Identify common injuries and conditions that occur to the hand, fingers, and thumb.
Demonstrate taping, wrapping, bracing, and padding techniques to the hand, fingers, and thumb when preventing, treating, and rehabilitating injuries.
Explain and demonstrate evidence-based practice for the implementation of taping, wrapping, bracing, and padding techniques to the hand, fingers, and thumb within a clinical case.
The hand, fingers, and thumb are essential to athletic, work, and casual activities such as catching a basketball, typing, and gardening. Because the hand, fingers, and thumb play a significant role in daily activities, injuries occur frequently. Although gloves do offer protection, shearing forces, compressive forces, and excessive range of motion often result in bony and soft tissue injury. Common injuries to the hand, fingers, and thumb include:
Contusions to the hand, fingers, and thumb are frequent in sports because of the minimal protection for the bony structures.1 Contusions are also common with work activities. Accumulation of edema is more frequently seen in the dorsal rather than the palmar hand because of the differences in the loose and elastic properties of the dorsal skin compared to the inelastic properties of the palmar skin.2 Mechanisms of injury include shear and compression forces. A contusion can result, for instance, when a diver strikes the diving board with her hand, fingers, and/or thumb while twisting in the air, sustaining a compressive force to the structures.
Sprains typically occur to the fingers and thumb as a result of hyperextension and varus or valgus forces.3 Finger and thumb sprains involve injury to the collateral ligaments and often to the capsular and tendinous tissues (Fig. 11-1). Sprains may occur at the metacarpophalangeal (MCP), proximal interphalangeal (PIP), or distal interphalangeal (DIP) joints. A sprain of the ulnar collateral ligament (gamekeeper's thumb) results from forceful abduction and hyperextension of the proximal phalanx.4 For example, a sprain to the ulnar collateral ligament can happen as a softball player slides headfirst into third base, making initial contact with the thumb, causing abduction and hyperextension (Fig. 11-2).
Bones and collateral ligaments of the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints of the fingers.
Ulnar collateral ligament sprain (gamekeeper's thumb).
The name "gamekeeper's thumb" originates from the gamekeepers who managed the game animals on private lands. These people were subjected to the abduction/hyperextension mechanism during their job-related tasks, which included snapping the necks of fowl with their hands.