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Hand injuries cause swelling, pain, stiffness, and sometimes limited movement. The most common injuries are tears (ruptures) of ligaments or fractures of bone. When a ligament is ruptured, bones can move out of position, resulting in a dislocated joint.
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Common Hand Injuries
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Gamekeeper's thumb is a rupture of the ligament on the palm side of the thumb, which is responsible for pinching movements. It usually results from a fall that jams the thumb backward onto a hard surface. This injury is so named because it used to be an occupational hazard of gamekeepers in England who broke the necks of rabbits with their hands. Treatment usually consists of a splint, but surgery is sometimes necessary.
Rupture of the scapholunate ligament may result from falling on an outstretched hand. Pain is felt mostly on top of the wrist. Treatment consists of surgical repair of the ligament and pinning of the bones.
Scaphoid fractures are a common type of wrist fracture. Tenderness is felt in the wrist below the thumb. Untreated scaphoid fractures often do not heal, eventually leading to arthritis of the wrist. Treatment consists of a cast or surgery. The bone may take 3 to 4 months to heal.
Dislocations may occur at the joint at the base of the thumb or other fingers or at the middle joints of the fingers. Dislocations usually result when the thumb is bent too far out or the fingers are bent too far back. Surgery is often required to correct dislocations at the base of the thumb or fingers. Dislocations of the middle joints may be treated by taping the dislocated finger to an adjacent finger. It the ligament is badly torn, a splint is used, usually for 3 weeks.
Fractures of the hook of hamate may result from striking the ground with a stick or making a divot playing golf. The lower part of the palm below the little finger is tender. The hand is put in a cast for 4 to 6 weeks, but the fracture may not fully heal. If an unhealed fracture causes pain, weakness, or numbness of the little finger, surgery to remove the unattached part of the bone may be necessary.
See Fractures: Hand for a discussion of other hand injuries.
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Sometimes doctors can diagnose a hand injury by examining the hand. A local anesthetic may be given before the examination, which otherwise might be too painful. However, x-rays may be needed to determine whether the joint is unstable and to detect fractures. Occasionally, computed tomography (CT) or magnetic resonance imaging (MRI) is needed. Often, an untreated injury can result in a permanent deformity of the hand. Therefore, an injured hand should be immobilized so that it can heal normally. A bandage, splint, or cast may be used, depending on the injury. Surgery is sometimes necessary if bones are out of position or a joint is unstable. Hand exercises are begun as soon as possible to prevent loss of function.
Last full review/revision March 2008 by David R. Steinberg, MD
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