Injuries of the Sportsman’s Hand
Authors: Pinheiro Ana Costa , Ferreira Filomena , Areias Margarida , Oliveira Carolina , Sousa Cristina , Leal Miguel 
Published: June 2018

Introduction:

Injuries from the athlete’s hand are frequent. We present 2 clinical cases: Stener injury and traumatic dislocation of the metacarpophalangeal joint of the thumb. The “skier’s thumb” is an injury to the ulnar collateral ligament of the metacarpophalangeal joint of the thumb produced by abduction and hyperextension of the thumb. Dorsal dislocation of the thumb metacarpophalangeal joint (MCP) in children is a rare entity. There are three types of dislocation: incomplete, simple and complete complete complex.

Methods:

Presentation of 2 clinical cases of injuries of the athlete’s hand: Stener injury and traumatic dislocation of the metacarpophalangeal joint of the thumb. Retrospective descriptive method with reports of clinical cases based on patients’ electronic clinical processes.

Results:

CASE 1:

Male 11 years old, put into service urgency by hand trauma during football match. He had pain and swelling at the ulnar rim of the joint of the first metacarpal-phalangeal joint. Radiogram unchanged. Coping with clinical suspicion was carried out ray under stress (radial deviation) showed that this instability of the joint. Ultrasonography confirmed complete rupture of the ulnar side of the attachment with the aponeurosis interposition of the adductor - stener lesion. Surgery decided. Focus through internal and distal reinsertion. 4 weeks immobilization period, followed by a return to activities of daily living. At the last visit, at 6 months after the operation there was no residual instability.

CASE 2:

Seven-year-old boy put into service urgency for thumb injury in hyperextension during football match. The objective examination shows hyperextension deformity of MCF. The radiological study confirmed complete MCF dorsal joint dislocation diagnosis of the thumb joint. A closed reduction procedure under sedation, by McLaughlin corset technique. Immobilization was performed for two weeks. At six weeks he was asymptomatic, with normal mobilities, symmetrical grip and clamp strength without instability or radiographic changes.

Discussion/Conclusion:

Lesion of the ulnar side ligament is a possible diagnosis of the pediatric age, even without associated withdrawal. Proper clinical observation and x-rays provide supplemented by ultrasound, often all the information necessary for diagnosis and therapeutic decision. The low frequency relevance of pediatric Stener injuries can damage your diagnosis of the emergency situation. In this clinical case, it is possible to detect this damage. The dislocations dorsal joint MCP thumb are more frequent than flying, lesional mechanism involving the traumatic hyperextension of it. The diagnosis is based on clinical information supplemented by radiography, which allows the differentiation between complete and incomplete dislocations. A complete dislocation can not be reduced by maneuvering bloodless injury is complex and requires surgical treatment. The reduction technique involves MCF hyperextension and replacement of the base of the phalanx. Other gestures should be avoided, and axial traction, risk of joint injury structures, cartilage growth or conversion of a simple dislocation into complex, to determine the need for surgical intervention. After reducing the stability of the collateral ligaments should be evaluated, often directly damaged by trauma or inappropriate gestures reducing the reduction of multiple attempts. Lateral instability may benefit from surgical correction.

References

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