Treating Hand and Wrist Injuries in Athletes: The Player Comes First
Athletes injure their hands and wrists in many different ways. They jam fingers, dislocate thumbs, tear ligaments, sprain joints, break bones, and more. Treatment for an athlete may be very different from treatment for a nonathlete. The "wait and see" approach sometimes used for nonathletes just won't work for someone in competitive sports.

Everything about the diagnosis, treatment, and return to activity (sport) is more intense for the athlete. Suddenly, it's not enough to identify a sprain. The degree of sprain and any other injuries must also be identified. This means more imaging studies, such as bone scans or magnetic resonance imaging (MRI). Additional X-rays may be required. Even minor injuries in athletes must be examined carefully to prevent problems later on.

Decisions about protecting the injury must be made. What's better for the player, taping the joint or using a splint? The sport and position played must be considered. For example, a football player with a cast on the thumb could return as a lineman, but not as a quarterback or receiver. And each sport has its own regulations for protective equipment on the field. It's necessary to protect the injured athlete without hurting other players.

Decisions about surgery must also be made. Sometimes surgery can be put off until after the season. Other times, waiting too long can mean a permanent injury or more extensive surgery later. Athletes whose bones are still growing must be given special care. Scholarship status and other financial concerns get thrown into the mix and affect how decisions are made.

Physicians treating competitive athletes are faced with many difficult decisions when planning the best treatment. The physician must plan the athlete's return to sport carefully. Parents, team owners, agents, coaches, and even the athletes themselves put pressure on the physician to make choices that may not be in the player's best interests.

The physician makes decisions based on a careful diagnosis. He or she must also understand the sport and the individual player's needs. What's best for the individual player and his or her future well-being are paramount. A safe return to competition is the final goal.
William J. Morgan, MD, and Lisa Schulz Slowman, OTR/L, CHT. Acute Hand and Wrist Injuries in Athletes: Evaluation and Management. In Journal of the American Academy of Orthopaedic Surgeons. November/December 2001. Vol. 9. No. 6. Pp. 389-400.