1. Injuries to the Wrist, Hand, and Fingers

2. Anatomy- Wrist Anatomy of the wrist is very complex Movements
8 small bones
Muscles/tendons
Ligaments
Nerves/arteries/veins
Retinaculum
Movements
Flexion/extension
Ulnar deviation/radial deviation
Pronation/supination

3. Injuries to the Wrist
Injuries to the wrist are fairly common in all sports
A variety of injuries can happen to this area
Most common MOI is forced extension
Injuries to this area are hard to diagnose

4. Forearm Fractures Very common MOI Signs and Symptoms Treatment
Falling on an outstretched hand
Direct trauma
Signs and Symptoms
Popping/snapping sound
Pain that is made worse with movement
Unable or unwilling to move wrist
Obvious/palpable deformity
Treatment
Splint and send for imaging
RICE
Be sure to monitor vital signs

5. Wrist Fractures- Scaphoid
Common in all sports
MOI
FOOSH
Signs and symptoms
May present as a bad sprain
Pain/swelling in anatomical snuffbox
Treatment
Imaging will be necessary
Immobilization
If not treated properly, complications will arise

6. Wrist Sprains Very hard to determine exact ligament that is damaged
MOI
Usually forced extension but can happen in any direction
Signs and symptoms
Pain in a specific area or with specific movement
Laxity when joint is tested
Swelling and discoloration
Treatment
RICE
Limited painful activity
Rehab exercises to build strength
A brace may be necessary

7. Triangular Fibrocartilage Complex (TFCC)
TFCC is a fibrous and cartilaginous structure
Major ligamentous stabilizers
MOI
Violent twist of the wrist
FOOSH
Signs and Symptoms
Not reported immediately
Pain on ulnar side
Pain with extension
Treatment
Immobilized for 4 weeks
Surgery if conservative treatment fails

8. Nerve Injuries to the Wrist
Major nerves of the wrist include the radial, ulnar and median
Most common nerve injured is median
Signs and symptoms
Pain, numbness, weakness
Symptoms will be worse with extreme flexion/extension
Treatment
Suspected nerve problems should be referred to a physician
Surgery is sometimes necessary to fully correct the problem

9. Unique Injuries to the Wrist
Ganglion cyst
Herniation of the synovium surrounding the tendons
Herniated tissue will fill with synovial fluid and produce a bump
Exact cause is unknown but chronic strain of extensor tendons is main idea
Signs and symptoms
Obvious bump on dorsal side of wrist
Painful at first but pain may go away and only be present at certain times
Treatment
Treatment will depend on size and impairment
Surgery or draining
Bible cyst?

10. Anatomy- Hand Very complex 19 bones Muscles Ligaments 5 metacarpals
14 phalanges
Muscles
Ligaments

11. Injuries to the Hand and Fingers
Injuries to this area are very common in all sports
Only a few sports offer protection
A variety of injuries are possible
Vary in severity as well
Fingers are very susceptible to injury
Imaging is usually necessary to diagnose
Rehabilitation can be very complicated and usually requires a specialist

12. Hand- Boxer’s Fracture
Fracture to the 4th or 5th metacarpal
MOI
Blow to hand in clenched position
Signs and Symptoms
Pain and swelling
Deformity and discoloration
Unable to make a fist
Treatment
RICE
Refer for imaging
Cast or splint until fracture heals
After cast is removed rehab may be necessary to restore strength

13. Gamekeeper’s Thumb
Injury to the metacarpophalangeal joint in the thumb
Sprain- ulnar (medial) collateral ligament
Possible avulsion fracture (30%)
MOI
Extreme abduction of the thumb
Signs and symptoms
Pain/discoloration
Swelling
Laxity
Treatment
Refer to physician for evaluation and imaging
Cast
Surgery may be necessary depending on severity of injury

14. Finger Injuries- Mallet Finger
Injury to the distal phalanx of the index or middle finger
Involves an avulsion of the extensor tendon from the distal interphalangeal joint
MOI
Blow to tip of finger when it is extending
Signs and symptoms
Pain/discoloration/swelling
Deformity
Unable to extend the tip of finger
Treatment
Splint finger in full extension
Possible surgery

15. Finger Injuries- Jersey Finger
Injury to the distal phalanx of the index or middle finger
Avulsion of the flexor tendon at the distal interphalangeal joint
MOI
Pulling of the tip of finger when in a flex position
Signs and symptoms
Pain/discoloration/swelling
Deformity
Unable to flex the tip of finger
Treatment
Surgery is usually necessary
Rehab program after surgery

16. Finger Fractures Quite common in sports
Can be a lot more severe than they present
Surgery may be necessary to prevent loss of function