Broken tendon can be reconnected on the finger

Capsule injuries on the fingers

Capsule injury on the finger (Finger capsule history, finger capsule tear): Overstretching or tearing of a joint capsule on the finger, sometimes combined with a bony tear. Capsule injuries are mainly caused by violent hyperextension of a finger joint, often in ball sports. With strong force and extensive rupture of the joint capsule, a finger dislocation sometimes also occurs. Immobilization in a splint is often sufficient for treatment, and surgery is occasionally necessary.

Leading complaints

  • Painful swelling and restricted mobility of a finger joint
  • Painful misalignment in the joint area and inability to move with additional finger dislocations.

When to the doctor

Immediately if

  • there is a gaping (cut) injury to the hand or fingers with restricted mobility or a misalignment in the area of ​​a finger joint.

In the next few days if

  • Do not quickly reduce pain, swelling and restricted mobility in the area of ​​a finger joint.

The illness

Joint capsules enclose the joint cavity and consist of two layers: The outer, tight, connective tissue part is connected to the periosteum and the adjacent ligaments. This stabilizes the joint and guides it in the desired direction when it moves. The inner part of the joint capsule is called the synovial membrane. It consists of loosely arranged connective tissue cells that produce and absorb the joint fluid (synovia, joint lubricant) and thus ensure that movement runs smoothly.

If a finger joint is overstretched, the flexor side is overstretched and often the joint capsule and the fibrous cartilage plate also tear, which strengthen the joint at this point. If a finger joint is bent to the side, the lateral joint capsule and the collateral ligaments that reinforce it are affected (as is the case with the skier's thumb). Sometimes the capsule or ligament, together with a small piece of bone, tear out of their anchoring on the bone (osseous capsule tear or osseous ligament tear). If the capsule and ligaments are completely torn, the joint is no longer adequately held together; a finger dislocation occurs.

Causes and Risk Factors

Finger capsule tears occur mainly during sport, e.g. B. by kinking the finger backwards when a ball hits. This happens particularly often in volleyball or handball. Other injury patterns are falls on the outstretched finger. Very rarely does the capsule tear when the finger is pulled hard.

Diagnostic assurance

An initial diagnosis is usually made when palpating and moving the injured finger. To rule out joint instability, the doctor tries to open the affected finger joint to the side and move the neighboring bones against each other. If the pain gets worse when the doctor compresses the finger in its longitudinal axis, this is more likely to indicate a broken bone.

In order not to overlook accompanying injuries to vessels and nerves, blood flow, mobility (motor skills) and sensitivity of the hand and fingers must also be examined.

X-rays of the injured finger joint are used to reliably rule out a bone fracture and to identify a possible torn capsule or ligament. If ligament damage is suspected, an MRI is usually performed.

Differential diagnoses. Acute pain, swelling or misalignment of a finger are also signs of a broken finger, a finger bruise or a dislocated finger.

treatment

The necessary immediate measures are summarized in the PECH rule:

  • Pause: immobilize your hand immediately and take it easy.
  • Cooling (E.is): Cool the joint for 15 to 20 minutes. Ice cubes and cool packs must not come directly onto the skin, but only wrapped in a cloth, as they would otherwise cause cold damage.
  • Compression (compression): A compression bandage relieves the swelling. Caution, do not put on too tightly, so that blood supply and drainage are guaranteed!
  • Hochlager. Raising the hand (e.g. in an arm sling) prevents excessive blood flow to the injured finger and also counteracts swelling.

If the pain is severe, anti-inflammatory pain relievers such as ibuprofen (e.g. Dolgit® or Ibuprofen AbZ) help. Caution: Aspirin (acetylsalicylic acid) must not be used to treat pain because it has a blood-thinning effect and this can lead to increased bleeding into the affected tissue.

Note: If the hand is injured, rings, bracelets and watches must be removed as the fingers are threatened with swelling.

Conservative

The doctor uses a finger splint made of plaster of paris, plastic or aluminum to calm down simple tears in the capsule and smaller bony tears. If there is a dislocation, the bones are set up again with measured tension and pressure before the splint is applied, usually under local anesthesia. The splint stays on the finger for 2 to 3 weeks. A capsule tear on the finger is completely healed after about 6 weeks, with accompanying injuries the healing can take longer.

Operational

Surgical therapy is recommended for severe joint instability as well as for larger displaced or bony capsular ligament tears, which after conservative therapy often lead to early osteoarthritis. Depending on the injury, the surgeon * sets up open dislocations, sutures torn capsule parts or attaches torn pieces of bone with wire or small screws. Sometimes she also temporarily blocks the joint with a wire to keep it still.

forecast

Simple joint capsule injuries usually heal without consequences. In the case of significant accompanying injuries, functional disorders such as the stiffening of a finger can remain despite surgical treatment.

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What you can do yourself

Patience.

Even if the finger splint is removed 2 to 3 weeks after a capsule rupture, rest is advised for the next three weeks. This not only means not exercising, but also being careful in everyday life. When the finger can be specifically exercised and fully stressed depends on the individual and needs to be clarified with the doctor.

Light massages.

After removing the finger splint, massage the area over the affected joint with gentle (painless!) Circular movements. This promotes blood circulation and mobilizes the synovial fluid.

Move carefully.

Grasping exercises with a soft ball or an empty plastic bottle prepare the finger for daily life after immobilization. In between, you can always do a little gentle finger gymnastics with bending, stretching or closing your fist. Warning: Pain is an alarm signal that the finger is being strained too much.

Finger gymnastics in a water bath.

After splint therapy, the finger can be mobilized particularly well in a warm water bath. It is recommended to take a five-minute bath in pleasantly lukewarm water 5 times a day. Which movements are allowed and to what extent must be clarified with the treating doctor.

Prevention

Tap your fingers.

Especially in volleyball, basketball, handball or rugby, the players try to stabilize their fingers with prophylactic taping and thus protect them from injuries.

Learn technique.

There is a risk of finger injuries in many activities. Especially in sport, accidents can be avoided if you have a good command of the technology. Fall training is useful for sports with a high risk of falling.

Authors

Dr. med. Michael Bedall in: Health Today, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 17:20


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.