FINGER SPRAIN |
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General Information
DEFINITION--Violent overstretching of one or more ligaments that hold the finger joints together. Sprains involving two or more ligaments cause considerably more disability than single-ligament sprains. When the ligament is overstretched, it becomes tense and gives way at its weakest point, either where it attaches to bone or within the ligament itself. There are 3 types of sprains:
Mild (Grade I)--Tearing of some ligament fibers. There is no loss of function.
Moderate (Grade II)--Rupture of a portion of the ligament, resulting in some loss of function.
Severe (Grade III)--Complete rupture of the ligament or complete separation of ligament from bone. There is total loss of function. A severe sprain requires surgical repair.
BODY PARTS INVOLVED
Ligaments holding the joints of the fingers together.
Tissue surrounding the sprain, including blood vessels, tendons, bone, periosteum (covering of bone) and muscles.
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SIGNS & SYMPTOMS
Severe pain at the time of injury.
A feeling of popping or tearing inside a finger or fingers.
Tenderness at the injury site.
Swelling in the finger.
Bruising that appears soon after injury.
CAUSESStress on a ligament that temporarily forces or pries finger joints out of their normal location. Finger sprains occur frequently in football, baseball, basketball and other exercise or sports activities.
RISK INCREASES WITH
Contact sports, especially "catching" and "throwing" sports.
Previous hand injury.
Poor muscle conditioning.
Inadequate protection from equipment.
HOW TO PREVENTTape vulnerable joints before practice or competition.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's diagnosis.
Application of a splint, tape or elastic bandage.
Self-care during rehabilitation.
Physical therapy (moderate or severe sprain).
Surgery (severe sprain).
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and exam by a doctor.
X-rays of the hand and wrist to rule out fractures.
POSSIBLE COMPLICATIONS
Prolonged healing time if usual activities are resumed too soon.
Proneness to repeated finger injury.
Inflammation at the ligament attachment to bone (periostitis).
Prolonged disability (sometimes).
Unstable or arthritic finger following repeated injury.
PROBABLE OUTCOMEIf this is a first-time injury, proper care and sufficient healing time before resuming activity should prevent permanent disability. Ligaments have a poor blood supply, and torn ligaments require as much healing time as fractures. Average healing times are:
Mild sprains--2 to 6 weeks.
Moderate sprains--6 to 8 weeks.
Severe sprains--8 to 10 weeks.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDUse instructions for R.I.C.E., the first letters of REST, ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.
CONTINUING CAREIf the doctor does not apply a splint, tape or elastic bandage:
Continue using an ice pack 3 or 4 times a day. Put ice chips or cubes in a plastic bag. Wrap the bag in a moist towel, and place it over the injured area. Use for 20 minutes at a time.
After 72 hours, apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments.
Take whirlpool treatments, if available.
Massage gently and often to provide comfort and decrease swelling.
MEDICATION
For minor discomfort, you may use:
Aspirin, acetaminophen or ibuprofen.
Topical liniments and ointments.
Your doctor may prescribe:
Stronger pain relievers.
Injection of a long-acting local anesthetic to reduce pain.
Injection of a corticosteroid such as triamcinolone to reduce inflammation.
ACTIVITYResume your normal activities gradually after clearance from your doctor.
DIETDuring recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs.
REHABILITATION
Begin daily rehabilitation exercises when the splint or supportive wrapping is no longer necessary.
Use ice soaks 3 or 4 times a day. Fill a bucket with ice water, and soak the injured area for 20 minutes at a time.
See Hand exercises.
CALL YOUR DOCTOR lF
You have symptoms of a moderate or severe finger sprain, or a mild sprain persists longer than 2 weeks.
Pain, swelling or bruising worsens despite treatment.
Any of the following occur after splinting:
Pain, numbness or coldness in the finger.
Blue, gray or dusky fingernail.
Any of the following occur after surgery:
Increased pain, swelling, redness, drainage or bleeding in the surgical area.
Signs of infection (headache, muscle aches, dizziness, or a general ill feeling with fever).
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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