Hand sprain

introduction

Wrist sprains are often the result of a fall.

The hand sprain is one of the most common injuries entering an orthopedic practice or hospital. Athletes are particularly affected. A sprain can generally be seen as an overstretching of the joint in which the ligaments involved and additional fibers in the joint and joint capsule have been severely irritated. The sprain of the hand is mainly the result of a fall in which one tries to catch the fall with an outstretched arm. Usually it is a painful but harmless injury. However, since more serious injuries than a hand sprain must be taken into account, a doctor should examine the wrist if the pain persists.

You might also be interested in: Sprain on the thumb

Symptoms

The extent of the symptoms after a hand sprain is independent of the severity of the injury. Even a slight sprain can cause pain similar to a fracture, just as if a hand sprain is suspected, a strain or a torn ligament can be behind it. The symptoms cannot therefore be used to precisely determine the type of injury.

The guiding symptom of a hand sprain is the Wrist pain. It occurs immediately after the application of force and is called stabbing and sometimes extremely heavily described. After the injury, the pain persists dull, throbbing character consist.
In the further course, the wrist usually swells within a few hours, sometimes not until the next day. In addition, there is often a blue discoloration caused by a bruise (Hematoma) is caused inside. This is caused by ruptures in small blood vessels.
A severe hand sprain can even cause small tears in tissue. However, with a mild sprain, pain can also be the only symptom.
In all cases, however, there is a more or less pronounced one Loss of function of the wrist. Movement is limited due to the pain and strain, for example when supporting, is only possible to a limited extent.
The stability However, if the hand is sprained, it remains, which is an important feature in contrast to a torn ligament or a broken bone.

How long the symptoms last varies. A hand sprain can cause discomfort for days to weeks. Crucial for that Duration until full recovery is this extent the injury, the physical condition and the Time to initiate first measures.

root cause

A hand sprain is due to a external force acting on the jointwhich goes beyond the physiological level and overstretched structures in the joint. In the case of a sprain, the joint surfaces involved are exposed for a brief moment Overstretching or twisting from the normal position lifted, but immediately jump back. This overloaded ligaments, Tendons and Joint capsule and can lead to injuries. The wrist is a functional unit made up of several small joints. In addition to the bones involved in the forearm and wrist, it consists of the joint capsule, cartilage and a large number of stabilizing ligaments. The normal range of motion of the wrist includes two axes of motion. The flexion towards the palm of the hand is possible up to approx. 80 °, the extension towards the other side is 70 °. In addition, the wrist can be spread apart, on the thumb side by 20 °, and on the little finger side by 40 °. Any movement beyond that can only be achieved passively through the application of external force and overloads the joint. The typical cause of a hand sprain is a fall in which one supports oneself with the hand and so the entire body weight acts on the wrist, as happens particularly when stumbling, but also often during sports. Above all, cyclists and snowboarders should be mentioned here, but theoretically, of course, all conceivable sports. The ligaments are overstretched so much that they cause pain and must be spared. Since the Tapes ensure stability, they are only stretchable to a limited extent. The more the wrist is stretched beyond normal, the greater the risk of tearing or tearing a ligament fracture. In addition to the fall, which is by far the most common cause of hand sprains, other causes include, for example, a football that is shot in the hand. A previously damaged wrist due to previous frequent sprains or overstretching is increasingly at risk, since the ligaments are already worn out in a certain way.

