Summary
Sports-related injuries to the intricate small joints of the hand are quite frequent. The majority of such injuries result in joint contusions, partial tears or ligament sprains which do not jeopardise the basic stability of the joint and readily respond to a short course of protective splinting with rapid recovery of motion, strength and function. In fact, many patients never seek medical attention unless persisting pain, chronic swelling or restriction of motion persuade them to do so.
Partial tears or sprains need to be distinguished from more serious injuries that cause profound ligamentous and capsular disruption resulting in dislocations, articular incongruency, joint instability or fracture-dislocations. While simple dislocations are readily reducible and generally stable, a complex dislocation by definition implies irreducibility by closed means. This category of complex joint injury requires prompt diagnosis, as optimal management warrants active surgical intervention to achieve a stable and congruous reduction. Following surgical repairs the injured joint is immobilised for a variable length of time, determined by the type, extent and the nature of the specific injury, prior to initiating remobilisation efforts. A supervised and well-executed rehabilitation programme should encompass all the various modalities of physical therapy that are effective in increasing mobility, correcting deformity and restoring strength and function to the injured hand. The ultimate goal of treatment is to enable the athlete to resume sports, unimpaired with the same skill, dexterity and competitive edge as before.
Similar content being viewed by others
References
Eaton KG. Joint injuries of the hand, Charles C. Thomas, Springfield, Ill., 1971
Eaton RG, Mallerich MM. Volar plate arthroplasty for the proximal interphalangeal joint: a ten year review. Journal of Hand Surgery 5: 260, 1980
Green DP, Terry GC. Complex dislocation of the metacarpophalangeal joint. Journal of Bone and Joint Surgery 55A: 1480, 1973
Kaplan EB. Dorsal dislocation of the metacarpophalangeal joint of the index finger. Journal of Bone Joint Surgery 39A; 1081, 1957
McCue MF, Honner R, Johnson Jr MC, et al. Athletic injuries of the proximal interphalangeal joint requiring surgical treatment. Journal of Bone and Joint Surgery 52A: 937, 1970
Melone Jr CP. Complex joint injuries of the hand. AAOS Symposium on Upper Extremity Injuries in Athletes, St. Louis, pp. 142–169, C.V. Mosby, 1986
Peimier CA, Sullivan DJ, Wild DR. Palmar dislocation of the proximal interphalangeal joint. Journal of Bone Joint Surgery 9A: 39–48, 1984
Redler I, Williams JT. Rupture of a collateral ligament of the proximal interphalangeal joint of the finger analysis of 18 cases. Journal of Bone Joint Surgery 49A: 332, 1967
Spinner M, Choi BY. Anterior dislocation of the proximal interphalangeal joint: a cause of rupture of the central slip of the extensor mechanism. Journal of Bone Joint Surgery 52A: 1329, 1970
Stener B. Displacement of the ruptured ulnar collateral ligament of the metacarpophalangeal joint of the thumb: a clinical and anatomical study. Journal of Bone Joint Surgery 44B: 869, 1962
Wagner CJ. Method of treatment of Bennett’s fracture dislocation. American Journal of Surgery 80: 230, 1950
Wilson JN, Rowlands SA. Fracture-dislocation of the proximal interphalangeal joint of the finger: treatment by open reduction and internal fixation. Journal of Bone Joint Surgery 48A: 493, 1966
Zemel N, Stark HH, Ashworth CR. Chronic fracture dislocation of the proximal interphalangeal joint: treatment by osteotomy and bone graft. Journal of Hand Surgery 6: 447–455, 1981
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Isani, A. Prevention and Treatment of Ligamentous Sports Injuries to the Hand. Sports Medicine 9, 48–61 (1990). https://doi.org/10.2165/00007256-199009010-00005
Published:
Issue Date:
DOI: https://doi.org/10.2165/00007256-199009010-00005