Epidemiology

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Injuries to the fingers or hand can occur from a direct blow, a crush injury, or a laceration. A direct blow causes most pha-langeal and metacarpal fractures. This typically results in a transverse fracture. Spiral fractures occur secondary to a torsional type injury. Intra-articular fractures occur secondary to an axial load. These are the most common fracture patterns seen in the hand.

Basketball players injure the PIP joint more frequently. Baseball players are more likely to sustain an injury of the distal pha-langeal joint and distal phalanx. Football players usually sustain a crush injury resulting in a metacarpal or proximal phalanx fracture.

A study performed at the Cleveland Clinic evaluated 113 hand and wrist injuries; 96 of these injuries were fractures and 97 of the injuries occurred in football, with metacarpal fractures being most common at 40% (38 fractures). DeHaven and Lintner2 described hand injuries based on 3431 cases treated at the University of Rochester. Hand injuries represented 5% (171 cases) of those treated, again the most common injury to the hand involved fracture. There were 102 fractures in this study representing 60% of the hand injuries, with the majority occurring in football. Of the 102 fractures, 72 were of the phalanx and 27 involved the metacarpals. A study by Dawson and Pullos3 looked at baseball and softball injuries in a suburban 150-bed hospital over a 3.5-month period. There were 153 injuries and fractures represented 6% of the injuries. Interestingly, a greater percentage of injuries occurred when a larger softball was used. The number of people seen for hand injuries represented 2.2% of the emergency department visits. Stein and Ellasser4 reported on significant hand injuries that occurred in a professional football team over a 15-year period. There were 46 major injuries, almost equally split among offense and defense. Fingers were the most commonly injured area of the body. Rettig5 performed a study over a 1-year period noting 213 injuries in 207 athletes. These 207 patients represented approximately 3% of the new patient visits seen at the center during this time period. Of these injuries, 1 25 were fractures. The greatest number of hand injuries occurred during football, and the majority of injuries occurred during competition.

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