flexion and extension by asking the patient to open and close his or her fist.

Clinical examination alone cannot diagnose fractures, and treatment protocols depend on radiography results. Patients with finger injuries should receive oblique, anteroposterior, and true lateral radiographic views.5 True lateral radiography is the most effective way to examine anatomic joint congruity.6,7 Ultrasonography is emerging as an effective tool to evaluate soft tissue structures. 8

The evaluation of finger injuries during an athletic event differs from an evaluation in the office. The primary goal on the field is to detect neurovascular compromise and determine if the athlete can safely continue participation. All on-field evaluations must be readdressed in the office for a more thorough examination including radiography. Failure to do so increases the risk of future dysfunction.

Common Injuries

Several techniques may be used to diagnose common ligament and tendon injuries. Most injuries require splinting and follow-up to evaluate the healing process.

EXTENSOR TENDON INJURY AT THE DIP JOINT

Injury to the extensor tendon at the DIP joint, also known as mallet finger (Figure 2), is the most common closed tendon injury of the finger. Mallet finger usually is caused by an object (e.g., a ball) striking the finger, creating a forceful flexion of an extended DIP. The extensor tendon may be stretched, partially torn, or completely ruptured or separated by a distal phalanx avulsion fracture. 9

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Figure 2.

Injury to the joint extensor tendon at the distal interphalangeal joint (mallet finger).


Figure 2.

Injury to the joint extensor tendon at the distal interphalangeal joint (mallet finger).

Patients with mallet finger present with pain at the dorsal DIP joint; inability to actively extend the joint; and, often, with a characteristic flexion deformity. It is important to isolate the DIP joint during the evaluation to ensure extension is from the extensor tendon and not the central slip. The absence of full passive extension may indicate bony or soft tissue entrapment requiring surgical intervention.4,7,10 Bony avulsion fractures are present in one third of patients with mallet finger.11,12

If no avulsion fracture is present on radiographs, the DIP joint should be splinted in a neutral or slight hyper-extension position for six weeks13; the PIP joint should remain mobile. A Cochrane review14,15 confirmed that all available splints achieve similar results. Furthermore, the use of surgical wires (i.e., fixing the affected joint in a neutral position by drilling a wire through the DIP joint to the PIP joint) did not improve clinical outcomes.14,15 Figure 3 describes different types of splints.

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Figure 3.

Physicians should advise patients with mallet finger not to flex the DIP joint during treatment; the splinting period must restart every time flexion occurs. A Cochrane review15 showed that patient compliance is the most important factor in the success of splint treatments. The distal phalanx should be supported during splint changes.16 This is difficult to achieve alone, and the patient may need to return to the physician’s office for splint changes. Necrosis of the skin can occur if the DIP joint is overextended during splinting. If the skin blanches, the DIP joint is overextended. Allowing the skin to “breathe” for 10 to 20 minutes between splint changes minimizes the risk of maceration.

Patients may continue to participate in athletic events during the splinting period, and physicians should follow up with patients every two weeks to ensure compliance. After six weeks of splinting, the joint should be reexamined. If active extension is present, splinting can be limited to when the patient is sleeping and during athletic events for another six weeks.

Conservative treatment is successful for up to three months, even with delayed presentation.11 Referral criteria include bony avulsions involving over 30 percent of the joint space or the inability to achieve full passive extension. Despite proper treatment of mallet finger, permanent flexion of the fingertip is possible. The finger can become deformed if the injury is left untreated.17

FLEXOR DIGITORUM PROFUNDUS TENDON INJURY

Disruption of the flexor digitorum profundus tendon, also known as jersey finger (Figure 4), commonly occurs when an athlete’s finger catches on another player’s clothing, usually while playing a tackling sport such as football or rugby. The injury causes forced extension of the DIP joint during active flexion. The ring finger is the weakest finger and accounts for 75 percent of jersey finger cases.18 The injury can occur if the force is concentrated at the middle phalanx or at the distal phalanx.

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Figure 4.

Flexor digitorum profundus tendon injury (jersey finger). Note that the injured finger is held in forced extension.


Figure 4.

Flexor digitorum profundus tendon injury (jersey finger). Note that the injured finger is held in forced extension.

A patient with jersey finger may present with pain and swelling at the volar aspect of the DIP joint and the finger may be extended with the hand at rest. There may be a tender fullness if the tendon has been retracted. The digitorum profundus tendon should be evaluated by isolating the affected DIP joint (i.e., holding the affected finger’s MCP and PIP joints in extension while the other fingers are in flexion) and asking the patient to flex the DIP joint. 18,19 If the digitorum profundus tendon is damaged, the joint will not move. The flexor digitorum superficialis tendon should be evaluated by holding the unaffected fingers in extension and asking the patient to flex the injured finger.19 An injured flexor digitorum superficialis tendon will produce no movement. Figure 5 illustrates these techniques.

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Figure 5.

Evaluating flexor digitorum tendon injury. (A) The profundus test is performed by holding the affected finger’s MCP and PIP joints in extension and asking the patient to flex the DIP joint. The other fingers should be flexed at the MCP and PIP joints. (B) The superficialis test is performed by holding the unaffected fingers in extension and asking the patient to flex the injured finger. (MCP = metacarpophalangeal; PIP = proximal interphalangeal; DIP = distal interphalangeal.)


Figure 5.

Evaluating flexor digitorum tendon injury. (A) The profundus test is performed by holding the affected finger’s MCP and PIP joints in extension and asking the patient to flex the DIP joint. The other fingers should be flexed at the MCP and PIP joints. (B) The superficialis test is performed by holding the unaffected fingers in extension and asking the patient to flex the injured finger. (MCP = metacarpophalangeal; PIP = proximal interphalangeal; DIP = distal interphalangeal.)

The prognosis for patients with jersey finger worsens if treatment is delayed and if severe tendon retraction is present.20 Patients with confirmed or suspected jersey finger should be referred to an orthopedic or hand surgeon for treatment.18

CENTRAL SLIP EXTENSOR TENDON INJURY

Central slip extensor tendon injury occurs when the PIP joint is forcibly flexed while actively extended; it is a common injury in basketball players. Volar dislocation of the PIP joint also can cause central slip ruptures.21

The PIP joint should be evaluated by holding the joint in a position of 15 to 30 degrees of flexion. If the PIP joint is injured, the patient will be unable to actively extend the joint; however, passive extension should be possible. Tenderness over the dorsal aspect of the middle phalanx will be present. A delay in proper treatment may cause a boutonnière deformity (flexion of the PIP joint coupled with hyperextension of the DIP and MCP joints) (Figure 6). A boutonnière deformity usually develops over several weeks as the intact lateral bands of the extensor tendon slip inferiorly. Occasionally, boutonnière deformities occur acutely.

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Figure 6.

Boutonniére deformity caused by a central slip extensor tendon injury. (A) Normal alignment. (B) Boutonniére deformity.


Figure 6.

Boutonniére deformity caused by a central slip extensor tendon injury. (A) Normal alignment. (B) Boutonniére deformity.

The PIP joint should be splinted in full extension for six weeks if there is no avulsion or if the avulsion involves less than one third of the joint. All available splints (Figure 3) can be used to treat PIP injuries, except for the stack splint, which is used only for DIP injuries. As with mallet finger, extension of the PIP joint must be maintained continuously. If full passive extension is not possible, the physician should refer the patient to an orthopedic or hand surgeon.

Patients with PIP joint injuries may continue to participate in athletic events during the splinting period, although some sports are difficult to play with a fully-extended PIP joint. Splinting duration is the same as with mallet finger.

COLLATERAL LIGAMENT INJURIES

Forced ulnar or radial deviation at any of the interphalangeal joints can cause partial or complete collateral ligament tears. The PIP joint usually is involved in collateral ligament injuries, which are commonly classified as “jammed fingers.”

Collateral ligament injuries present as pain located only at the affected ligament. The injury should be evaluated by applying valgus or varus stress to the involved joint in 30 degrees of flexion while the MCP joint is flexed at 90 degrees; an extended MCP joint will tighten the collateral ligaments, inhibiting the evaluation. The physician should compare the laxity of the injured finger with an unaffected finger. Radiography may demonstrate an avulsion fracture at the ligamentous insertion point.

