Sports-related wrist and hand injuries: a review

Abstract

Background: Hand and wrist injuries are common during athletics and can have a significant impact especially if initially disregarded. Due to their high level of physical demand, athletes represent a unique subset of the population.

Main body: The following is an overview of hand and wrist injuries commonly seen in athletics. Information regarding evaluation, diagnosis, conservative measures, and surgical treatment are provided.

Conclusion: Knowledge of these entities and special consideration for the athlete can help the team physician effectively treat these players and help them achieve their goals.

Keywords: Fracture; Hand injuries; Ligament; Return to play; Sports; Surgical treatment; Wrist injuries.

Fig. 1

a PA radiograph of a nondisplaced proximal pole scaphoid fracture in a recreational hockey player. b PA radiograph of a nondisplaced scaphoid waist fracture in a high school soccer player treated with headless compression screw fixation

Fig. 2

a PA radiograph showing a flexed scaphoid (signet ring sign). b Intraoperative finding of a complete SL interosseous ligament tear with the tip of the probe on the scaphoid (yellow arrow). c Open reduction of the SL interval (blue arrow) prior to ligament repair

Fig. 3

a Intraoperative finding of a volarly subluxed ECU tendon (between yellow lines) in a recreational tennis player. b The ECU tendon back in its reduced position (red lines) after an anatomic repair of the subsheath

Fig. 4

a PA radiograph of a patient with ulnar abutment revealing both 6 mm of ulnar-positive variance and incidentally an ulnar styloid nonunion. b Neutral to −1 mm of ulnar variance after a diaphyseal ulnar shortening osteotomy is performed

Fig. 5

a A T2-weighted coronal sequence of a wrist MRI revealing an ulnar-sided peripheral tear of the TFCC (yellow arrow). b Arthroscopy view from the three to four portal showing the peripheral tear (red arrow). c Intraoperative arthrosopic image during an arthroscopic-assisted outside-in repair using PDS suture (blue arrow)

Fig. 6

Axial CT image demonstrating a hook of the hamate fracture (red arrow) in a college hockey player

Fig. 7

a Preoperative photograph demonstrating a patient with no endpoint to valgus stress testing of the thumb MCP joint. b A T2-weighted coronal sequence demonstrating a complete tear of the UCL which is detached from the proximal phalanx (yellow arrow)

Fig. 8

a Intraoperative and b fluoroscopic images of a long oblique metacarpal shaft fracture secured with three lag screws. c Intraoperative and d fluoroscopic images of a transverse shaft fracture secured with a plate and screws

Fig. 9

Plate and screw fixation of an angulated fifth metacarpal neck fracture in a high school running back

Fig. 10

A PA radiograph of a small finger transverse proximal phalanx fracture with clinical malrotation which was treated with closed reduction and crossed K-wires

Fig. 11

Lateral radiograph of a dorsal fracture dislocation of the PIP joint with 50 % articular involvement of the middle phalanx

Fig. 12

a Intraoperative findings of a patient with a torn radial sagittal band and ulnarly subluxed EDC tendon before repair b and after repair

Fig. 13

Lateral radiograph of a ring finger of a patient whose finger got caught on a basketball net showing an FDP bony avulsion fracture with the fragment caught up distal to the A4 pulley level (yellow arrow)

Fig. 14

Lateral radiograph of a mallet finger with a bony avulsion fragment (red arrow)