diagnosis

X-ray image of the hand

The diagnosis of a hand sprain is primarily one clinical diagnosis. A sprain of the hand can also be correctly recognized for the layperson if the symptoms are appropriate. A doctor should be consulted in the event of severe or long-lasting symptoms that do not improve. The nature of the accident and the symptoms described by the person concerned give the doctor sufficient information to investigate further in the direction of the sprain of the hand. Easy Scan calls you Tenderness and confirms that the wrist is injured. An important measure is that Movement test of the handto demarcate a sprain from a more severe injury such as a torn ligament or fracture. As long as the patient can actively move his hand, this is a good sign. However, a reliable diagnosis of a hand sprain cannot be made only through clinical examination and observation of the swollen wrist. To rule out more serious injuries, an X-ray of the affected area should be arranged. Computed tomography (CT) is also a good method for assessing bony structures. In cases of doubt, magnetic resonance imaging (MRI) can be helpful to visualize the ligaments and tendons. CT and MRI are not routinely used for a sprained hand; the X-ray image should be taken to be on the safe side even in the case of minor injuries and persistent complaints.

therapy

The therapy of a hand sprain looks mainly general measures which are useful for all sports injuries. The aim is to go easy on the hand and control the symptoms, which helps healing and alleviates the discomfort. Here comes the PECH rule of central importance, which takes four strategies into account:

1) break

An instant one Relief of the wrist is an important measure. Exercise should be paused for some time and it is also recommended to take care of a sprained hand in everyday life. Carrying heavy loads should also be avoided.

2) ice cream

One is no less effective for a hand sprain Timely cooling with cool packs, Ice cream or the like. This has the effect that the vessels are narrowed and so the Swelling with bruising will be reduced. In addition, the cold raises the excitation threshold for nerve fibers and thus helps to alleviate the pain somewhat. It is recommended to start cooling immediately after the hand sprain and as it progresses every 2 hours for 20 minutes especially on the first few days to cool. Ice or cool packs are better than ice spray.

3) compression

In addition to pausing and cooling, compression is another useful measure to help a hand sprain heal and relieve symptoms. The goal is that Contain the swelling and the Immobilization of the affected joint. In this context, an elastic bandage can be helpful, which has to be applied while pulling, but without cutting off the blood supply. If the fingers become blue or numb, the dressing should be loosened immediately.

4) Elevate

Raising it above heart level has the least effect of the measures mentioned on hand sprains, but it also contributes to faster healing. This is caused by gravity Swelling accelerated somewhat. All of these measures are more effective the earlier they are started. Especially when it comes to cooling down and taking a break, the earlier the better.

In addition to the PECH rule, those affected can use other remedies and aids for the hand sprain. Pain medication plays a major role. The classic drugs that can be used here are diclofenac, ibuprofen or paracetamol. They should be taken when needed and only for the first few days without medical advice. Especially in the context of a hand sprain Anoint that act locally and do not suffer from the general side effects of oral pain medication. A popular remedy here is Voltaren, which also contains the active ingredient diclofenac. There are other types of wrist stabilization rails and Supportthat can be used in the event of long-term injuries. Once the hand sprain has cured, slowly increase the load.

forecast

The hand sprain is a painful, but in most cases harmless injury that usually heals without complications. It is important to rule out serious injury to the bones or ligaments after the force has been applied, since in these cases early, adequate therapy is important.A sprained hand is also more prone to further injuries, which is why protecting the joint not only helps to heal but also prevents complications. A slight sprain of the hand will heal after 1-2 weeks. In severe cases, the injury can drag on for several weeks.

Please also read our article on this Duration of a sprain.

prophylaxis

There are a number of ways to prevent a hand sprain stabilizing wrist protectorswhich are mainly used in sports. People who do a lot of snowboarding or inline skating should think about purchasing these protectors. Also a tight tape reduces the risk of a hand sprain. In addition, a healthy assessment of your own abilities is essential in the context of sport. Generally speaking, practice yourself before exercising warm up and stretch well. A good fitness level also plays a role. However, these are all measures to reduce risk. Targeted prevention is difficult because the wrist is sensitive and can be strained in a variety of situations. There is always a certain risk of contracting a hand sprain in sport and in everyday life.

Further information

More interesting information from the field of Sports injuries:

  • sprain
  • Sprain duration
  • Overview of sports injury
  • Diclofenac

You can find an overview of all previously published topics in the field of sports medicine at Sports medicine A-Z.