Home Pulpitis How to disguise clenched fists. Boxer's knuckle - a dangerous syndrome

Pulpitis

How to disguise clenched fists. Boxer's knuckle - a dangerous syndrome

Hello.
I have a knuckle on my middle finger right hand increased.
Once 2 months ago I hit a concrete wall with all my strength...

Then it was swollen and painful, then after a week everything went away.

But still, the knuckle has grown...

Now I wanted to ask how you can reduce it a little with the help of baths or ointments and massages?

Now it doesn’t hurt, and everything is fine, it just stands out a little more from the rest.

If there are any good tips please respond.

Thank you in advance.

Answer:

I want to disappoint you a little...

Most likely, the knuckle will not become smaller, and if it does, it will be only slightly.

The way you describe the current symptoms suggests that at the moment all regeneration processes have already been completed.

If you had started treatment in the acute phase, when there was swelling, pain, and other symptoms, then there would have been a high probability that everything could still be reversed...

I am telling this as an orthopedic doctor. However, I can say that he himself is a “shoemaker without boots,” i.e. a doctor with problems in his specialty...

Not having at the dawn of my sports youth the knowledge that I have now, I myself had exactly the same problems, which, however, I don’t consider as problems now, except for some dubious cosmetic defect. For a man this is not critical at all.

Look at my right fist. Knuckle index finger“flattened” and flattened, the middle one – enlarged, the little finger – the same. Only the nameless one “survived to old age” without changes. Although compared to his brothers, he looks especially awkward.

This, of course, could have been avoided. Which is what I recommend everyone to do. I received these defects from excessive fanatical zeal, multiplied by my own ignorance.

Now we have knowledge and experience, but it’s too late... to straighten the bones...

For comparison...

Relatively " correct form"left fist.

And for the future...

Broke a knuckle:

cold

hunger

doctor

NSAIDs

peace

physical therapy

...and everything will be Ok...

© Mikhail Shilov (SHIVA)

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Who in childhood did not punch his fists against a pear hanging forlornly in the corner of the room or a fence in the yard, and then, inspired by the example of masters of oriental martial arts, with an awkward blow try to punch through a wooden block or crumble a brick into dust?

What is padding and why is it needed?

Stuffing is a relatively long process, reminiscent of a Zen Buddhist procedure in its ceremonial monotony. If we add to this the masochistic tendency towards pain of the person producing it, then we can safely distinguish it as a special, unlike anything else spiritual practice. It has, however, a completely practical goal - to get a teeth-breaking fist.

In essence, padding is a procedural hardening of the striking surface: be it a fist, shin, head or even heel, allowing you to deliver and receive blows without pain, injury and damage to the connective tissues of the body, which, when hit with an unplanned force, risk turning into minced meat. Just like when a guitarist plays for a long time, his fingers become calloused, and his nerves become distant. longer distance from the surface, allowing him not to feel pain when playing on hard strings, and when hitting, bone structures are gradually transformed, joints are strengthened and the skin is thickened, reducing pain when striking.

How to punch your fists

Those who do not want to spend a large amount of Fastum Gel to heal inevitable injuries should practice all kinds of fist stands at first. There are a lot of options here - first of all, it’s worth experimenting with a stand in a push-up position, raising your arms and legs alternately or holding a short wooden pole in your fist. To begin with, it is better to stand on a wooden floor, and then move on to harder surfaces, for example, asphalt, if your Gym provides for its presence. Gradually, it is worth adding knuckle rolls and finger push-ups to the stand, and for the most athletic, an upside-down fist stand with an emphasis on the wall is suitable.

Such exercises, which are simple in some sense, actually give a serious primary result, forming the striking surface of the fist and strengthening the wrist joints and muscles directly involved in the blow - the deltoid, pectoral and abdominal press.

Having had plenty of fun in horizontal position, you can finally (after one or two months, depending on your physical fitness) move on to punching. The ideal tool in this sense is the makiwara, which was used by apologists of oriental martial arts to practice a knockout blow back in the 18th century. Then it was a wooden board dug into the ground, tied with several layers of rice straw, which the fighter gradually knocked down layer by layer until he began to beat on the bare wood. An important property of the makiwara is elasticity - when struck, its upper end, which receives the blow, should spring slightly.

