Common Hand Injuries in Ball Sports
Injuries of the hand and finger are common in ball sports. They could be prevented with protective gear but such equipment isn't used because it limits dexterity. The most common finger injuries are the topic of this article. Mallet finger, Jersey finger, Boutonnière deformity, Boxer's fracture, and Gamekeeper's thumb are presented. Ligament and fractures of the fingers as well as finger dislocations are also discussed.

History, clinical exam, and test procedures for each type of injury are provided. Conservative (nonoperative) care may be okay for some injuries. Others require immediate surgery for the best result. When to order X-rays and what to look for in each type of injury is outlined.

Traumatic injuries of the fingers are usually fairly easy to identify. For example, mallet finger (also known as baseball finger) results in the tip of the finger remaining in a permanently flexed position without treatment. A splint may be all that's needed but surgery is advised if loss of movement persists after six months.

For more difficult to diagnose injuries, such as Jersey finger, special tests and X-rays help the physician rule out fractures and identify the true problem. Jersey finger is named as such because it occurs when a player (usually a football player) grabs another player's jersey. The bent finger gets pulled into extension. In the process, one of the flexor tendons to the finger is torn.

A Boutonnière deformity occurs from the same mechanism as the mallet finger but affects the middle joint of the finger (instead of the tip). The finger was extended at the time of the injury and gets forced into flexion. Painful swelling and an inability to straighten the finger are typical signs of a Boutonnière deformity. Splinting and hand therapy are usually prescribed.

Some injuries, such as the Gamekeeper's thumb can occur with any sport. The athlete falls onto the hand with enough force to tear the ulnar collateral ligament (UCL). X-rays provide information needed to guide the treatment plan. For instance, a splint to immobilize the thumb may be all that's required. This is true if the UCL is torn but there's no fracture. A rehab program starts about six to eight weeks after immobilization.

Punching someone or something with enough force to fracture the knuckle is called a Boxer's fracture. Splinting is required for four to six weeks followed by an aggressive rehab program. Flexibility and strength may be regained but the knuckle may not ever look normal again.

Many of these types of hand and finger injuries are misdiagnosed at first. Delay (or wrong) treatment applied can affect a ball player's abilities. Early diagnosis and treatment is always advised.

Regaining motion and strength are important in the dexterity needed for ball sports. Healing of the soft tissues or bone usually takes six to eight weeks. An equal amount of time may be required to complete the rehab program and return to full participation in sports.
Deepak Patel, MD, and Christopher B. Ranney, MD. Managing Hand and Finger Injuries in Ball Sports. In The Journal of Musculoskeletal Medicine. April 2008. Vol. 25. No. 4. Pp. 198-204.