Hand clinics
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Injuries to a competitive athlete's hand are common occurrences routinely treated by team training staff and physicians. These injuries are particularly prevalent in contact and ball catching sports. ⋯ These injuries are classified according to the pattern of fracture and the resultant stability of the joint. Treating physicians must have an understanding of the biomechanics, injury patterns, assessment, and treatment guidelines in order to identify these injuries and provide for the earliest safe return to play with the best functional outcome for the athletes.
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Most metacarpal fractures are minimally displaced and are treated without surgery. Markedly displaced fractures, fractures causing finger rotation, and displaced intra-articular fractures require surgical intervention. The challenge with the elite athlete is achieving an early return to play without compromising fracture position. Casts, splints, and surgery each have a role in getting the athlete back into action as soon as possible.
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Osseous injuries to the ulnar aspect of the carpus are increasing in frequency because of greater participation in sporting activities. Hamate body fractures are subdivided into coronal, sagittal oblique, proximal pole, and medial tuberosity fractures. ⋯ Displaced hamate hook fractures are optimally treated with early excision to avoid sequelae such as flexor tendon and nerve injury, and to allow early return to activity. Undisplaced pisiform fractures are managed nonoperatively, whereas displaced fractures and nonunions are treated by simple excision.