Since then, the makiwara and the basic principles of working on it have not changed qualitatively. It is still a very affordable and effective hitting tool. A homemade makiwara can be installed in the backyard by digging a wooden beam of suitable height into the ground, securing it in the ground with bricks and wrapping the area to be struck with thick twine.

A slightly more adapted and practical version of the makivara can be installed at home by nailing a stack of newspapers eight to nine centimeters thick or a telephone directory of some million-plus city to the wall. While filling your fists (60–80 blows from each hand will be enough), you can tear off one leaf every day or let them fall off on their own - as a result, you will approach the initially frightening surface of a bare wooden wall without fear and timidity, with already prepared, calloused fists . Adherents of more authentic training methods, inspired by the example of Chinese monks from the foothills of Songshan, can be advised to attach wormwood leaves to the makiwara - it promotes the formation of calluses, so necessary for stuffing, and is also a good antiseptic.

When filling the fist specifically, the emphasis shifts to the kentos, that is, the protruding knuckles of the index and middle fingers (the knuckles of the ring and little fingers participate in blows to a lesser extent, and it is not worth filling them hard, since there are many nerve endings there). When punching your fists, you should limit the force of the blow - it should not be one hundred percent, otherwise you will simply injure your hands. Still, the main purpose of padding is to form and harden the striking surface, and not to sign up for an orthopedic therapy session based on the results of training. Therefore, 50–60% impact power will be quite enough.

In principle, such a tandem of exercises from push-ups on fists and impact procedures should be enough to reach a certain level at home, without the supervision of a trainer - of course, not in the shortest possible time. The result, as is customary in sports, will not appear in a week or a month - in bones, unlike muscles, the deformation process takes longer and they react more slowly to loads. Systematic exercise, coupled with perseverance and hardening, and in a year or two, fists will turn into a working tool with which you can calmly beat meat for steaks or form neat bruises on the body and faces of hooligans.

There are only two bundles (radial and ulnar); if one ruptures, the extensor tendons move to the opposite side.

The striking surface of the hand in most martial arts is the “knuckles” of the fist or, scientifically, the metacarpophalangeal joints (MCP) in a bent position. The hand clenched into a fist is vulnerable to injuries such as synovitis, rupture of ligaments and tendons upon impact. Most often, boxers suffer from a bruised fist. Boxer's Knuckle is the most dangerous injury for professionals and amateurs alike. The name appeared in 1957, when this syndrome was discovered in four boxers. Moreover, the injury is not related to boxing in itself. It can be obtained even if you fall to the ground unsuccessfully.

In boxing and other martial arts, the syndrome can be considered an occupational disease. It is provoked by regular blows with clenched fists in sparring or on a punching bag (as well as on wooden boards or walls). The tissue around the knuckles is injured and pain appears. The worst conditions are on the middle and index fingers, as they protrude forward.

A bruised fist after a blow in a boxer most often indicates an incorrect position of the fist at the moment of the blow. Another reason is the wrong choice of place of impact, for example, a blow to the forehead or elbow.

Proper hand bandaging will save you from injury

Boxer's Knuckle Symptoms

pain and sensitivity in the injured knuckle;
finger weakness or inability to fully straighten your fingers on your own;
the finger does not straighten on its own (complete tendon rupture);
swelling and edema.

The danger of boxer's knuckle syndrome is the difficulty of diagnosis. Due to swelling, tendon displacement or rupture of the capsule is almost impossible to detect immediately after injury. Accordingly, treatment of the syndrome begins late. When the swelling goes down, the pain disappears. The patient believes that everything has passed and returns to classes. However, after training with a punching bag or water bag at home, the pain and swelling return. Treatment after relapse is complicated by scarring of the damaged tissue.

To practice punches on a punching bag or bag, you need to use projectile gloves.

Treatment and prevention of boxer's knuckles

An important element of boxing, kickboxing and other combat sports is injury prevention. Boxer's knuckle syndrome is easier to prevent than to cure. Firstly, a fighter must learn to deliver precise, accurate strikes. Improper hand strokes increase the risk of injury. Hands must be protected with appropriate equipment (gloves, bandages).

Strikes should only be struck with protected hands.

