Sprain of the ligament
Last reviewed: 23.04.2024
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Causes of stretching of the ligament
From the anatomical point of view, the causes of the extension of the ligaments of the hand (as well as the extension of other ligaments) lie in the fact that at the moment of traumatic action the joints of the hand, strengthened by the ligaments, are in a position that goes beyond the range of their functional movements. To keep bones in the joint, the fibers of the ligaments stretch to the extreme limits of their capabilities. And in this case they fulfill their second most important function - they limit the mobility of bones in the joints in the prescribed state.
Due to the parallel arrangement of collagen fibers, the ligaments are strong, and due to the elastic fibers, they are sufficiently elastic. But the strength is directly dependent on the transverse dimension of the ligament, and the elasticity and extensibility (resistance to deformation) depends on the length. That is, the narrower and shorter the ligament (as in the brush), so their strength and elasticity is less.
Most often stretching of the hand ligament happens with lateral (collateral) ligaments of the radiocarpal joint (radial and ulnar), navicular-semilunar ligament, semilunar triangular ligament, and lateral ulnar ligament of the metacarpophalangeal joint of the big toe.
Among them, the stretching in the region of the wrist joint is leading, providing flexion, extension and circular movements of the brush. Traumatologists explain this by the fact that more than a third of all the bones of the hand (8 of 27) are in the wrist, and all bones are connected to each other with the help of ligaments. Therefore, with such complexity of the structure, functional differentiation of individual ligaments and intensive wrist loadings, the level of its traumatic injuries - in particular, the sprain of the ligaments - is very high.
As experts in the field of the musculoskeletal system note, the key causes of stretching of the ligaments of the hand: excessive tension when falling on the hands, straightened at the elbow joint; swipe; weight lifting (especially when trying to sharply tear them away from the plane or lift them up from the shoulder level); keeping the body weight in the absence of support (for example, when hanging and pulling on the crossbar). In general, this type of injury takes place both in sports and in physical education, and in everyday life.
It should be borne in mind that a strong stretching can be accompanied by rupture of ligaments, and especially often in cases of impact and fall on the wrist, a scaphoid-semilunar or semilunar-trihedral ligament is torn.
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Symptoms and Diagnosis of Sprains of Brushes
The symptoms of stretching the ligaments of the hand depend on the level of damage to their fibers. If the damage is slight, the pain is insignificant, but it increases with movement (flexion-extension of the hand) or with pressure on the joint.
When the degree of damage to the ligaments is medium, the pain is severe, the brush movements are limited, swelling of the soft tissues is observed (especially intense in the first days after injury).
In severe stretching, ligament rupture often occurs, characterized by: intense acute pains, diffuse joint swelling, reddening of the skin and subcutaneous hematoma (bleeding) at the site of injury, as well as complete inability to move the brush, or non-physiological increased mobility (instability) of the joint.
Diagnosis of stretching of the ligaments of the hand is carried out on the basis of the clinical picture of the damage (during the examination by the doctor), patient complaints and their descriptions of the circumstances in which the injury was received. Mandatory X-rays of the brush (with suspicion of a fracture or fracture of the bone - in several projections). Usually this is quite enough for therapeutic recommendations, the implementation of which will ensure the improvement of the condition and the elimination of the effects of stretching.
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Treatment of stretching of ligament brushes
In most cases, stretched and even torn ligaments come to their original state and grow together themselves. But nevertheless the treatment of stretching of the ligament brushes is necessary, and it should be started immediately after the injury.
Mandatory complete immobilization (immobilization) of the hand and hands is mandatory: the brush is bandaged sufficiently tightly, but so that the fingers do not become chenille or cold; bent at the elbow, it is advisable to put a hand on a supporting bandage, fixed behind the neck. When stretching with a rupture of ligaments, the so-called rigid immobilization of the brush (gypsum langa with special dressing) is performed.
On a mandatory basis, cold compresses (best ice) should be applied to the damaged area for two days - for 20-30 minutes every 3-4 hours. This will help reduce swelling and pain.
Also to reduce pain, non-steroidal anti-inflammatory drugs (NSAIDs) - Ibuprofen, Nurofen and others - are taken internally (one tablet twice a day). Of analgesic agents for external use, traumatologists recommend ointments and gels Finalgon, Diclofenac (Voltaren), Fastum Gel (Ketonal), Naise Gel (Nimesulide) - lubricate the skin over the damaged area 4-5 times a day).
As puffiness and pain decrease, the physiotherapy treatment of stretching of the ligaments of the hand starts, which includes: exercises for developing the joint and expanding the range of motion, electrophoresis, UHF.
In the case of long-term instability of the joint, especially of the wrist, caused by rupture of the ligaments, an orthopedic operation for the reconstruction of damaged ligaments can be performed.
Prophylaxis and prediction of sprain of the ligament
What can prevent the stretching of the ligament? Take care when walking on a slippery, wet and uneven (not to fall), in preventing injuries in the gym, on the tennis court, on a regular sports ground. If the load is too heavy - do not try to lift it at all costs: remember the stretching of the ligaments, and not just the brushes ...
If, after the injury, everything was done correctly (as described above), then the prediction of stretching the ligament is positive. If to treat the received damage lightly, you can get a partial or complete loss of mobility of the injured joint, as well as arthrosis or arthritis.