SPORTS INJURIES OF HAND

& WRIST
Approximately 25 % of all sports-related injuries
involve the hand or wrist
High school & collegiate athletes
General population
RADIAL SIDED WRIST INJURIES
SCAPHOID FRACTURE
 Most commonly injured
 Female > Male

MOI
 HYPEREXTENDED + PRONATED + RADIALLY DEVIATED
SIGNS & SYMPTOMS
Located at the radial side of the carpus,
athletes will complain of
 Radial-sided wrist pain
 Exquisite tenderness in the anatomical snuff box
 Axial loading of the thumb
 Pincer grasp
RADIOGRAPHIC ASSESSMENT
 Include a postero-anterior (PA), lateral, and ulnar deviated
view
 Subtle line
 Difficult to locate un-displaced fracture due to irregular
contour of scaphoid bone
 CT
 MRI
REHABILITATION
PROTOCOL
REHABILITATION
PROTOCOL
CARE & CURE PHYSICAL THERAPY CLINIC
MALLET FINGER DEFORMITY
 TRAUMATIC DISRUPTION OF THE TERMINAL TENDON
Avulsion of the extensor tendon from its distal insertion at the dorsum of DIP joint.
One of the most common hand injuries sustained by the athletic population
Mallet finger of bony origin
Mallet finger of tendinous origin
Hallmark finding
 Flexed or dropped posture of the DIP joint
 Inability to actively extend or straighten the DIP joint
 Extensor Lag

Mechanism of Injury
 Forced flexion of the fingertip often from the impact of a thrown ball.
Common in the BASEBALL CATCHER and the FOOTBALL RECEIVER

The initial injury usually results from the delivery of a longitudinal force to the tip of

the finger, which produces a sudden acute flexion force and a subsequent rupture of

the extensor tendon just proximal to its insertion into the third phalanx or a fracture at

the base of the distal phalanx

TREATMENT
FACTORS CONTRIBUTING TO POOR PROGNOSIS ( Abound & Brown 1968)
1. Age > 60 years

2. Delay in treatment > 4 weeks

3. Initial Extensor lag > 50˚

4. Too short a period of immobilization < 4 weeks

5. Short , stubby fingers

6. Peripheral Vascular Disease / arthritis

 TENDINOUS ORIGIN

Continuous extension splinting of DIP joint leaving PIP free.

for 6- 10 weeks

SPLINTS
 Stack Splint

 Perforated thermoplastic Splint

 Aluminum Foam Splint

If no Ext. lag exists at 6 weeks Night splinting for 3 weeks /

splinting during sports for additional 6 weeks.

Active ROM of MCP and PIP

Tenodermodesis
 Young patients
 edges of the tendon coapt
 Kirschner wire

3–5 Days
 Remove the postoperative splint and
fit the DIP joint with an extension
Splint
 PIP joint exercises are begun to maintain full PIP joint motion

5 Weeks
 remove k-wires
 begin active DIP motion with interval splinting