If the joints are stable and no large fracture fragments are present, the injury can be treated with buddy taping (i.e., taping the injured finger, above and below the joint, to an adjacent finger) (Figure 7). If the ring finger is involved, it should be secured to the fifth digit, because the fifth digit is naturally extended and easily injured if exposed.

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Figure 7.

Buddy taping for the treatment of finger injuries. (A) Self-adhesive wrap. (B) Velcro wrap.


Figure 7.

Buddy taping for the treatment of finger injuries. (A) Self-adhesive wrap. (B) Velcro wrap.

Patients with collateral ligament injuries may continue participating in athletic events as symptoms allow. If joints are unstable with active ranges of motion, patients should be referred to an orthopedic or hand surgeon. A low threshold for referral should exist for collateral ligament injuries in children, because the growth plate often is involved.7,11

VOLAR PLATE INJURY

Hyperextension of a finger joint, such as a dorsal dislocation, can injure the volar plate (Figure 8). The PIP joint usually is affected, and collateral ligament damage often is present. The volar plate can be partially or completely torn, with or without an avulsion fracture.11 The subsequent loss of joint stability may allow the extensor tendon to gradually pull the joint into hyperextension, causing deformity.


Figure 8.

Volar plate tear.

Maximal tenderness will be located at the volar aspect of the affected joint. Full extension and flexion will be possible if the joint is stable. The collateral ligaments should be tested as with collateral ligament injuries. Radiographs may show an avulsion fragment at the base of the involved phalanx.

A stable joint without a large avulsion fragment should be splinted with a progressive extension splint (“block splint”) (Figure 9) starting at 30 degrees of flexion7,22 for two to four weeks, depending on injury severity; buddy taping should follow. Increasing the extension of a dorsal aluminum splint weekly will progressively increase range of motion.22 In less severe injuries, the injured joint should be buddy taped. This will restrict some extension and provide support. These two techniques may allow a patient to continue participating in athletic events sooner; however, participation depends on the athlete’s sport and position; it is difficult to play some sports with a flexed PIP joint. Referral criteria include an unstable joint or a large avulsion fragment.

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Figure 9.

Progressive extension using a dorsal aluminum splint to improve range of motion.


Figure 9.

Progressive extension using a dorsal aluminum splint to improve range of motion.

Fingertip Injuries | TriHealth

Our fingertips play a huge role in our day-to-day activities. A fingertip injury due to blunt force trauma or a crush injury can be incredibly painful and make it impossible to perform the simplest tasks. Finding fast, effective treatment for fingertip injuries is important to ensure that permanent damage or scarring doesn’t occur. Turn to the expert hand specialists at TriHealth Orthopedic & Sports Institute for customized care you can count on.

Fingertip Injuries

Fingertip injuries can affect the bones at the ends of the fingers (distal phalanges), the fingernails or the soft pads of the fingers. Crush injuries are the most common causes of injury to the tip of the finger, but cuts and dislocations can also occur. Some injuries can affect the sensory nerves in the fingertips, which is why it’s essential to get the right treatment for fingertip injuries.

Types of fingertip injuries include:

  • Distal phalanx avulsion fracture—broken bone due to a ligament or tendon tear.
  • Distal phalanx dislocation—fingertip joint is forced out of alignment.
  • Fingertip laceration—a deep cut in the nail bed or skin of fingertip.
  • Jersey finger—inability to flex the distal knuckle due to tendon injury.
  • Mallet finger—inability to straighten the fingertip joint (distal knuckle) due to tendon injury.
  • Nail root avulsion—nail is torn partially or completely away from the nail bed.
  • Subungal hematoma—bleeding or bruising beneath the nail.

Fingertip injuries causes

The most common causes of fingertip injuries include:

  • Crush injuries
  • Lacerations from sharp objects
  • Sports injuries

Fingertip injuries symptoms

Symptoms of a fingertip injury will depend on the cause of the injury, but may include:

  • Bleeding or bruising beneath the nail bed
  • Deformity of the fingertip if the bone has been shoved out of alignment
  • Fingertip numbness if nerves are damaged
  • Fingertip pain and swelling
  • Lacerations of the nail or nailbed

Fingertip injuries treatment

When the fingertip or nail bed sustains an injury, common treatments include:

  • Closed reduction—the fractured or dislocated bone is nonsurgically realigned.
  • Hematoma decompression—tiny pin holes in the nail bed drain blood and relieve pressure.
  • Splinting—a splint stabilizes the fingertip joint as minor fractures, dislocations or tendon injuries heal.
  • Nailbed repair – the nail must sometimes be removed and the nailbed repaired to prevent future nail deformity.
  • Surgery—surgery is reserved for cases of complex fractures, tendon tears or fingertip amputations.

Fingertip injuries risk factors

Certain risk factors can increase your chances of sustaining a fingertip injury, including:

  • Contact sports
  • Occupational hazards

Fingertip injuries fingers prevention

It’s impossible to prevent accidents that can cause fingertip injuries, but taking the following precautions may reduce your risk:

  • Keeping nails trimmed to avoid nail plate avulsions
  • Refraining from high-risk activities like rock climbing or contact sports
  • Wearing protective gloves when handling heavy machinery or sharp objects

Make an appointment

Fast treatment for fingertip injuries is necessary to prevent long-term damage to the joint or sensory nerves of the fingertips. Get an accurate diagnosis and the most effective treatment at TriHealth Orthopedic & Sports Institute. Call 513 246 7846 to learn more.



Soft Tissue Injury: Finger | Hull University Teaching Hospitals NHS Trust

  • Reference Number: HEY-250/2021
  • Departments: Orthopaedics, Physiotherapy

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Introduction

This leaflet has been produced to give you general information about your injury.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and the healthcare team but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is a soft tissue injury?

The term soft tissue refers to muscles, ligaments and tendons that surround and support our joints. Injuries to the soft tissue surrounding the fingers joints are usually caused by a forceful stretch or direct blow, for example when playing ball sports.

What are the symptoms?

A soft tissue injury to one or more of the fingers may result in:

  • Pain.
  • Heat, redness or bruising.
  • Swelling.
  • Stiffness and loss of function.

Pain relief

To manage your pain it is advised that you regularly take simple pain relief which can be bought over the counter. If you have allergies or conditions which prevent the use of pain relieving or anti-inflammatory medication please seek advice from your doctor or a pharmacist.

What should I do in the first 72 hours after the injury?

The most important initial treatment is aimed at controlling the pain and swelling by following the principles of RICE:

R – Rest

Complete rest is not advisable but it is important that you prevent putting the finger under strain in the early stages of healing. Ensure you continue to move the other fingers and wrist as normal as it is common to quickly become stiff in these joints.

I – Ice

Ice will help reduce the pain in your finger and so should be applied for 10-15 minutes. This will help to reduce the swelling.

There are many different ways in which ice can be applied however it believed crushed ice, in the form of frozen peas for example, is the most effective. Whichever method you choose it is important that you wrap the ice in a damp towel, in order to prevent it from ‘burning’ the skin.

Please Note:
Only use an ice pack on areas that have normal skin sensation i.e. where you can feel hot and cold.
Do not apply over an open wound.
Do not apply an ice pack to an area that has poor circulation.
When you apply ice to your skin, check the skin every five minutes and discontinue its use if:

  • the area becomes white, blue or blotchy.
  • the area becomes excessively painful, numb or tingles.

C – Compression

You may have been given a special compression bandage to wear to help control the swelling in your finger. It is important this is removed if you develop any signs of poor circulation such as tingling, numbness, blueness of the skin around the finger and increasing pain. The bandage should be removed when you go to bed at night as when you are asleep you cannot monitor these symptoms.

E – Elevation

If you have swelling in your fingers sit on a chair and place your elbow on cushions so that it is level or slightly higher than your shoulder. In this position point your hand towards the ceiling then open and close your hand as this will help to reduce any swelling further.

What not to do

Consuming alcohol, massaging the injured area and applying heat can all be detrimental in the early stages of healing and therefore should be avoided. It is important to note that smoking may also delay the healing process.

Rehabilitation and recovery

If you follow this basic advice your injury should take around six weeks to heal. However, everyone recovers from injuries at different rates and it is dependent on the severity of the injury and the presence of any other medical problems. It is possible that you may be back to normal in two weeks, however it is also possible you may suffer symptoms for up to three months.

