Finger and hand injuries

Fractures and Injuries of the Hand and Wrist

  • Gait Foot Fracture and Misdiagnosis

    • Commonly missed injury.

    • Important to consider special X-ray views if initial results are inconclusive.

    • Referral recommended if symptoms persist despite initial treatment.

  • Clinical Acknowledgment of Missed Diagnoses

    • Human error leads to misdiagnosis in cases like a shoulder injury.

    • Example of personal experience (mother's injury misdiagnosed as a chip).

    • Critical to reassess if initial treatment results aren't satisfactory.

KT Tape and Its Efficacy

  • Use in Sports

    • Popular among athletes and coaches due to its aesthetic appeal.

    • Although widely marketed, scientific evidence supporting its benefits is lacking.

    • Considered unnecessary unless budget permits for frequent purchases.

Budgeting in Athletic Training

  • Historical Anecdote

    • Reflecting on budgeting for athletic tape ($95,000 initially, potentially $140,000 now).

    • Emphasizes the disparity between experienced programs and smaller budgets.

Common Wrist Injuries

  • TSCC Injury

    • Hyperextension or twisting leading to UCL injuries.

    • Symptoms: pain on the ulnar side of the wrist.

    • Difficult to treat if injury is overlooked leading to complications.

  • Tendonitis and Inflammation

    • Symptoms may include pain and limited mobility depending on location and activity.

    • Initial injury management focuses on symptom relief and avoiding aggravation.

    • Progressing to techniques like cross-friction massage as inflammation decreases.

Neurological Considerations

  • Nerve Compression

    • Median and ulnar nerve compression leading to conditions like carpal tunnel.

    • Symptoms could include tingling, weakness, and loss of sensation due to injury or chronic conditions.

  • Ergonomics and Prevention

    • Importance of ergonomic setups to reduce injury incidence.

    • Consultation experiences demonstrating improvement strategies at work environments.

Deformities Related to Nerve Damage

  • Benedict's & Bishop's Deformity

    • Resulting from chronic nerve compression, leading to complications in hand function.

Carpal Tunnel Syndrome

  • Management Options

    • Non-invasive treatment such as ice, braces, and cortisone injections used initially.

    • Surgical decompression may be necessary for chronic cases.

Specific Hand Injuries

  • Trigger Thumb and Finger

    • Common among repetitive motion tasks.

    • Treatment focuses on eliminating strain triggers and managing symptoms.

  • Mallet Finger

    • Dependency on splinting to avoid permanent deformity post-injury.

    • Critical to maintain immobilization for proper healing.

  • Jersey Finger

    • Requires surgical intervention due to flexor tendon rupture from gripping actions.

Diagnostic Approaches

  • Physical Examination

    • Palpation for tenderness and examination of deformities or abnormalities.

    • Importance of imaging (e.g. X-rays) to rule out fractures.

Dislocated Finger Protocol

  • Immediate Response

    • Importance of ensuring no concurrent fractures accompany dislocation.

    • Habitual self-reduction can lead to oversight of necessary medical assessments.

Comprehensive Approach to Hand and Wrist Injuries

  • General Guidelines

    • Consideration of activities of daily living (ADLs) post-injury when developing treatment plans.

    • Tailoring rehabilitation strategies based on specific patient needs and profession.

  • Deformities of the Nail

    • Signaling potential underlying health problems (e.g. cyanosis, scaling).

    • Distinction between fungal infections and other nail disorders emphasizing the lengthy treatment process for fungal infections.