Finger Sprain

Question 1

What is the etiology of a finger sprain? (Ligament/capsule)

Answer 1

1. Typically due to a blow to the finger or falling on the hand as well as a twist or over-stretching
   *stretching or tearing of the ligaments that support the small joints of the finger

Question 2

What are the grades to a finger sprain?

Answer 2

I: joint is stable, ligament tissue is stretched with micro tearing present
II: mid instability (finger is moving in ways that it shouldn’t) present, partial tearing of ligament tissue
III: significant instability of the joint, severe or complete tearing of ligament tissue

Question 3

What will be found on the physical exam?

Answer 3

1. Edema/swelling of the joint
2. Tenderness of the affected side
3. Pain with side-side stressing of the joint
4. Volar pain aggravated by passive over-stretching and maximal flexing of the joint

Question 4

What are the diagnostic tests?

Answer 4

1. X-rays to rule out fracture
2. MRI: may be used to asses for a complete ligament tear

Question 5

What is the prognosis?

Answer 5

1. Good if treated/protected until healed
2. Poor in unstable joints with complete ligament tearing that aren’t protected/no surgery
   *bracing for 6-12 weeks

Question 6

What is the treatment?

Answer 6

1. RICE
2. NSAIDS
3. Splinting/taping
   *buddy-taping is often sufficient in milder sprains and can allow return to sport
   *if no fracture motion should be initiated within one week to avoid stiffness

Question 7

When is surgery indicated?

Answer 7

1. In a complete ligament tear (grade 3)
2. If there is a fracture present especially if it involves the joint surface

Question 8

When can someone return to their sport?

Answer 8

1. Aerobic training - immediately
2. Sport = once pain free, then 2-3 weeks after