Introduction
A finger has a variety of structures, such as ligaments, tendons and joint capsules, to perform its function fully. In everyday life and during sporting activities, the finger is often exposed to a high level of force, which the ligaments and tendons cannot always withstand. The result can be overstretching or even tearing of the corresponding structure and the associated loss of function.
The ligaments on the finger can tear either in isolation or together with other structures, such as the joint capsule, or the flexor or extensor tendons of the fingers. The part of bone to which the ligament is attached can also tear. In order to be able to move the finger again later without problems, a special therapy with follow-up treatment is required.
Cause
Since the fingers are exposed to great force in many different situations and the ligaments can always tear, there are many different causes. A frequent cause of torn ligaments is a so-called impact trauma, especially during ball sports. The ball bounces with full force against the stretched or strained finger.
Many ligaments are also tensed in this position and threaten to tear if such a force is applied. A fall, in which a finger is involved to support the ball, can also be a cause for torn ligaments. Other popular causes include squeezing the finger in a door, for example, and cutting the finger during handicraft work. In addition, arbitrary force can also lead to torn ligaments in the finger.
Symptoms
A torn ligament on the finger primarily causes severe pain, especially if other structures have also been injured in this context. The pain is usually limited to the region of the torn ligament, but can also radiate into the immediately surrounding structures. The pain can occur as a permanent pain and a pain dependent on movement. In addition, there is swelling, bruising and restriction of the function of the finger.
Diagnosis
First of all, questioning the person affected about the course of the injury can be of decisive importance for the diagnosis. Then the diagnosis of torn ligaments can be supported by an examination of the finger with inspection, palpation and testing of mobility. In some cases, an x-ray of the finger is also taken, which may help to better visualise the torn ligament and other injuries, even if surgery is necessary.
Therapy
Torn ligaments on the finger can be treated conservatively, which means therapy without surgery, or surgically, depending on the extent of the injury and the external circumstances. In the case of a simple and closed torn ligament, the finger is immobilised in a special splint or bandage for about two to three weeks after it has been put back in place, if necessary. The aim of immobilization is to enable the body to repair the injury through its own repair mechanisms.
In order to allow the ligament to grow back together in time, the finger is fixed in an extended position. A splint made of plastic, plaster or similar material, or a stable bandage is suitable for fixation. When attaching the splint or bandage, it is essential to ensure a secure hold with good blood circulation and to correct it if necessary.
After immobilisation, the finger should be mobilised again so that the structures on the finger, which may have been shortened by the fixation in an extended finger position, can maintain their function and no unwanted adhesions of the tissue occur. Furthermore, the finger should be protected for a while to ensure complete healing. In some cases, it can help if the finger is taped or tied to the neighbouring healthy finger for stabilisation.
If there is a complicated torn ligament, or a torn ligament in combination with an open wound or with several concomitant injuries, an operation may also be necessary in which the torn ligament and other tissue injuries are sutured, the surrounding structures are restored and the wound is then closed. As a rule, the finger is then immobilised and treated in a similar way to the closed torn ligament. During surgical treatment, treatment with antibiotics can be used to prevent infection.
In addition, pain therapy can always be carried out in the case of a torn ligament in order to keep the patient’s level of suffering as low as possible and to prevent the finger from having to be held gently during the course of the operation. A splint is a typical means of conservative treatment for a torn ligament on the finger. Here, the affected finger is placed in an extension splint so that the finger can no longer be bent.
The finger is clearly overextended. The splints are made of plastic, for example thermoplastic acrylic resin, and the finger is simply fixed in them with plaster strips or Velcro tape. An operation (surgery) to treat a torn ligament is recommended, especially if there is a displacement of the structures, which can only be pushed back into position openly, or if the torn ligament has an accompanying bony injury.
If necessary, the torn ligament can be sutured after the finger has been repositioned. The bony structures can also be treated with a wire or screws. The tendon and capsule apparatus can be treated with sutures.
After closing the wound with a suture, the finger is immobilised and treated as in the case of a closed torn ligament, as the healing process also takes time. However, in the case of a simple torn ligament on the finger, a conservative, i.e. non-surgical, method is usually sufficient. Pain therapy is recommended in any case, as injuries to the finger can be very unpleasant.
Tapering can be used for therapy as well as prophylaxis of torn ligaments. How the tape bandage is applied depends on the benefit and the location of the torn ligament. It can be applied to the extensor side of the affected finger with traction, so that flexion is avoided.
In the case of swelling at the finger joint caused by the torn ligament, this area can be left out with figure-of-eight loops, with simultaneous stabilization. In general, however, it is best to consult an expert in this regard so that taping is used correctly and does not cause any harm. It is important that the finger is sufficiently supplied with blood despite the tape bandage and does not hurt.
Taping has two effects. Firstly, it stabilises the finger at the affected area. On the other hand, the bandage stimulates the skin receptors in the region, which should accelerate healing.
Since the tape bandage is quite uncomplicated in application and can be used in many ways, it is quite popular with patients. All fingers are fixed by tape structures so that any finger, including the thumb, can be affected by a torn ligament. A torn ligament on the thumb typically results from a direct violent impact, in which the thumb is strongly spread to the side.
The ulnar collateral ligament, a collateral ligament of the thumb joint, is typically affected. Since a torn ligament of the thumb is often associated with skiing accidents, the torn ligament of the thumb is also called ski thumb. A torn ligament of the thumb can be very painful and can lead to further damage, such as bone fractures and other ligament or tendon injuries. Depending on the severity of the injury, conservative treatment or surgery may be required. In case of a complete ligament rupture of the thumb, surgery is performed early.