Bandage - very effective method avoid rupture of ligaments and tendons of the hands. You need to use cotton bandages up to 5 cm wide. You need to bandage tightly, but do not overtighten. When the hand is unclenched, the bandage does not squeeze, but when clenched into a fist, it completely covers the hand. Inelastic bandages are preferable to elastic ones, since the latter compress blood vessels and lead to blood stagnation.

A boxer's knuckle can mean the end of a professional fighter's career. As for steroid drugs, they will help you stay in the ring for some more time, but will only increase the degradation of the damaged hand (arthrosis of the PFJ).

Do not ignore treatment for a bruised fist; this can lead to complications and more serious injuries. If your fist hurts after being hit, apply a cold compress to it as soon as possible. You can use ice, snow, a cold water bottle, or any cold object. Treatment of a bruised fist after a blow in boxers can also be carried out with the following ointments: Ibuprofen ointment, Heparin gel, Voltaren emulgel.

Boxer's knuckle syndrome

The main, and sometimes the only, striking surface of the hand in many martial arts (boxing, kickboxing, karate, etc.) is the metacarpophalangeal joints in a bent position. Simply put, these are the so-called “knuckles” of the fist. When the hand is clenched into a fist, the metacarpophalangeal joints are in a very vulnerable position for a whole range of injuries - bruise, synovitis

tendon of the second lumbrical muscle

extensor retinaculum

deep transverse metacarpal ligament

medial

Antonym - lateral edge. .

The metacarpophalangeal joint is formed by the head of the metacarpal bone and the base of the proximal

On the back side, the articular capsule is covered by the tendon of the extensor digitorum muscle and the tendon of the interosseous and lumbrical muscles, the fibers of which cover and hold the tendon of the extensor digitorum muscle and form the so-called “retainer” of the extensor muscle (Fig. 1, 2: (2)). The fibers that form the “retainer” of the extensor are called sagittal bundles, which in turn are divided into lateral

Antonym - medial edge. .

1 - rupture of the extensor retinaculum, 2 - head of the fifth metacarpal bone, 3 - tendon of the extensor muscle of the little finger, 4 - tendon of the muscle of the general extensor muscle of the fingers, 5 - muscle abductor of the little finger

The main mechanism of damage to the capsule of the metacarpophalangeal joint is a blow with a clenched fist. The joints of the index and middle fingers are most often affected, since they protrude most forward and are the main striking surface in boxing or other martial arts. Damage is most likely to occur when hitting a hard surface such as a piece of wood or a concrete wall (see forum post). Tendon dislocation can also occur due to inflammatory processes in the joint area (for example, rheumatoid arthritis

), which weaken and destroy the fibers of the sagittal fascicles, as well as in people with congenitally imperfect or absent sagittal fascicles.

In the acute phase, due to edema and swelling, rupture of the joint capsule and tendon displacement are almost impossible to diagnose. It is also difficult to detect a rupture of the joint capsule when the clinical presentation is atypical - there is a full range of motion in the joint and there is no tendon displacement detected by palpation

Boxer's Knuckle Syndrome

In martial arts, the hands are injured much more often than other parts of the body. One of the most common hand injuries is boxer's knuckle syndrome.

What is Boxer's Knuckle Syndrome?

Boxer's knuckle syndrome, which is characterized by pain and weakness, occurs due to injury to the tendons in the finger joints. The extensor tendons are attached by the forearm muscles to the bone that straightens the finger. When an injury occurs, the tendon or tissues that hold the tendons in a certain position are torn. This type of injury occurs mainly in the knuckle of the middle finger.

How does boxer's knuckle syndrome occur?

Boxer's knuckle syndrome occurs due to direct punching or repeated punching with a knuckle as seen in boxing or other martial arts and martial arts. The risk of damage increases from impacts with a wooden plank or concrete wall. The result of such blows is a rupture of the extensor tendon; the tissues that help hold the tendon in place accidentally injure the tissue surrounding the knuckle nodes.

Causes that increase the risk of boxer's knuckle syndrome

Sports such as boxing and other martial arts.
Poor physical preparation of the hands (poorly developed strength and flexibility).
Past or concomitant knuckle injuries.
Past or untreated sprains.

What are the symptoms of boxer's knuckle syndrome?

