Anatomy: The five fingers on a hand consist of a total of 14 small, tubular finger bones (phalanges). Above the fingers (dorsal) runs the stretching tendons and below (volar) runs the flexor tendons.

Symptoms: Pain on top of the finger’s outer joint, which cannot be stretched completely.

Acute treatment: Click here.

Examination: Everyone with sudden powerful pains in a finger and stretching defect should be medically examined. The diagnosis is usually straight forward, but in cases with a stretching defect an x-ray examination should be performed to evaluate whether surgery is indicated.

Treatment: Bandaging of the finger with the outer part completely stretched. Usually a small fingerstall of plastic (Oakley-splint) is used. The plastic bandage must be used for at least 6 weeks. Surgery may be indicated if a larger bone severing has occurred.

Rehabilitation: Fitness training in the form of cycling and running, along with rehabilitation according to the guidelines under rehabilitation, general, can usually be commenced immediately. Once the pain is completely gone you can participate in sports activity, although handball, volleyball, basketball and similar activities should be avoided for a few additional weeks after removal of the splint.

Bandage: It will often relieve the injury if, after the bandage has been removed, the injured finger is taped to its neighbour (tape-instruction)

Complications: In the vast majority of cases the tendon rupture heals without complications. In a number of cases a small stretching defect will remain, which increases the chance of renewed injuries from handball, volleyball etc., which is why tape treatment can be indicated.

Anatomy: The bones in the wrist consist of 8 carpal bones (ossa carpi), that along with the two forearm bones, ulna and the radius, form the wrist. Furthermore there are 5 metacarpus bones (ossa metacarpi) and a total of 14 finger bones (phalanges).

Symptoms: Pain in the joint upon movement. Occasional swelling in the joint (synovitis).

Examination: Often an ordinary clinical examination is sufficient, although it may be necessary to supplement with an x-ray examination. Ultrasound is well suited to detect fluid in the joints (Ultrasonic image) (article).

Treatment: Relief from pain inducing activities until the swelling has decreased. Rehabilitation can subsequently be commenced with the primary goal to strengthen the muscles around the joint and maintain joint-mobility. There is no treatment that can regenerate the destroyed cartilage (and bone). Cartilage transplants are not yet suitable for general degenerative changes. In cases of swelling in the joint, you can attempt to dampen the inflammation (synovitis) with rheumatic medicine (NSAID) or by draining the joint fluid and injecting corticosteroid, which can advantageously be done with ultrasound guidance. Pain with no swelling is best treated with paracetamol.

Rehabilitation: The rehabilitation is dependant on which joint has suffered degenerative changes. Exercise is generally advised to maintain joint mobility and non-strenuous strength training for the muscles around the joint, which, however, does not have as large an effect as around joints with large muscles (e.g. the knee).
Also read rehabilitation, general.

Bandage: With degenerative changes in the wrist and thumb a bandage that supports (and relieves) the joint, can be manufactured. With degenerative changes in the thumbs base joint (MCP joint), a tape can be applied (tape-instruction) .

Complications: With severe degenerative changes with pain when resting (at night) it may become necessary to fix the joint by an operation. It should be considered whether the swelling in the joint is not part of a general rheumatic disorder.

Anatomy: The five fingers on a hand consist of a total of 14 small, tubular finger bones (phalanges). Above the fingers (dorsal) runs the stretching tendons and below (volar) runs the flexor tendons. In most places the tendons are surrounded by a tendon sheath.

Symptoms: Pain along the tendon sheath, which can sometimes feel swollen and crepitating upon movement.

Acute treatment: Click here.

Examination: Slight cases do not necessarily require medical examination. The doctor should be consulted if there is lack of progress despite relief. The diagnosis is usually made from a normal medical examination, however, in the event of doubt in connection with the diagnosis an ultrasound scan can be performed which will easily and quickly detect the inflammation (article), (Ultrasonic image).

Treatment: Relief from the triggering load factor. In case of lack of progress with relief, a medical treatment in the form of rheumatic medicine (NSAID) or the injection of corticosteroidi in the tendon sheath can be considered. Since the effect and the risk is dependant on the injection being done correctly, it can advantageously be performed with ultrasound guidance.

Rehabilitation: Usually fitness training in the form of cycling, running and rehabilitation according to the guidelines under rehabilitation, general can be started immediately.

Bandage: With many tenosynovitis cases a support splint can be used to advantage as needs require.

Complications: Lengthy periods of tenosynovitis can cause damage to the tendon resulting in a rupture of the tendon, following which the functions of the fingers (stretching, bending) can suddenly be lost.

Anatomy: The tendons around the wrist are surrounded by tendon sheaths, as are the tendons located externally (radial) on the wrist which contribute to the movement of the thumb (M abductor pollicis longus and M extensor pollicis brevis).

