Finger, Hand, and Wrist Injuries

Topic Overview

At one time or another, everyone has had a minor injury to a finger, hand, or wrist that caused pain or swelling. Most of the time our body movements do not cause problems, but it's not surprising that symptoms develop from everyday wear and tear, overuse, or an injury.

Finger, hand, or wrist injuries most commonly occur during:

• Sports or recreational activities.
• Work-related tasks.
• Work or projects around the home, especially if using machinery such as lawn mowers, snow blowers, or hand tools.
• Accidental falls.
• Fistfights.

The risk of finger, hand, or wrist injury is higher in contact sports, such as wrestling, football, or soccer, and in high-speed sports, such as biking, in-line skating, skiing, snowboarding, and skateboarding. Sports that require weight-bearing on the hands and arms, such as gymnastics, can increase the risk for injury. Sports that use hand equipment such as ski poles, hockey or lacrosse sticks, or racquets also increase the risk of injury.

In children, most finger, hand, or wrist injuries occur during sports or play or from accidental falls. Any injury occurring at the end of a long bone near a joint may injure the growth plate (physis) and needs to be evaluated.

Older adults are at higher risk for injuries and fractures because they lose muscle mass and bone strength (osteopenia) as they age. They also have more problems with vision and balance, which increases their risk of accidental injury.

Most minor injuries will heal on their own, and home treatment is usually all that is needed to relieve symptoms and promote healing.

Sudden (acute) injury

An acute injury may occur from a direct blow, a penetrating injury, a fall, or from twisting, jerking, jamming, or bending a limb abnormally. Pain may be sudden and severe. Bruising and swelling may develop soon after the injury. Acute injuries include:

• Bruises. After a wrist or hand injury, bruising may extend to the fingers from the effects of gravity. See an illustration of a bruise (contusion) .
• Injuries to ligaments. See an illustration of a torn thumb ligament as in skier's thumb.
• Injuries to tendons, such as mallet finger.
• Injuries to joints (sprains).
• Pulled muscles (strains).
• Broken bones (fractures), such as a wrist fracture .
• Dislocations.
• Crushing injury, which can lead to compartment syndrome.

Overuse injuries

Overuse injuries occur when too much stress is placed on a joint or other tissue, often by "overdoing" an activity or repeating the same activity. Overuse injuries include the following:

• Carpal tunnel syndrome is caused by pressure on a nerve (median nerve ) in the wrist. The symptoms include tingling, numbness, weakness, or pain of the fingers and hand. See an illustration of carpal tunnel syndrome .
• Tendon pain is actually a symptom of tendinosis, a series of very small tears (micro tears) in the tissue in or around the tendon. In addition to pain and tenderness, common symptoms of tendon injury include decreased strength and movement in the affected area.
• De Quervain's disease can occur in the hand and wrist when tendons and the tendon covering (sheath) on the thumb side of the wrist swell and become inflamed. See an illustration of de Quervain's disease .

Treatment

Treatment for a finger, hand, or wrist injury may include first aid measures; medication; "buddy-taping" for support; application of a brace, splint, or cast, physical therapy; and in some cases, surgery. Treatment depends on:

• The location, type, and severity of the injury.
• How long ago the injury occurred.
• Your age, health condition, and activities (such as work, sports, or hobbies).

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

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Author:	Susan Van Houten, RN, BSN, MBA	Last Updated: February 14, 2007
Medical Review:	Martin Gabica, MD - Family Medicine William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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