Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Houston Methodist Orthopedics & Sports Medicine

Common Injuries - Hand/Wrist

Skier's Thumb (ulnar collateral ligament tear)

An ulnar collateral ligament tear is an injury to a ligament in the area where the thumb meets the hand. This type of tear can result if one falls and lands directly upon one’s hand or wrist, since the impact can push the thumb back and causes the joint to separate. Damage to this ligament can also occur through overuse or injury if the ulnar collateral ligament is stretched too far. Swollen joints and pain are common signs of ulnar collateral ligament damage. Athletes may have difficulty gripping a ball or holding other objects.
Partial tears can be treated with a thumb splint, but ruptured (severely torn) ligaments may require surgery. The procedure will require only a small incision and a few stitches to reattach the ligament to the bone.

Scaphoid Fracture

The scaphoid bone, located between the thumb and the wrist, can fracture due to a fall or other strong impact to the hand. The damage can even affect the arm bone if the fall is hard enough, especially in high-impact sports like football, basketball and baseball, where the risk of injury is high.
The most common symptoms of a scaphoid fracture are visible swelling and tenderness near the thumb. These symptoms can be mistaken for a less severe injury, but if bruising, pain and tenderness persist, it is highly likely that you have fractured the bone. In most cases, a cast will be the only treatment required, but severe fractures may require surgery.

Distal Radius Fracture

A distal radius fracture is a break in the radius bone, the more fragile of the two bones within the forearm. The radius bone is commonly injured after a fall upon an outstretched hand. Typical symptoms of a distal radius fracture will be tenderness, swelling and pain in the wrist, along with a feeling of looseness.
Distal radius fractures, like other fractures, will usually heal with the use of a cast. If the injury is more severe, the bone may need to be realigned with surgery using a metal pin or plate to keep the bone in place. After surgery, physical therapy may also be used to strengthen the arm and restore mobility.

Baseball Finger (Mallet Finger)

Each finger has a small tendon, known as the extensor tendon, which prevents the tip of the finger from bending past a 45-degree angle. Injuries to this tendon usually occur during contact sports - such as basketball and football - when the finger is jammed or stretched too far back, causing the tendon to tear or snap.
Common symptoms of baseball finger are pain, swelling and minor bruising near the tendon, along with an inability to straighten the finger. Most cases will heal through the use of a splint, but surgery may be necessary to repair a full tear.

Carpal Avascular Necrosis

Avascular necrosis, or bone death, is a condition caused by a lack of blood supply to the bones. Avascular necrosis can develop in any bone in the body, due to injury or trauma that damages blood vessels in the area. Bone death is usually associated with patients who already have arthritis, since this condition has a weakening effect upon the joints. Blood supply to the bones can be reestablished using microsurgery.

Flexor/Extensor Tendon Injuries

The flexor tendons are found just above the wrist where the forearm begins, and are responsible for moving the thumb and fingers. These tendons are extremely sensitive, and even a minor injury - such as a deep cut on the hand - could tear or disconnect a tendon. Patients who have had injuries to these tendons are not able to move their thumbs and fingers on their own.
Tendons are able to re-grow only if they are not fully torn. A slight tear in a flexor tendon has a greater chance of healing than a tendon that has completely been cut in half. Therefore, if a deep wound has been sustained and the flexor tendon is separated, surgery is needed to stitch the two pieces together before the body can begin to re-grow the tendon cells.
Extensor tendons are also found in the hand, but control the movements of the fingers themselves, such as bending and straightening. They are located on the inside of the fingers. Injuries to the extensor tendons are easier to sustain because they are located just below the surface of the skin, meaning that even a relatively minor cut or injury can damage these tendons. Treatment will be similar to that of a flexor tendon injury.

Proximal Interphalangeal (PIP) Joint Injury

The proximal interphalageal (PIP) joints of the fingers are between the distal interphalangeal (DIP) joints – which are closest to the fingertips – and the metacarpophalangeal joints (at the bottom of the fingers). PIP joints can become dislocated, or can completely break if the finger is jammed hard enough. The ligament near the joint may also tear.

If the injury has caused the joint to become dislocated, or if the bone has sustained a fracture, the doctor will use a tight bandage to reduce the amount of swelling on the finger, and a splint to keep the bone in place while it heals. If the injury has completely severed the ligament, a surgeon may first have to reattach it.