Pain and tenderness of the injured knuckle
Weakness or inability to fully straighten your fingers on your own
Full passive finger movement (can be straightened)
Swelling and swelling of the injured finger

The knuckles of the middle and index fingers are most often affected because they protrude more forward and take the brunt of the blow.

How is a medical examination carried out?

The patient's condition is diagnosed by examining the injured arm. An x-ray will need to be taken to determine the condition of the injury. Sometimes, if complications are suspected, an MRI is prescribed.

Treatment for Boxer's Knuckle Syndrome.

If the injury does not require surgery, initial therapy consists of applying a splint to keep the finger in a straight position. Ice should be applied to the injured finger, and the hand should be kept at eye level to prevent the swelling from enlarging. Painkillers may be prescribed to reduce pain. The duration of wearing the splint depends on the complexity of the injury and the degree of recovery.

Treatment of Boxer's Knuckle Syndrome surgical methods

Very often, boxer's knuckle syndrome requires surgery to restore injured tissue. After the operation, the muscles are fixed using a specially designed plaster splint, or a splint is applied.

Possible complications

Immediately after receiving an injury and when the first symptoms appear, you must immediately seek medical help. Otherwise, various complications may arise, such as:

Temporary loss of full range of motion.
Finger immobility.
Weakness of the hand and fingers.
Tendon rupture.
Inflammation of the joints.
Rapid return of symptoms and recurrence of injury.
More time is needed to heal the injury.
Injury to related organs (bones, cartilage, tendons).
Chronic injury.
Sometimes prolonged deterioration.
Risk of surgery. Infection and injury to nerve endings may occur, resulting in weakness and numbness.

Additional medical care

Seek additional medical help if the following symptoms persist or appear despite treatment:

increased pain,
feeling of weakness, numbness or coldness of the injured finger,
the nail becomes blue, gray or dark in color,
signs of infection: fever, increased pain, swelling, redness, fluid or blood on the affected area of the arm.

When can I return to sports?

Orthopedic traumatologist, Samilenko Igor: “If the patient plans to continue boxing, keep in mind that the rehabilitation period necessary for full recovery after surgery for boxer’s knuckle takes at least 5 months. The volume of loads needs to be increased gradually.”

After the splint, cast or cast is removed (with or without surgery), it is necessary to rehabilitate the injured arm by stretching and strengthening the injured and weakened joint and muscles.

Boxing for more than six years is dangerous for brain health, scientists from the USA have found.

Hand restoration can be carried out independently without additional medical manipulations such as acupuncture or special medical massage. Return to striking can begin no sooner than four months after full range of motion and strength have been restored.

How to prevent boxer's knuckle syndrome?

One of the main causes of hand injuries is incorrect equipment and imperfect striking technique.

It is necessary to maintain appropriate physical shape of the hands: flexibility of the fingers and hands, strengthen muscles and increase endurance.

Use protective equipment, such as boxing gloves and bandages.

To strengthen the joints and ligaments of the hands, as well as to prevent injuries to the hands, you need to do push-ups up to 100 times a day.

Bruised knuckle treatment

How to treat a broken joint on a fist? (1)

2 deniskaizer: Thanks for the advice! I'll try to look for this ointment.

And I thought that it just didn’t last so long for me.

By the way, in the past (this is even before the injury), I stood (resting on my hands) on the centuses, and developed decent calluses. But then I gave up on this matter, and they went away for me. But in vain, probably! In the past, I remember, one person was doing karate, working on his kentus, so (I saw with my own eyes) the cartilage on his kentus actually increased in size! He told me that he knew a person who had the same thing, but only these two increased in size cartilages had fused together! But no matter how hard I tried, I could not achieve the formation of thickened cartilage, only calluses. Interestingly, the increase in cartilage is individual feature body or some techniques that not everyone knows about?

Before this, there was also work on moistening hands, stuffing, and doing push-ups with fists. Now the joint is enlarged compared to the left hand, but at least it doesn’t hurt when struck.