After 72 hours it is very important you try to start using your hand and fingers normally again when doing everyday tasks like washing, dressing and eating.

The exercises below will help you to regain full function, flexibility and strength and you should try to practice them on each injured finger 10 times, 4 times per day.

You may experience more discomfort when you start the exercises. However, this is normal and does not mean you should stop. If your symptoms remain worse for more than two hours after the exercises then you should decrease the number of each exercise that you do and build up again slowly.

1. Hold your finger with your other hand just below the top joint, preventing the other joints from moving.

Now bend the top joint of your finger down as far as you can and feel it stretching.

Hold 10 seconds and then straighten.

2. Hold your finger with the other hand just below the middle joint, preventing the bottom joint from moving.

Bend the middle joint of your finger down as far as you can and feel it stretching.

Hold 10 seconds and then straighten.

3. Support your elbow on a table with your wrist straight and fingers pointing towards the ceiling.

Bend your fingers across the knuckles and middle joints only. Keep your fingertips straight and trying to stretch them towards your wrist.

Stretch for 10 seconds and then straighten your fingers again.

4. Support your elbow on a table with your wrist straight and fingers pointing towards the ceiling.

Bend the top two joints of your fingers down as far as you can into a hook grip and feel them stretching.

Hold the stretch for 10 seconds, and then straighten.

5. Support your elbow on a table with your wrist straight and fingers pointing towards the ceiling.

Bend your fingers into your palm as tightly as you can and feel them stretching. Hold the stretch 10 seconds.

Now stretch your fingers as wide as you can and feel them stretching. Hold the stretch for 10 seconds.

All photos with kind permission of ©Physiotec™

When can I return to normal activities?

If your job involves activities using your hand and fingers regularly you must ensure that you practice similar tasks so that you build your strength and function up gradually.

If you participate in an active hobby then it is advised that you do not return to this until you have full range of movement, strength and you can use your hand normally without experiencing pain or swelling.

If you play a sport involving use of your hand, practice sports specific activities like throwing and catching to prepare and build this up gradually before returning to full training sessions and competition.

Do I require further treatment?

You may be advised that you require physiotherapy following this type of injury, unless your symptoms are minimal on your initial appointment. Your physiotherapy could be at a variety of locations in the Hull and East Riding area.

You can self-refer to physiotherapy by contacting the following number depending on the location of your doctor:

  • Hull GP patients self-refer to Healthshare: 01482 300003
  • East Riding GP patients self-refer to East Riding Physiodirect: 01377 208300 or self-refer online at chcpmsk. org.uk

On occasions the clinician may wish to refer you to the physiotherapy team within the hospital trust. If this is the case they will advise you of this and you should receive an appointment at Hull Royal or Castle Hill Hospitals within 5 to 7 days of your attendance at the Emergency Department. If you have received no contact within this time please call the physiotherapy admin team on (01482) 674880.

When to seek further help

If 10 days following your injury you are unable to use the hand and it remains painful and swollen, despite following the above advice, please contact the physiotherapy team that you were advised to contact at your Emergency Care attendance.

Additionally if, after doing the exercises regularly and following the advice for three weeks, you notice that you are still unable to straighten your finger out fully please contact the physiotherapy team that you were advised to contact at your Emergency Care attendance.

Sudden (Acute) Injuries | Florida Orthopaedic Institute

Treatment for sprains includes rest, immobilization, ice, compression, and elevation.  An easy way to remember this treatment is to use the acronym RICE: Rest, Ice, Compression, and Elevation. This treatment should be used as soon as possible after a sprain to relieve pain and swelling, as well as promoting healing and flexibility.

  • Rest. Rest and protect the sore or injured area. Take a break, change, or stop any activity that is causing the pain or soreness.
  • Ice. Cold reduces pain and swelling. Apply ice or cold pack immediately to prevent and reduce swelling. Apply it for 10 to 20 minutes at a time – three or more times a day. If the swelling is gone after 48 to 72 hours, you can apply heat to the area. Never apply ice or heat directly to the skin – place a towel between the cold or heat pack and the skin.
  • Compression. Wrapping the injured or sore area with an elastic bandage (such as an Ace bandage), helps decrease swelling. Don’t wrap too tightly as this can cause swelling below the affected area. Check the wrap and look for signs that the bandage is too tight (numbness, tingling, increased pain, coolness, or swelling) in the area below the bandage.  If the bandage gets too tight, loosen it. If you think you need to use compression for longer than 48 to 72 hours, contact your doctor to make sure there’s not a more serious problem.
  • Elevation. Anytime you are sitting or lying down, raise the injured area with pillows while applying ice. If you can keep the area at or above the level of your heart, it will help minimize swelling.

Advil or Motrin (ibuprofen) and Aleve or Naprosyn (naproxen) are nonsteroidal over-the-counter anti-inflammatories that help relieve pain and swelling.

Minor sprains often heal well with home treatment but moderate to severe sprains need prompt medical evaluation and treatment. Your doctor may prescribe a cast or splint, physical therapy, medicine, or surgery. Recovery time for sprains varies depending on a person’s age and health, and the location and severity of the injury.

SPECIFIC INJURIES TO LIGAMENTS (SKIER’S THUMB)

Skier’s Thumb is an acute injury to the ligament of the thumb, located on the inside of the thumb’s first knuckle. This ligament (the ulnar collateral ligament – UCL) provides stability for the thumb. The injury is commonly called Skier’s Thumb because it is seen among skiers who fall with their ski pole in their hand. The ligament can be partially torn, completely torn or stretched, and sometimes includes a small fracture of the thumb bone where the ligament is attached. Skier’s Thumb is also termed Gamekeeper’s Thumb.

INJURIES TO TENDONS (MALLET FINGER)

Tendons are the strong and flexible fibers connecting muscle to bone. As you move, they glide smoothly over muscles. Tendons vary in size and shape. Mallet finger (also known as baseball finger or drop finger) is when you try to catch a ball and your fingertip is struck by the ball with a lot of force. The tendon ruptures at the base of the finger joint. The result is a bent fingertip that can’t be straightened or is painful and swollen.

STRAINS (PULLED MUSCLES)

Overstretching muscles causes most strains. They can be severe, such as a torn muscle or tendon, or minor.  Symptoms of a strain vary depending on the severity the strain and can include:

  • Pain
  • Tenderness (that is worse with movement)
  • Swelling
  • Bruising
  • Limited muscle movement
  • A bulge at the site of a complete tear

Recovery time for a muscle strain varies depending on a one’s age and health as well as the type and severity of the strain. While minor strains often heal well with home treatment, severe strains need medical treatment. If severe strains are not treated, long-term pain, limited movement, and deformity can result.

BROKEN BONES (FRACTURES)

Fractures are breaks in a bone that can range from hairline cracks to bones broken into two or more pieces. Fractures can occur at the same time as other injuries, such as sprains, strains, or dislocations.

Signs and symptoms of fractures include:

  • A pop or snap at the time of injury
  • Pain that increases with movement or when pressure is applied
  • Swelling and bruising
  • Limited movement
  • Bone movement where there is no joint (for example, a bend in the arm between the elbow and wrist)
  • Bone poking through the skin
  • Bone visible in the wound

Fractures require medical attention, along with any other injuries that may have occurred at the same time. The broken bone may need to be set, cast, or splinted to help it heal. Depending on the type of fracture, it may need surgery.

Recovery time for a fracture can vary from weeks to months, depending on:

  • Age
  • Health
  • Type of fracture
  • Location of the fracture
  • Severity of the fracture

Other injuries may complicate treatment:

DISLOCATIONS

Dislocations are when a bone is pulled or pushed out of place, and out of its normal relationship to the other bones that make up a joint. This can happen in joints such as the kneecap, hip, finger, elbow, or shoulder.

Dislocation can be caused by direct blows to a joint, falls, or sudden twisting movements. Even everyday activities can cause dislocations if a person has unstable joints.

Dislocations can be problems even if the bone pops back into place. Soft tissues in or around a joint (such as ligaments, tendons, muscles, cartilage, and the joint capsule) can stretch or tear.  Nerves and blood vessels can be damaged. Pieces of bone at the base of the joint can break off and end up inside the joint. Dislocations can cause fractures that extend into the joint.

