Ligament Injuries (Fingers)

Fingers are vulnerable to stretching and twisting injuries because of their long, thin shape and the, often significant, forces which pass through them during everyday use.

The joints of the fingers must produce enormous mobility, whilst at the same time providing significant stability. This would be a difficult problem for an engineer to solve if designing a machine, yet the structure of the soft tissue retaining structures around the finger joints is remarkable in its simplicity.

A 'box-like' arrangement of soft tissues surrounds the sides and palmar surface of each of the finger joints. The sides of the joints are bound together by collateral ligaments and the front (palmar surface) of the joint is secured by a thick, squat, flexible rectangular structure, the volar plate.

The collateral ligaments prevent abnormal sideways movements of the bones, whilst the volar plate prevents over extension of the joint when the finger is forced backwards. Either or both of these structures can be torn in an injury. When both structures tear, the joint may dislocate.

Treatment of these injuries initially concentrates on diagnosing dislocation - usually with an x-ray. Dislocations must be reduced, and checked that they have gone back into perfect alignment by a second x-ray. The injured soft tissues usually heal themselves and only in very rare circumstances require surgery.

Joints that have not dislocated (or have been put back into joint after a dislocation) can remain unstable. That means they may yet dislocate during the healing process. Consequently, unstable injuries may be monitored during treatment.

The vast majority of these injuries are treated successfully by restricting movement during the 3 week period it takes for healing to occur. They can be strapped to the adjacent digit for support (neighbour strapping) or be protected by a small external plastic splint. Physiotherapy may then be necessary to restor movement in the stiff joint, but an almost complete recovery can be expected in most cases.

You can read more about ligament injuries in the fingers here