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Friday, September 5, 2008
Health
St. Paul, MN
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By: Nicholas J. Meyer, MD
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Keeping your Fingers in the Game: How to Protect your Valuable Digits
Fingers are the most commonly injured body parts in sports. While many of these injuries go on to uneventful healing, they can result in significant time away from sports and other activities because of pain, swelling and stiffness. With some appropriate knowledge of the fingers and how to best protect or treat them, we can hopefully guide you through another season while avoiding injury to your valuable digits.
Finger injuries most commonly occur while playing sports that involve catching, deflecting or blocking a fast-moving ball such as a basketball, volleyball, baseball and football. The most common finger injuries are sprains, dislocations, tendon ruptures and fractures.
Sprains
Collateral ligaments are the band-like structures on either side of the finger joint that stabilize and prevent the joint from bending side-to-side. A finger sprain, which usually involves the middle joint, occurs when a collateral ligament is completely or partially torn. The sprain can be categorized into three different “Grades” of severity with Grade 1 being a stretched ligament, Grade 2 a partially torn ligament and Grade 3 a completely torn ligament.
Buddy taping the injured finger to the adjacent uninjured finger can usually treat these injuries. The healthy finger acts as a protective splint and helps control the injured finger’s range of motion. Buddy taping is also a good way to prevent injuries, especially when playing volleyball, basketball and football.
Dislocations
A finger dislocation results when a Grade 3 ligament sprain occurs and the bones are displaced so that the joint surfaces are no longer in contact with each other. This usually requires a manipulative procedure to bring the joint back into alignment, although it will sometimes realign itself spontaneously. X-rays are taken to assure that there are no additional injuries such as a fracture. Once realigned, these injuries are often fairly stable and can be treated in a similar way to sprains (as described above).
Tendon ruptures
A tendon rupture most commonly results when the finger is forcefully straightened while the person is attempting to flex the finger or grab something. This is often referred to as a “Jersey Finger” as it commonly occurs in football when a defender is attempting to tackle an opponent. Player 1’s fingers are grasping the jersey, but Player 2 forcefully pulls away. This results in an inability to actively flex the last joint (the “DIP joint”) of the finger and should be treated promptly (surgically) for optimal results. If it is not repaired, this can result in a chronic inability to flex the last joint of the finger.
Fractures
Finger bone fractures can often mimic dislocations and sprains. Fractures, dislocations and sprains usually occur the same way and all result in significant swelling and pain. The only way to conclusively determine if a fracture has occurred is to seek medical attention and obtain an x-ray. Once diagnosed, finger fractures may be treated with simple buddy taping, splinting, casting or surgery depending on the fracture pattern.
How do you avoid finger injuries?
While some injuries are unavoidable, you can minimize the risk to your digits by minimizing their “exposure”. Here are a few techniques to consider:
1. Buddy tape digits at risk. Most commonly, the ring and small fingers are taped together while the index and middle fingers are taped together.
2. Avoid blocking balls (such as a volleyball) with an open hand - use a fist instead.
3. As a reminder to keep your hand closed, hold something in your hand. Ever wonder why you see baseball players holding their batting gloves while running the bases? This is often to prevent injury to the fingers when sliding into the base or opponent.
*Disclaimer: The information should NOT be used in place of visits with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
BIO:
Dr. Meyer joined St. Croix Orthopaedics in 2003. He completed his orthopaedic surgery residency at the Medical College of Wisconsin and received fellowship training in hand and microvascular surgery at the University of Minnesota. Dr. Meyers is board certified and is a member of the American Academy of Orthopaedic Surgeons. He holds a Certificate of Added Qualification in Hand Surgery and is a member of the American Society for Surgery of the Hand.
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