CRUSHING INJURY, LEADING TO COMPARTMENT SYNDROME

Compartment syndrome develops when swelling takes place within an enclosed area (a compartment), in which muscles, nerves, blood vessels, and bones have no room to expand. Pressure on arteries, veins, and nerves causes extreme pain, slows circulation to the muscles and nerves, and can cause permanent damage to the tissue.

Swelling that causes compartment syndrome is usually caused by decreased blood flow, trauma, bleeding and fluid buildup. Compartment syndrome requires immediate emergency medical treatment to prevent tissue death and permanent dysfunction.

People involved in a greatly increased level of physical activity such as long-distance runners or new military recruits can develop chronic compartment syndrome. Symptoms are less sudden, less severe, and often improve with rest.

SEEK MEDICAL ATTENTION

Anyone with a finger, hand, or wrist injury should immediately seek medical attention. Time is of the essence as the potential for permanent damage and destructive injury increases greatly when medical attention is delayed. Cuts and hand injuries need advanced treatment to prevent infection or loss of function, regardless of size.

A cut that may require stitches needs medical evaluation. If in doubt about whether a cut needs stitches, call a doctor for guidance.

Injuries to the hand with the following symptoms generally require emergency medical attention:

  • Severe bleeding
  • Numbness
  • Loss of motion or strength
  • Severe pain
  • Obvious deformity
  • Signs of infection (tenderness, local warmth, redness, swelling, pus, or fever)
  • Exposure of underlying structures (tendons, bones, joints, arteries, veins, or nerves)

Also, seek emergency medical care in these situations:

  • Fractures
  • Dislocations
  • High-pressure injuries
  • Amputations
  • Deep, gaping (open), or dirty cuts
  • Wounds from a human or bite (including cuts from striking a tooth during a fight)
  • Burns (if the skin is disrupted or if the burn goes completely around a finger, hand, or wrist)

Hand and Wrist Conditions Orthopaedic Care – UR Medicine, University of Rochester Medical Center

Conditions We Treat

Arthritis:Chronic pain, swelling, and stiffness in your joints often means that you have arthritis. This disease can be particularly troublesome when it affects your hand, fingers, or wrist, as it can limit your ability to do the things you do on a daily basis.

Baseball (Mallet) Finger: This injury to the outermost joint of the finger is very common among baseball and basketball players. Pain, swelling, and trouble extending the finger are all symptoms of this injury to the tendon.

Boutonniere Deformity: An injury to the tendons that straighten the middle joint of your finger can make you finger bend—and make it impossible to straighten. This is usually the result of a blow to the hand or an accident.

Boxer’s Knuckle: A direct blow to the knuckle—usually at the base of the middle finger—can cause a tear in the tendon that straightens the finger. The knuckle becomes weak and painful. The injury gets its name from its frequency among boxers and martial arts fighters.

Brachial Plexus Injury (Erb’s Palsey): The nerves that send signals from your spine to your shoulder, arm, and hand are known as the brachial plexus. When these nerves are compressed or stretched to the breaking point, you may feel a burning sensation in your arm—or a sharp pain, like a lightning bolt, at the moment of impact. This may be followed by numbness or weakness in the injured arm.

Carpal Tunnel Syndrome: If you feel numbness or tingling in your hand and arm, you may have the pinched nerve in your wrist that doctors call carpal tunnel syndrome. Repetitive motion causes this injury—which is was assembly line workers, people who work at a computer all day, and people in many other professions develop this disorder.  Early treatment with pain killers, a wrist splint, and cortisone injections can help you avoid surgery.

DeQuervain Syndrome (Washerwoman’s Sprain, Gamer’s Thumb): It’s not clinically proven that too much gaming or thumb-typing causes this painful condition, but DeQuervain Syndrome still gets one of its nicknames from video game enthusiasts. The pain begins in the thumb and travels down through the wrist. You may have trouble gripping things with the affected hand, and your wrist may be swollen on the thumb side.

Dupuytren’s Contracture: Over the course of several years, this hand deformity pulls the pinky and ring finger toward the palm in a permanently curled position. You may feel a tough lump in the palm of your hand, and cords of tissue extending up the afflicted fingers.

Flexor Tendon Injuries (Jersey Finger): When a deep cut on the palm side of your hand damages the tendons that control your hand’s movement, you have a flexor tendon injury. This condition makes it impossible to bend your fingers toward your palm.

Fractures: All broken bones are known as fractures. At UR Medicine Hand and Wrist Services, we can diagnose and treat any kind of fracture in the wrist or hand, and we are ready to work with you on recovery and rehabilitation.

Ganglion Cyst: These round or oval lumps may form on the tendons or joints of your wrist. They are non-cancerous and filled with a jelly-like fluid, and they may be painful if they press on a nerve. These often go away without treatment. Talk to your doctor about the treatment options and what will be best for you.

Kienböcks Disease (Avascular Necrosis of the Lunate or Lunatomalacia): An interruption of blood flow to a small bone in the wrist called the lunate can cause this bone to die. The symptom to watch for is pain and stiffness in the wrist. The cause of this disease is not known, but

Ligament Injuries: A sprain is an injury to a ligament, one of the strong bands of tissue that connect one bone to the next. It’s very common to sprain a wrist, an injury that may stretch or partially tear a ligament. In a severe sprain, the ligament is torn clean through—and it may take a small bone chip (an avulsion) with it.

Nailbed Injuries: If you hit or jam your finger in an accident, the nail may separate from the nailbed. It can take six months for a new nail to grow back in its place. A doctor can help you detach the remaining nail and protect the nailbed from infection

Radial Tunnel Syndrome: The radial nerve runs from the side of the neck to the hand, passing through a tunnel in the elbow. When the nerve gets squeezed at the elbow joint, it can be very painful. This squeezing can come from repetitive pushing and pulling, bending the wrist, pinching, and gripping—all motions that are common in everyday life.

Raynaud’s Phenomenon: If your fingers turn pale, then blue, then red when they are exposed to cold temperatures, you may have this unusual condition. While the cause of Raynaud’s Phenomenon is not known, some treatments (including medications and protection of the hands) have been found to protect the fingers and toes from this spasm of the blood vessels.

Reflex Sympathetic Dystrophy Syndrome: Also known as Complex Regional Pain Syndrome, this rare condition involves the sympathetic nervous system affects involuntary functions throughout the body. Patients have chronic, severe pain in an arm, fingers, palm, shoulder, or a leg or knee. The painful area may be swollen or inflamed, sensitive to hot and cold, and warm to the touch. The cause of this syndrome is not known, though it may come from a nerve injury, trauma, cardiovascular disease, or radiation therapy.

Repetitive Motion (Stress) Injury: People who perform the same motion over and over can injure muscles, tendons, ligaments, and nerves in the hand, wrist, foot, or ankle. This kind of injury can happen with athletes who play tennis, baseball or golf, but it’s also common in long-distance runners.

Rheumatoid Arthritis: This form of arthritis is an autoimmune disorder—your immune system mistakenly attacks your body instead of fighting off infection. Rheumatoid arthritis affects the lining of the joints, causing pain and swelling and, eventually, bone erosion and deformity. It begins in the joints of your hands and feet, and it sometimes affects other organs like your eyes, skin, and lungs. Treatment can help slow the joint damage and help you manage the pain.

Skier’s Thumb: This injury accounts for as many as 10 percent of all skiing accidents, because skiers fall on an outstretched hand holding a ski pole. The result is a painful tear of the ligament that connects the bones of the thumb. Ice and immobilization can help, but a full rupture requires a surgical repair.

Tendinitis: Any one of a wide range of activities can affect your tendons, either through repetitive motion or a sudden injury. Anyone can be affected, but tendinitis is more common in people over 40 because tendons become less elastic and tolerant of stress as we get older. Localized pain and restricted motion are the most common symptoms.

Trigger Finger: If one of your fingers or your thumb gets stuck in a bent position and you feel a popping or clicking when you try to straighten it, you may have trigger finger. This most often develops in the hand you use most. Your finger may be stiffer in the morning, and you may get a bump at the base of the finger.

 

Finger sprains | The British Society for Surgery of the Hand

What is a finger sprain ?