Boxer's knuckle syndrome

"Boxer's knuckle" is a well-known sports medicine term used in the literature to describe one of the most serious and frequent injuries brushes

“Boxer's knuckle” is a well-known sports medicine term used in the literature to describe one of the most serious and common hand injuries: damage to the joint capsule of the metacarpophalangeal joint, the tendon of the extensor digitorum muscle, and the sagittal fascicles (radial and ulnar) that support the tendon. in a central position (Hame, 2000). When one of the sagittal fascicles is torn, the extensor digitorum tendon is displaced to the opposite side (Lopez-Ben, 2003; Posner, 1989). May also be present partial rupture joint capsule and longitudinal tendon dissection. Gladenn first described this injury in four boxers in 1957 and coined the term “boxer's knuckle” (Gladden, 1957). Since then, this injury has been called that, regardless of where and how it was received - during boxing or other martial arts, or when a person who had never practiced martial arts fell to the ground (Drapé, 1994)

Anatomy of the metacarpophalangeal joints

The metacarpophalangeal joint is formed by the head of the metacarpal bone and the base proximal phalanx. The joint is strengthened by collateral ligaments located on the sides of it. On the palmar side, the joint is stabilized by the palmar ligament. Its fibers are intertwined with the fibers of the deep transverse metacarpal ligaments, which prevent the heads of the metacarpal bones from diverging to the sides. (see Anatomy of the hand).

The fibers of each fascicle form a thin superficial layer that extends over the tendon of the extensor digitorum muscle and unites with the fibers of the opposite sagittal fascicle of the fascicle; and a thicker, deeper layer that lies underneath the tendon and forms a depression, a kind of channel, that stabilizes and holds the tendon in place. The intertendinous junctions (Fig. 1 (3)), connecting the tendon bundles of the index-middle finger, middle-ring finger and ring finger and little finger and located near the metacarpophalangeal joints, also help in stabilizing the tendons of the extensor digitorum muscle. The common digital extensor tendon at the level of the metacarpophalangeal joint consists of the superficial extensor tendon located centrally and the deep extensor tendon located on the sides.

The finger extensor muscles are located on the dorsum of the forearm, and their tendons stretch across the entire hand, pass through the tops of the metacarpophalangeal joints and are attached to the middle and tip of the fingers. For the index finger and little finger, there are additional extensor muscles of the index finger and little finger, respectively (Fig. 1 (10 and 11)). Their tendons also pass through the apices of the corresponding metacarpophalangeal joints, adjacent to the extensor digitorum communis and are stabilized by the same structures.

Mechanism of injury and symptoms of boxer's knuckle

The main mechanism of damage to the capsule of the metacarpophalangeal joint is a blow with a clenched fist. The joints of the index and middle fingers are most often affected, since they protrude most forward and are the main striking surface in boxing or other martial arts. Damage is most likely to occur when hitting a hard surface such as a piece of wood or a concrete wall (see forum post). Also, tendon dislocation can occur due to inflammatory processes in the joint area (for example, rheumatoid arthritis), which weaken and destroy the fibers of the sagittal fascicles, as well as in people with congenitally imperfect or absent sagittal fascicles.

Clinical signs of boxer's knuckle include joint pain, swelling, finger weakness on extension, and ulnar and radial displacement of the extensor digitorum tendon. In particularly severe cases, complete rupture of the tendon may occur. In this case, the corresponding finger completely loses the ability to straighten on its own.

In the acute phase, due to edema and swelling, rupture of the joint capsule and tendon displacement are almost impossible to diagnose. It is also difficult to detect a tear of the joint capsule when the clinical presentation is atypical - there is a full range of motion in the joint and there is no tendon displacement detected by palpation of the joint. Therefore, often the injury is not treated properly and after a while, when the pain goes away, repeated displacements and renewed inflammation are possible. Posner and Ambrose (1989) described 5 boxing cases, in each of which the pain went away after a few days, but after each sparring the pain and swelling reappeared (Posner, 1989).

Also, untreated injury can subsequently lead to constant clicking in the joint area. After the tumor disappears, determining instability and dislocation of the tendon is usually not difficult (with the exception of atypical cases), but treatment is complicated due to scar contraction. Drapé J. L. et al argue that physical examination is not sufficient for an accurate diagnosis. An example is the study by Posner and Ambrose, in which accurate diagnosis rupture of the tendon retinaculum was placed only during surgery (Posner, 1989). Drapé J. L. et al showed that diagnosis using MRI helps to determine the rupture of the sagittal fascicles. Early diagnosis is justified because early treatment leads to good results (Drapé, 1994).