Symptoms: Slowly commencing pain along the wrist on the side of the thumb. The area can occasionally feel swollen, and crackling sensation felt upon movement of the thumb. The pain deteriorates when twisting a rag, and when the thumb is moved away from the index finger against resistance.

Acute treatment: Click here.

Examination: Slight cases do not necessarily require medical examination. The doctor should be consulted if there is lack of progress despite relief. The diagnosis is usually made from a normal medical examination, however, in the event of doubt in connection with the diagnosis an ultrasound scan can be performed which will easily and quickly detect the inflammation (Ultrasonic image) (article).

Treatment: The treatment primarily involves relief, stretching and strength training of the muscles around the wrist. It is imperative for the treatment that the triggering load factor is reduced (article). In cases with a lack of progress following relief, a medical treatment can be considered in the form of rheumatic medicine (NSAID) or the injection of corticosteroid in the tendon sheath. Since the effect and the risk is dependant on the injection being performed correctly, the injection can advantageously be executed under ultrasound guidance. Surgery is rarely indicated.

Bandage: It will often relieve the injury if a wrist splint is used.

Complications: If there is a lack of progress it should be considered if the diagnosis is correct or whether complications have arisen:

• Bursitis
• Fracture of the forearm bones in the wrist (fractura ossis scaphoidei)
• Degenerative arthritis

Anatomy: The five fingers on a hand consist of a total of 14 small tubular finger bones (phalanges). The finger bones are held together by various ligaments. The joint capsule around the finger joints are reinforced by three ligaments (two side ligaments and a ligament under (volar) the joint). The ligaments under the finger joints are reinforced by a small cartilage plate (fibrocartilago), that stabilizes the intermediate joint of the fingers (PIP-joints).

Symptoms: Ligament damage will typically cause a swelling of the joint and tenderness on the side of the joint which is aggravated if the joint is twisted from side to side. With damage to the cartilage disc (laesio fibrocartilaginis volaris) under the joint, the pain will be localized to the underside of the joint (volar) which is aggravated with passive over-stretching and maximal flexing of the joint.

Acute treatment: Click here.

Examination: With sudden powerful pain in a finger it is advisable to have the joint examined to ensure a correct diagnosis and treatment. The results are best if the diagnosis is made and the treatment is commenced immediately following the injury (article). A tearing of the ligament anchor on the side of the finger is occasionally visible on x-rays.

Treatment: The vast majority of ligament ruptures can be treated without surgery, while other ligament ruptures with clear laxity require surgery. It may be necessary to perform an x-ray, ultrasound scan (article 1) or an MR-scan (article 2). Damage to the cartilage disc is often treated with a splint on the finger for about 3 weeks, although not all physicians agree with this (article 3).

Rehabilitation: Fitness training in the form cycling and running along with rehabilitation according to the guidelines under rehabilitation, general can usually be commenced immediately. Once the pain is completely gone you can participate in sports, although handball, volleyball, basketball and similar activities should be avoided for a few additional weeks.

Bandage: It will often stabilise the joint if the damaged finger is taped to its neighbour (tape-instruction).

Complications: In the vast majority of cases the ligaments heal without complications. In some cases, particularly after a lesion of the cartilage disc under the joints, long-term discomfort can continue for as long as a year after the injury (article). In cases of persistent pain and lack of progress you should consult your doctor again.

Anatomy: The five fingers on each hand consist of a total of 14 small tubular bones (phalanges).

Symptoms: Sudden pain in the finger after a fall, twist or blow. Pain is aggravated upon maximal movement of the finger and upon applying direct pressure on the fracture. A visible angling of the finger can occasionally be seen.

Acute treatment: Click here.

Examination: Everyone with sudden powerful pains in a finger after a fall or blow should be examined by a doctor if the pain does not quickly abate. In case of visible angling of the finger, the medical examination should be acute. The fracture is usually visible on x-rays allowing the best treatment to be chosen accordingly.

Treatment: If there is dislocation of the finger bone, the fracture can be reset under local anaesthetic. Most fractures can be managed with relief and light bandaging, while others require a cast or surgery (article).

Rehabilitation: Fitness training in the form of cycling, running and rehabilitation according to the guidelines under rehabilitation, general can usually be started immediately. When the cast is removed you can commence training of the hand and arm. Thrusts or jabs with the hand (boxing, handball, volleyball and similar sports) should be avoided for an additional few weeks.

Bandage: The fracture will often be stabilized if the finger is taped to the neighbouring finger (tape-instruction). Individual plastic bandages can be made for use during sports activity after bone fractures.

Complications: In the vast majority of cases the fracture heals without complications although in some cases the healing can complicated. Therefore, in case of persistent pain and lack of progress, you should consult your doctor again.