A sprain refers to an injury to the tissues surrounding and supporting a joint. This includes the ligaments and joint capsule. The ligaments are strong structures that prevent a joint from going into an abnormal position. The capsule is less strong and acts to seal the joint from the other tissues. A sprain can be of varying degrees. In a minor sprain the tissues essentially remain intact and recover rapidly, in a more serious sprain the tissues may be badly torn and sometimes need to be repaired surgically.


After a sprain the injured joint will become swollen, painful and stiff. The amount of swelling usually reflects the degree of injury.


The commonest joint to be sprained is the PIP joint. The ligament that is injured most often is called the volar plate (palmar plate). This ligament prevents the joint from over straightening. The volar plate is damaged when force is applied in a longitudinal direction for example a ball hitting the end of the finger and the joint is forced into hyper-extension.


The MP joint of the thumb is vulnerable to injury and one of the most frequently is the so called ‘skiers thumb’ where the ligament on the inside of the thumb is torn. Further information on this injury can be found under Skiers thumb (also known as Game keepers thumb).


What is the treatment ?


The aim of the treatment is to restore movement to the injured joint. The initial assessment will look at which structures have been damaged and decide on the appropriate method of treatment. An x-ray will often show small fragments of bone which are attached to the damaged ligaments. Your Hand Surgeon will advise you of the plan of treatment which will likely be instituted by a hand therapist.


In the initial phase the joint may be rested using a splint or cast if there is a lot of bruising and swelling. Otherwise the joint will be encouraged to move straight away, this is done using specific exercises.  The swelling will reduce with time but can be helped by using compressive bandaging. Other measures may include dynamic and static splints, ultrasound and massage. Your therapist will advise on these techniques.


Surgical treatment is uncommon but may be required if one of the ligaments has been torn and if not repaired give rise to a risk that the joint may not fully recover and in particluar be unstable and unable to function satisfactorily.


What is the outcome ?


These injuries can take a suprisingly long time to heal. In particular the swelling around the joint may last several months. Most patients, however, will regain a full range of movement.


One of the recognised problems, after any sprain, is loss of movement which may be either a loss of bending or more commonly the straightening of the joint. The loss of full straightening may be minor and not need any treatment, however if the finger is in a bent position that causes problems with use of the hand then additional treatment can be helpful. The therapists will undertake a programme of stretching, massage and exercises combined with the use of splints which can improve the situation. If the joint does not respond then a surgical release may be needed.


The other slightly less common problem that can develop after a joint sprain, where a ligament has been damaged, is instability. This means the joint cannot resist the normal forces applied to it and will give way. The symptoms are pain and weakness causing difficulty with use of the hand. Under those circumstances your surgeon may suggest either the use of splints to support the joint or a repair or reconstruction of the damaged ligament. Your Hand Surgeon and Therapist will discuss the options with you and an appropriate decision made.


In the long term a sprained joint may have a slight increased risk of developing osteoarthritis. The risk does depend on the joint involved and the nature of the injury and you should discuss this with your surgeon where appropriate.



Most Common Hand/Wrist Injuries – BID Needham

Sprains


Sprains are damage to ligaments. A ligament is a type of tissue that connects bone to bone. There are different grades of sprain from a minor tear to complete rupture. Treatment and recovery time will depend on grade of sprain.


Thumb Sprains


Breaking a fall with the palm of your hand or taking a spill on the slopes with your hand strapped to a ski pole could leave you with a painful thumb injury. The ulnar collateral ligament may be sprained. This ligament acts like a hinge and helps your thumb to function properly. If you sprain your thumb, you could lose some or all of your ability to grasp items between your thumb and index finger or to grasp well with the entire hand.


Wrist Sprains


When you fall forward, as when you trip running or rollerblading, your natural response is to put your hands out in front of you to catch yourself. Unfortunately, this natural response causes you to land on your palm, bending your wrist backwards, and possibly stretching or tearing the ligaments connecting the bones in your wrist. The resulting injury is a wrist sprain.


Injuries to the Bone


Bones can be fractured and dislocated. A fracture is a crack or break in a bone. It is commonly referred to as broken bone. A dislocation is when a bone is pushed out of place so that they no longer line up correctly at the joint. This can decrease the ability to move and cause pain.


Hand Fractures


Fractures of the metacarpals (the bones in your hand just before your knuckles) and your phalanges (the bones between the joints of your fingers) are also common sports injuries.


Finger Fractures


The most common fracture of the metacarpals is a boxer’s fracture. A boxer’s fracture usually occurs when you strike an object with your closed fist. With a boxer’s fracture, the fifth metacarpal joint (the one at the base of your littlest finger) is depressed and the surrounding tissue is tender and swollen.

Wrist Fractures


Scaphoid fractures account for many wrist fractures. The scaphoid bone is one of eight small bones that make up the wrist. Wrist fractures are common both in sports and motor vehicle accidents. The break usually occurs during a fall on the outstretched wrist. The angle at which the wrist hits the ground may determine the type of injury. The more the wrist is bent back (extension), the more likely the scaphoid bone will break. With less wrist extension it is more likely the lower arm bone (radius) will break. 


Scaphoid fractures are not always immediately obvious. Many people with a fractured scaphoid think they have a sprained wrist instead of a broken bone because there is no obvious deformity and very little swelling.

Dislocations of the PIP Joint


One of the most common injuries to an athlete’s hand is an injury to the joint above the knuckle, the proximal interphalangeal (PIP) joint. Injuries to the PIP joint occur when the finger is either hyperextended (forced backwards) or forced into flexion (downward into a bent position). Injuries to the PIP joint may include fractures, dislocations, and fracture dislocations.

Soft Tissue and Closed Tendon Injuries


Tendons are a type of connective tissue that attaches muscle to bone. A common injury of the tendon is called tendonitis, an irritation of the tissue.

DeQuervain’s Syndrome


DeQuervain’s syndrome is a common injury in racquet sports and in athletes who use a lot of wrist motion, especially repetitive rotating and gripping.

De Quervain’s Tenosynovitis


The overuse of the hand may eventually cause irritation of the tendons found along the thumb side of the wrist. This irritation causes the lining around the tendon to swell, making it difficult for the tendons to move properly.

ECU Tendonitis


Extensor carpi ulnaris (ECU) tendonitis is another common sports-related closed tendon injury. ECU tendonitis is an inflammation of the tendon that runs along the back of the wrist and is caused by repetitive twisting and backward flexion of the wrist. It is most commonly seen in basketball players and those playing racquet sports.

Baseball Finger


Baseball finger (or mallet finger) is an injury that commonly occurs at the beginning of the baseball season. It occurs when a ball hits the tip of your finger, bending it down. Normally, the tip of your finger can bend toward the palm of your hand about 60-70 degrees. However, add the force of a ball that has been batted through the air, and it can push your finger beyond that limit, tearing the extensor tendon that controls muscle movement in the affected finger. If the force is great enough, it may even pull tiny pieces of bone away, as well.

Jersey Finger


Jersey finger is the opposite of mallet finger and occurs when the fingertip, usually the ring finger, is forcibly extended, such as if your finger gets caught in an opponent’s jersey. This causes the flexor tendon, which bends the fingertip, to be pulled away from the bone and will leave you unable to bend your finger without assistance.

Boutonnière Deformity


Boutonnière deformity is an injury to the tendons that straighten your fingers. It occurs when your finger receives a forceful blow when it is bent. Several tendons, running along the side and top of your finger, work together to straighten the finger. If the tendon on the top that attaches to the middle bone of the finger (the central slip of tendon) is injured by a forceful blow, it can sever the central slip from its attachment to the bone, in some cases, even popping the bone through the opening. The tear looks like a buttonhole (“boutonnière” in French). If you have a boutonnière deformity, the middle joint of your finger will bend downward and the fingertip end joint bends back. People with a boutonnière deformity cannot fully straighten their finger.

Preventing Sports-Related Hand and Wrist Injuries


The best ways to prevent sports-related hand, wrist, and upper extremity injuries include

  • Wrist guards

    If your sport is rollerblading, street hockey, or skateboarding, wrist guards may help protect you from bone fractures and hand scrapes if you fall or slide.
  • Gloves

    Use gloves to protect your hands, particularly if you are a bicyclist or skateboarder. The gloves will help protect your hands if the palm suffers a direct blow. In addition to protecting your nerves, gloves can protect your skin from direct wounds and cuts.
  • Warm up

    Before playing sports, include a warm-up routine where you focus on stretching and improving your flexibility.

