Spotlight on Hand Injuries
INTRODUCTION TO HAND INJURIES
This series on injuries serves to highlight a few common, every-day injuries and provide some background. Any physical damage should be dealt with by a medical practitioner or trained physiotherapist, who will recommend if any specialist intervention is required.
This is not an exhaustive list and does not contain comprehensive detail. The selection of injuries will be added to on an ad hoc, but regular basis.
A Quick Look at Hand Injuries
The hand is composed of 19 bones (5 metacarpals and 14 phalanges), more than 30 tendons and numerous complex structures. The metacarpals are long, thin bones which are located between the carpal bones in the wrist and the phalanges in the digits.
A metacarpal fracture is a break in one of the five metacarpal bones of either hand and can occur either at the top (head), middle (shaft) or bottom (base) of the bone. Falling off your bicycle or onto your hands in an accident are dominant causes. Boxers are susceptible to a fracture of the fourth or fifth metacarpal as they punch objects (and other boxers) with a closed fist.
Worldwide, hand injuries constitute 5-10% of emergency department visits. The most common causes are road traffic accidents, blunt trauma (e.g. crush injury, contusions), and assault. Fifth metacarpal fractures occur more frequently and are responsible for between 16% to 34% of hand fractures.
Patients with metacarpal fractures generally experience:
– Pain, swelling and/or bruising
– Limitation of movement
– Deformity or finger misalignment
– A metacarpal head fracture may be the cause when you cannot extend your finger(s)
– In a metacarpal base fracture, movement of the wrist or stretching your hand open wide exacerbates the pain.