Pathological anatomy"boxer's knuckles"

Rupture of the sagittal bands can cause the extensor digitorum tendon to move away from the center of the metacarpal head. During flexion movement in the metacarpophalangeal joint, the interosseous and lumbrical muscles contract and strain the medial and lateral sagittal bundles, stretching them in opposite directions. If the medial fascicle is destroyed, then the unopposed lateral fascicle will pull on the extensor digitorum tendon, which will lead to its ulnar dislocation (Fig. 3). Thus, the detection of tendon displacement to the ulnar side on MRI provides indirect evidence of a torn medial sagittal fascicle.

The metacarpophalangeal joint of the middle finger is most commonly affected by boxer's knuckle injuries. Dislocation of the common extensor tendon of the middle finger usually occurs in the ulnar direction. In a review of injuries in 55 people, all but 2 cases experienced ulnar displacement (Araki, 1989). Normally, the metacarpophalangeal joints of the index and middle fingers are rotated 10°-15° to the ulnar side, which predisposes the medial sagittal bundles increased risk injury. Experimentally on cadaveric material, it was determined that the extensor tendon is displaced to the ulnar side when the medial sagittal fascicle is dissected by two-thirds, while only when the lateral sagittal fascicle is completely dissected does a slight displacement to the radial side occur (Lopez-Ben, 2003).

With injury in the area of the 2nd and 5th metacarpophalangeal joints, another situation is possible. The rupture occurs between the tendon of the common extensor digitorum and the accessory tendon of the extensor muscle of the index finger or little finger (Fig. 1 (10 and 11, respectively). The rupture causes the two tendons to separate on either side of the head of the metacarpal bone (Fig. 4). A similar situation can become another condition is Weinstein's contracture (Drapé, 1994).When the MCP joint is in flexion, the displacement of the extensor tendon increases (Fig. 5). Therefore, diagnosis (MRI or simple physical examination) of the rupture joint capsule carried out with a clenched fist.

Some controversy surrounds the question of best method treatment of rupture of the joint capsule of the metacarpophalangeal joint. A 1994 paper by Drapé J.L. talks about 5 studies that report successful conservative treatment. In the early phase, the injury was treated by splinting the fully extended joint for 47 weeks. It is reported that this treatment led to complete restoration of finger function without recurrent dislocations. However, all the cases described were quite mild (Hame, 2000). Dr. Sharon Hame believes that conservative treatment is only possible if the person does not engage in sports in the future.

If the tear is severe and the person desires to continue his sports career, most authors recommend surgical treatment. If the joint capsule is damaged, experts recommend only treating it, but not protecting it, as this will cause tension on it, which will further limit the range of motion in the joint. In the work of Posner M. A. and Ambrose L. for 1989, 5 cases were reported when, after unsuccessful conservative treatment in all cases was carried out surgery with a recovery period of 24 weeks or more. Dr. Hame reports surgical treatment 7 ruptures, all of which ended successfully with full restoration of range of motion in the joint and return to boxing after an average of 5 months of rehabilitation (Hame, 2000).

IN chronic cases Surgery may be required, consisting of weakening the opposite sagittal fascicle and autoplasty of the damaged tendon. (Drapé, 1994)

Prevention of boxer's knuckle injuries

Prevention of injuries to the metacarpophalangeal joints includes measures such as a careful approach to training and striking technique, proper bandaging of the hands and the use of good boxing gloves, additional special protective equipment and constant medical supervision.

A boxer must learn to throw effective, accurate, accurate punches. You should avoid a large number of inaccurate, “loose” strikes, which increase the likelihood of vulnerable hand positions. Strikes can only be performed if there is no pain in the hand, and only with a protected fist.

When practicing striking martial arts, the athlete’s fists must be protected. First of all, the hand should be well bandaged with special bandages. Hands should be bandaged with a cotton bandage; the most convenient width of bandages is the length - from 3.0 to 4 m. Now all commercially available bandages are already equipped with a thumb loop at one end of the bandage and Velcro for fastening at the other. The hand should be bandaged tightly, but not overtightened, so as not to squeeze the blood vessels. When unclenched, the bandage should not press, but when the fist is clenched, it should tightly clasp the hand. Many athletes advise using inelastic bandages that do not stretch, since an elastic bandage can overly tighten the hand and lead to blood stagnation.