WHAT TO DO IF A FINGER ERROR HAS BEEN …

If a bruised toe occurs, what to do in this case? Almost every second person asks such a question, because a bruise in this area is not uncommon.

Despite the small scale of the injury, a bruise of the big toe is just as serious an injury as an injury to any other limb or body part. With severe injury, the consequences can be quite serious: from unbearable pain to dislocation and tissue necrosis, nail death.Any symptoms of a bruised finger should alert the victim.

Even if the victim does not feel severe symptoms, it is necessary to treat a bruised toe with full responsibility. Lack of proper attention to trauma can be fraught with damage to tendons, bones and joints, the formation of hematomas and subsequent arthritis and arthrosis in the joint of the injured finger.

Symptoms of a bruised toe

Scheme of applying a bandage to a finger in case of bruise Symptoms of bruising usually develop in the first seconds after injury, may occur after several hours or even days due to painful shock.A bruised toe results in the release of a large amount of natural pain reliever in the human body, which temporarily hides the symptoms.

A bruise of the big toe occurs most often as a result of a heavy object falling on the leg, a painful landing of a person from a height, or hitting an object. Little finger injury is always due to impact on the surface.

The first symptom of any injury is severe pain at or near the injury site. It occurs in the first minutes after the impact, is sharp, but over time it can become aching and pass completely.Returns on palpation and during movement, putting on socks and tights.

In case of severe damage, the treatment may take some time. Chestnut tincture in camphor oil can be used as a supportive agent. About a dozen ripe chestnut fruits are crushed and infused in a glass of camphor oil. The liquid for the treatment is prepared for several days. All this time, the chestnut oil should be in a dark place. Then it is mixed with dark rye bread crumb and applied to the damaged area.

Other symptoms depend on the degree of injury. The contusion can be light, moderate, and severe, accompanied by dislocation of the joint, damage to soft tissues, and even a bone fracture.

Plantain for the treatment of bruises In case of slight damage, the skin and subcutaneous tissue suffer. The bruise is accompanied by the following symptoms: slight bleeding, scratches and other damage to the skin, slight bruising and swelling, various violations of the structure of the nail. Minor bruising occurs when a person trips over or touches an object with a finger.

Medium to severe injuries occur when a large object falls onto the leg during a strong impact. It could also be part of a leg injury.

With severe bruising, there may be a temporary loss of sensation in the injured finger. She then returns in great pain. A hematoma develops on the nail and finger skin. Over time, the nail may come off. There is also a change in the color of the finger and nail itself. This is due to the occurrence of subcutaneous bleeding.

In some cases, severe swelling appears.This indicates the severity of the injury. Swelling may indicate a possible fracture or dislocation of the bone. In case of severe injury, it is necessary to urgently go to the emergency room. With the help of an X-ray and a visual examination, they will help to exclude such serious consequences of an injury as fracture, sprain and dislocation.

First aid for a bruised toe

First aid for a bruised toe – cold. In the first minutes after the impact, it is necessary to apply something cold to the injured area.This can be any metal object, a towel, a cloth soaked in ice water, or a product from the freezer. Cold will help temporarily relieve pain, prevent swelling and hematoma.

In case of severe pain, you must take any pain reliever. It can be analgin, no-spa or another drug.

After all surgical procedures, it is necessary to carefully examine the affected leg. This will help assess the number of fingers injured and the extent of the injury. If the structure of the nail is disturbed or bleeding occurs, it is necessary to carefully apply a bandage.Especially carefully you need to examine the site of injury in children.

If possible, seek immediate medical attention. Before arriving at the Clinic, you need to fix the injured finger with a special bandage or sterile bandage. This is necessary if the possibility of a fracture is being considered.

It is strictly forbidden to:

rub the leg with alcohol or ointments immediately after injury;
warming or steaming a damaged nail;
to independently heal a bruise in case of severe damage.

Joint development after injuries and operations

Rehabilitation of children and adolescents after injuries and operations. Joint development and limb rehabilitation.

The restoration of joint mobility in children and adolescents after injuries and surgeries is a necessary measure in the post-traumatic and postoperative period, even taking into account the fact that a young organism, in comparison with an adult, acquires the necessary functionality and performance much faster, which is due to the fact that they have more elastic and flexible soft tissues of the body, young energy makes you use the injured area earlier and the age of the patient plays a huge role in this matter.But, nevertheless, the VELM Rehabilitation Clinic has extensive experience in the rehabilitation of children in the fields of orthopedics and neurology, and, as a rule, these cases are when the need is urgently needed and has no alternatives.

Indications for the development of joints and restoration of the upper and lower extremities after injuries and surgeries are – removal of immobilization with plaster cast after fractures; operations on tendons, muscles and nerves; bone surgeries; operations on joints, as well as their endoprosthetics (replacement of a joint with its artificial analogue). The causes of injuries, in the modern world, are the use of various entertaining devices in everyday life – for example, based on the experience of 70% of persistent contractures of the elbow joint in children, this is a consequence of the use of a herascooter.

“Before” and “After” rehabilitation course:

To achieve these results, the patient must be present in person at the VELM Rehabilitation Clinic by appointment, where a course of necessary procedures is prescribed, including: firstly, consultation with a rehabilitation specialist, or, if necessary, an orthopedic surgeon in order to determine the timing of rehabilitation, types of procedures used and their individual contraindications. Secondly, warming up the injured area before starting the manipulations. Thirdly, the rehabilitation specialist begins to massage the injured area, relieving muscle spasm, improving metabolism and blood circulation in the affected segment. Fourth, the rehabilitation specialist proceeds to manually develop the affected joint to restore its mobility. The final stage of the procedures is the passive development of the ARTROMOT apparatus of the German company ORMED, provided that this apparatus can be used in view of the age characteristics of the patient.This set of measures and procedures is applied until full mobility is restored.

Thus, the rehabilitation specialists of the VELM Rehabilitation Clinic help children and, most importantly, their parents to solve problems that have arisen in the post-traumatic and postoperative period:

1. Limited mobility of the limb and body associated with joint contracture.

2. Fear and uncertainty of the child to use the traumatized area, which arose in the post-traumatic and postoperative period, passes. This circumstance is due to the fact that the patient is clearly demonstrated his own motor abilities.

3. The result of the treatment will be a complete restoration of the range of motion in the joint.

General information about the proposed treatment and prices

You can get from the administrators by phone:

  • VELM-KONDI 8 (347) 216-2-216, +7 (917) 777-06-25;
  • VELM-Sipailovo 8 (347) 2-444-084, +7 (917) 473-24-16.

To determine the indications and contraindications, as well as the method, timing and nature of the complex of rehabilitation procedures, an in-person consultation with a doctor is required.

Volleyball injuries. Part II

In the second part, we will talk about a fairly common injury – this is a finger injury.

Volleyball finger injuries are very common. Perhaps not a single volleyball player will meet who has not encountered this problem. In professionals, finger injuries usually occur on the block when the blow hits the extended toe. In less professional athletes, finger injuries can occur in more trivial situations such as a pass or a pass. By the type of injury, these are most often ligament microtrauma, which is more often called “ligament sprain”. Sprains and fractures of fingers also occur in volleyball.

In some studies, the percentage of finger injuries in relation to the total number of injuries is absent or not high.This may be due to the fact that in these studies, the injury was characterized by the time of non-participation in training, and most athletes continue to play, fixing the injured finger with tape or plaster. Trauma can occur in any of the joints of the finger (Fig. 7). The most unpleasant injury is the metacarpophalangeal joint, since this joint is not easy to fix and usually requires a break from training. Trauma can occur as a result of a blow to a straightened finger, as a result of which the bones in the metacarpophalangeal joint are displaced and collateral ligaments are damaged.In extreme cases, a dislocation of this joint can occur. It can also lead to another serious injury – damage to the flexor tendon of the fingers, sometimes called the hammer toe. For more information on this injury, see the article “Hammer toe”.

Treatment mainly depends on the diagnosis made by the doctor. To exclude a fracture, an x-ray must be taken. In mild cases, it will be enough to fix the injured joint with a plaster or tape.In more severe cases, such as a complete rupture of a ligament, tendon, or fractures, an iron or plastic splint or splint is used. Many professional athletes, especially attackers and blockers, often tap their fingers for preventive purposes, especially on the right hand (see the article “Equipment for volleyball players” http://volleyball.ua/news/133-ekipirovka-ighrokov-v-volieibol).

Based on materials from the Internet edition www.sportmedicine.ru

Spine Center

Spinal cord injury is injury or illness to any part of the spinal cord or nerves in the spinal canal.These injuries often cause impairment or loss of motor or sensory function.

Many scientists do not abandon the idea that spinal cord damage will someday be completely reversible. Therefore, research in this area is being conducted all over the world. At the same time, the treatment and rehabilitation programs that exist today allow many patients to become active members of society again.

The ability to control the limbs of the body after a spinal cord injury depends on two factors: the location of the injury (part of the spinal cord) and the severity of the injury.If the spinal cord is seriously damaged, the pathways that link together several parts of the spinal cord are destroyed, then the consequences of spinal trauma are catastrophic.

The severity of the injury is subdivided into:

Full damage

Such an injury leads to a loss of sensation and motor functions of all organs and parts of the body below the level of damage.

Incomplete damage

In case of incomplete spinal cord injury, the organs and limbs located below the lesion site retain partial motor activity.

Also, spinal cord injuries can lead to tetraplegia (aka quadriplegia) – a violation or loss of functions of the arms, trunk, legs and functions of the pelvic organs.

Paraplegia is a complete paralysis or paralysis that affects part of the trunk, legs and pelvis.

  • The attending physician will perform a series of tests to determine the neurological level of the injury and the severity of the injury.
  • Signs and symptoms of spinal cord injury (may manifest as several or one of the following):
  • loss of motor functions,
  • Loss of sensation, including the ability to sense warmth, cold, or touch.
  • Loss of control over bowel and bladder function
  • Increased muscle tone or uncontrolled spasms
  • Sexual dysfunction and infertility
  • Pain or tingling sensations caused by damage to the nerve fibers of the spinal cord
  • shortness of breath, cough.
First signs of spinal cord injury:
  • Severe back pain or pressure in the neck and head
  • Weakness, lack of coordination or paralysis in any part of the body
  • Numbness, tingling, or loss of feeling in the hands, fingers, feet or toes
  • Loss of bowel or bladder control
  • Difficulty walking and maintaining balance
  • Respiratory problems
When to see a doctor

Anyone with a serious injury to the head or neck should seek immediate medical attention.Doctors will evaluate the possible damage to the spinal cord. For any suspected spinal cord injury, doctors must perform all appropriate medical procedures until proven otherwise, this is important because:

  • Serious spinal injury is not always immediately apparent. If it is not recognized in time, it can lead to more serious consequences.
  • Numbness or paralysis may also not appear immediately, without timely diagnosis, the situation can be aggravated by prolonged internal bleeding and swelling in or around the spinal cord.
  • The time elapsed after the injury and the provision of medical care directly affects the possible complications and subsequent rehabilitation of the patient.
How to deal with someone who has just been injured:
  1. Call 1719 or the nearest hospital ambulance service.
  2. Place towels on both sides of the head and neck to keep them stationary and await an ambulance.
  3. Provide first aid to the victim: take steps to stop the bleeding and keep the victim as comfortable as possible, but without dislocating the neck or head.

Damage to the spinal cord is possible as a result of damage to the vertebrae, ligaments or spinal discs. Traumatic spinal cord injury can be associated with a sudden blow to the spine, resulting in a fracture, displacement, or compression of the vertebrae. Spinal cord injury can also be sustained as a result of a gunshot or stab wound. Complications usually occur within days or weeks after the injury due to bleeding, swelling, inflammation, and fluid accumulation in and around the spinal cord.

Non-traumatic spinal cord injury is also possible due to a number of diseases: arthritis, cancer, inflammation, infection or disc degeneration of the spine.

Your brain and central nervous system

The central nervous system consists of the brain and spinal cord. The spinal cord, made up of soft tissue surrounded by bones (vertebrae), runs down from the base of the brain, is made up of nerve cells and their processes, and ends just above the waist. Below this area is a bundle of nerve endings called the cauda equina.

The nerve processes of the spinal cord are responsible for communication between the brain and the body. Motor neurons transmit signals from the brain to control muscle movement. Sensory regions carry signals from body parts to the brain to convey information about heat, cold, pressure, pain, and limb position.

Damage to nerve fibers

Regardless of the cause of the spinal cord injury, nerve fibers passing through the injured area may also be affected. This leads to a deterioration in the functioning of the muscles and nerves located below the injury site.Injury to the thoracic or lumbar region can affect the function of the muscles in the trunk, legs, and internal organs (bladder and bowel control, sexual function). Neck injuries can affect hand movements and even the ability to breathe.

Common causes of spinal cord injury

Most common causes of spinal cord injury in the United States:

Traffic accidents. Accidents involving cars and motorcycles are the leading cause of spinal cord injury, more than 40% annually.

Falls. Spinal cord injuries in the elderly (over 65 years of age) are usually associated with falls. In general, statistics assign this reason ¼ part of all cases.

Acts of violence. 15% of cases of spinal cord injuries are caused by violence (including gunshot and stab wounds). Data from the National Institute of Neurological Disorders and Stroke.

Sports injuries. Professional sports carry many dangers, as well as active recreation, for example, diving in shallow water.8% of back injuries fall under this article.

Alcohol. One in four injuries, one way or another, is associated with alcohol consumption.

Diseases. Cancer, arthritis, osteoporosis and spinal cord inflammation can also cause damage to this organ.

Despite the fact that such injuries are usually caused by an accident, a number of factors have been identified that predispose to risk, such as:

Gender. The number of statistically affected men is many times greater.In the United States, there are only 20% of women with similar and injuries.

Age. As a rule, injuries are received at the most active age – from 16 to 30 years. Traffic accidents remain the main cause of injury at this age.

Love of risk and extreme. Which is logical, but most importantly, athletes and amateurs are primarily injured in violation of safety techniques.

Diseases of bones and joints. In the case of chronic arthritis or osteoporosis, even a minor back injury can be fatal to the patient.

After spinal cord injuries, patients face a large number of unpleasant consequences that can radically change their lives. When such a serious injury is received, a team of specialists comes to the patient’s aid, including neurosurgeons, neurologists and doctors of the rehabilitation center.

Specialists of the Rehabilitation Center will offer a number of methods for controlling vital processes (the work of the bladder and intestines). They will develop a special diet to improve the functions of organs, which will help to avoid future formation of kidney stones, urinary tract and kidney infections, obesity, diabetes mellitus, etc.Under the supervision of experienced physiotherapists, an exercise program will be developed to improve the patient’s muscle tone. You will receive detailed advice on skin care to avoid pressure ulcers and keep your cardiovascular and respiratory systems working. Specialists in urology and infertility treatment can also be called upon if needed. Doctors will teach you how to deal with pain and depression. We are able to offer a comprehensive approach to fully stabilize the patient’s condition.

Medical Research:

Radiography. It is with her that it is advisable to start research. The images give a general picture of the situation, allow you to assess the deformation of the spine, detect fractures, dislocations of the bodies and processes of the vertebrae, and clarify the level of damage.

Computed tomography (CT). CT scan more gives more detailed information about the damaged area. During the scan, the doctor receives a series of cross-sectional images and provides a detailed examination of the walls of the spinal canal, its membranes and nerve roots.

Magnetic resonance imaging (MRI). MRI makes it possible to obtain an image of the spinal cord along its entire length in different projections. And it will be very useful in identifying disc herniation, blood clots and other masses that can compress the spinal cord.

A few days after the injury, when the swelling subsides, the doctor may perform a neurologic examination to determine the severity of the injury. It includes testing muscle strength and sensory sensitivity.

Unfortunately, the spinal cord injury cannot be completely cured.But ongoing research is providing physicians with more and more new treatments for patients that can help regenerate nerve cells and improve nerve function. At the same time, we should not forget about the work that is being carried out in the field of maintaining an active life for patients after injury, empowering and improving the quality of life of people with disabilities.

Provision of emergency medical care

Prompt first aid is critical to minimizing the consequences of any head or neck injury.Likewise, treatment for a spinal cord injury often begins at the scene.

The emergency medical team on arrival should immobilize the spine as gently and quickly as possible using a rigid cervical collar and a special stretcher to transport the victim to the hospital.

In case of spinal cord injury, the patient is taken to the intensive care unit. The patient can also be taken to the Regional Spine Injury Center, where a team of neurosurgeons, orthopedic surgeons, psychologists, nurses, therapists and social workers are always on duty.

Medicines. Methylprednisolone (Medrol) is used for acute spinal cord injury. When treated with Methylprednisolone within the first eight hours after injury, there is a chance to get a moderate improvement in the patient’s condition. This drug reduces damage to nerve cells and relieves tissue inflammation around the injury site. However, this is not a cure for the spinal cord injury itself.

Immobilization. Stabilizing the injured spine during transport is extremely important.For this, the brigade’s arsenal contains special devices for keeping the spine and neck stationary.

Surgical intervention. Often, doctors are forced to resort to operations to remove fragments of bones, foreign objects, herniated discs, or fix a fracture of the vertebrae. Surgery may also be required to stabilize the spine to prevent future pain or bone deformity.

Period of hospitalization

After the patient is stabilized and the first-priority treatment is carried out, the staff begins to work to prevent complications and related problems.This can be a deterioration in the patient’s physical condition, muscle contracture, pressure sores, bowel and bladder dysfunction, respiratory infections and blood clots.

The length of hospital stay depends on the severity of the injury and the rate of recovery. After discharge, the patient is sent to the rehabilitation department.

Rehabilitation. Patient work can begin early in the recovery phase. The team of specialists can include physiotherapists, occupational therapists, specially trained nurses, psychologist, social worker, nutritionist and supervising physician.

In the early stages of rehabilitation, doctors usually work to maintain and strengthen muscle function by using fine motor skills and teaching adaptive behaviors in daily activities. Patients receive advice on the consequences of trauma and the prevention of complications. You will be given recommendations on how you can improve the quality of life in the current conditions. Patients are taught new skills, including the use of special equipment and technologies that make it possible not to depend on outside help.Having mastered them, you can find for yourself a possibly new hobby, participate in social and sports activities, return to school or work.

Drug treatment. The patient may be prescribed medications to control the effects of a spinal cord injury. These include medicines to control pain and muscle cramps, and medicines to improve bladder, bowel, and sexual control.

New technologies. To date, modern means of transportation have been invented for people with disabilities, ensuring the full mobility of patients.For example, modern lightweight electric wheelchairs. Some of the latest models allow the patient to independently climb the stairs and raise the seated person to any desired height.

Forecast and recovery

Your doctor cannot predict the recovery of an admitted patient alone. In case of recovery, if it is possible to achieve it, it will take from 1 week to six months after the injury. For another group of patients, small improvements will come after a year of work on themselves or more time.

In the event of paralysis and subsequent disability, it is necessary to find the strength to accept the situation and start another life, adaptation to which will be difficult and frightening. A spinal cord injury will affect all aspects of life, be it daily activities, work, or relationships.

Recovery after such an event takes time, but it is up to you to choose whether you will be happy in the current situation, not the injury. Many people have gone through this and were able to find the strength to start a new full-fledged life.One of the main components of success is high-quality medical care and support of loved ones.

90,000 progamer retired with finger injury

American Thomas Paparatto, who played under the nickname ZooMaa, wrote that he would no longer be able to play due to a finger and hand injury. Paparatto competed in the shooter Call of Duty.

“My heart is broken, I quit the game to which I gave my soul, heart and eight years of my life. I have tears when I write this, but there is no other way out, ”the player admitted.

He explained that several years ago he already had problems with his finger and hand and then he needed surgery. It took Paparatto a lot of strength to recover, but now the old injury again made itself felt.

“I can no longer play without paying attention to weakness and pain. I don’t enjoy the competition when I can’t be the ZooMaa everyone knows and loves, ”he added.

Paparatto promised that he would think about other options for how he could participate in esports, as he loves Call of Duty too much to just leave the game.

The New York Subliners, for which Paparatto played in the Call of Duty League, wished him a speedy recovery.

We are thankful for everything that @ZooMaa has done for the Subliners & our entire org wishes him a speedy recovery. His incredible talent as a teammate & competitor has always made him amazing & the positivity he brings to the community is truly special. We’ll see you soon. https://t.co/P5ZIKnvE72 pic.twitter.com/Lm4xLRsEAd

– NYSL (@Subliners) January 19, 2021

Compared to the injuries that cause athletes to end their careers in more traditional sports, Paparatto’s case may seem frivolous, if not curious.But, as Futurism notes, such cases rather prove that esports is the same sport as everyone else, and has finally become mainstream.

Nurmagomedov published a photo of the injury received before the fight with Gatji

https://rsport.ria.ru/20201027/khabib-1581704149.html

Nurmagomedov published a photo of the injury received before the fight with Gatji

Nurmagomedov before the fight with Gatji – RIA Novosti Sport, 27.10.2020

Nurmagomedov published a photo of an injury received before the fight with Gaji

Winner of the Absolute Fighting Championship (UFC) lightweight champion Khabib Nurmagomedov published a photo of a toe broken in preparation for a fight with RIA Novosti Sport, 10/27/2020 2020-

10-27T10: 41

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2020-10-27T13: 10

martial arts

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MOSCOW, October 27 – RIA Novosti. UFC lightweight champion Khabib Nurmagomedov posted a photo of a toe fractured in preparation for a fight with Justin Gaethje. The Russian defeated the American by submission in the second round at UFC 254 on Saturday and defended his title. After the fight, it became known that during the last month of preparation Nurmagomedov had been ill with mumps, broke his toe and injured his foot.On Instagram stories, the UFC champion posted two photos, including an X-ray of his left ring toe from October 7, and another from October 8 shows Nurmagomedov’s foot with a swollen and blue toe. Thumb closed with emoji.After defeating Gaji, Nurmagomedov announced the end of his sports career.

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Knott’s disease (stenosing ligamentitis)

Stenosing ligamentitis (Knott’s disease or “clicking” finger) is a disease of the hand that is characterized by the typical “snapping” of the finger or fingers at maximum flexion into a fist, restriction of movement, pain at the base of the fingers upon pressure, morning stiffness in the hand.Often occurs against the background of systemic diseases – diabetes mellitus, gout, rheumatoid arthritis.

Typical signs of stenosing ligamentitis:

  • Characteristic clicking sensation when the finger or fingers are extended
  • Pain at the base of the finger on pressure
  • The presence of a dense, rounded formation at the base of the toe
  • feeling of stiffness, difficulty in flexing or extending the fingers, mainly in the morning

There are 4 degrees of the disease:

1 – pain, periodic snapping

2 – visible snaps of the finger, the finger unbends on its own

3 – visible snaps, you can straighten your finger only with the second hand

4 – it is impossible to straighten the finger even with the second hand

Treatment

Depending on the degree of the disease, various methods of treatment are used.

At 1-2 degrees, a blockade with hormonal anti-inflammatory drugs is performed, and physiotherapeutic treatment is also prescribed.

With the ineffectiveness of the blockade, as well as with 3-4 degrees of the disease, surgical intervention is recommended – dissection of the A1 ligament at the base of the finger. This operation can be performed in two ways: openly, with a small skin incision, stitches and further dressings, or minimally invasive, through small skin punctures with a needle, without stitches and dressings.

What is needed for treatment in one visit?

Thanks to modern information technologies, it is quite possible to solve many problems in one visit. To do this, you only need to answer questions and send photographs of hands to [email protected] Our specialists will study the information received and draw up an individual treatment plan.

It is desirable to indicate in the letter:

  1. Full name and year of birth
  2. Contact phone number and city of residence
  3. Do you have tight subcutaneous bands or deep folds on your palm and fingers?
  4. Do you experience clicking or snapping your finger or fingers when extending?
  5. Do your fingers go numb (do you wake up feeling that your hand is lying down?)
  6. Can you forcefully extend your finger or fingers with your other hand?
  7. Do you have problems with your arm after your injury?
  8. Have you been operated on before? If so, where and when (it is advisable to send a copy of the discharge summary after the operation, and mark the postoperative scar on the photo of the hand with a marker)
  9. Attach a photo of the hand (top view, side view), it is advisable to indicate problem areas on the hand with a marker or pen
  10. Do you have any chronic diseases – rheumatoid arthritis, gout, diabetes mellitus, etc.