Also during training, for additional protection of the “knuckles,” you can use special silicone pads or gloves with such inserts. Experts recommend using such pads on both the back and palm sides of the hand. The rear silicone inserts will protect the hand from a direct blow, and on the palm side they will prevent excessive bending of the fingers upon impact.

Also, it will never be superfluous to constantly undergo medical examination and draw the attention of doctors to any inflammation and painful sensations in the area of the hand and metacarpophalangeal joints.

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Restoring a hand after a bruise - symptoms and types of hand and wrist injuries

The upper extremities are susceptible to injury. One of the most typical injuries is a bruise of the arm in the area between the elbow joint and the hand. Anatomically, this area is called the forearm. Despite the apparent simplicity of the injury and the ease of progression of the bruise, the painful condition can limit a person’s quality of life for several weeks. Moreover, the consequences of some injuries can persist for a long period, leading to serious impairment of limb function.

Causes and methods of getting hand bruises

The painful condition is a traumatic injury to all tissues of the forearm without destruction of bone structures. Usually the muscles suffer subcutaneous tissue, as well as the vessels and nerves located in this area. The main cause of hand bruises is trauma due to direct strong contact of this part of the body with a hard surface.

Most often the problem occurs in the following situations:

when falling on your hand;
if a knuckle is injured during sparring between athletes or in a street fight;
when hitting a hard surface;
during careless handling of equipment in dacha conditions;
as a result of compression by two hard objects.

Since hands are an integral part of a person’s active life, they are especially often injured during everyday or sports activities. Hand bruises occur regularly in the following population groups:

The mechanism of injury is always the same - as a result of strong contact with a hard surface, the soft tissues of the forearm are damaged. This leads to rupture of small capillaries, destruction of nerve fibers, and muscle damage. As a result of a violation of integrity vascular wall Local hematomas are formed, and edema forms and increases in the area of injury.

The main manifestations of hand bruises

The problem is always a consequence acute injury, so all symptoms develop immediately after receiving it, and then progress. The forearm is anatomically characterized by a small layer of subcutaneous fat, so with bruises there is a high probability of damage to nerve trunks and vascular lines. In the same area are the bone structures of the wrist joint and small joints of the hand.

Clinical manifestations of bruise are as follows:

severe pain in the damaged area, which radiates to the shoulder, hand, or even to the armpit;
swelling of the tissues of the forearm;
skin hyperemia, which then turns into long-lasting cyanosis;
limb dysfunction;
inability to work with a brush;
numbness and paresthesia distal sections upper limb.

The bruise can involve the bones of the wrist, elbow, as well as neighboring parts of the limb - the shoulder or phalanges of the fingers. In this case, there is a sharp limitation in the function of the hand, it goes numb, since the painful condition is accompanied by damage nerve structures over a large area.

The main symptom that forces the patient to seek medical help is pain. Its strength is initially caused directly by a strong blow, and then persists due to the formation of a hematoma.

Any damage radius increase pain, but there are no visible fractures with bruises. The swelling of the arm, due to massive swelling caused by impaired circulation and lymphatic drainage, remains for several days.

As the function of the arm is restored, the pain first disappears, then the swelling, and only after that the normal color of the skin appears. However, bruises can persist for a very long time, since their resorption is highly dependent on individual characteristics blood parameters and the strength of the traumatic impact.

There are three degrees of severity of a hand injury. Their main differences are discussed below.

Slight bruise. The injury is limited to a small area. Bone structures and great vessels are not damaged. All clinical manifestations disappear within 2 weeks.
Moderate bruise. Severe swelling and pain syndrome. There is a hematoma, which is characterized by a persistent course. Individual areas of soft tissue crushing. Bone structures are intact. Convalescence occurs within a month.
Severe bruise. Signs of soft tissue crushing and damage to periosteal structures. Sharp pain, prolonged swelling, damage to nerve trunks and great vessels. Complications often arise that require surgical treatment. Convalescence is long, symptoms of general intoxication last up to a week, and recovery takes up to 3 months.

A severe bruise cannot be cured quickly, as it often persists for a long time afterwards. neurological disorders(the hand goes numb) and the function of the limb decreases.

A long-lasting hematoma has high risk infection, which is dangerous due to the development of phlegmonous inflammation. As a result, ossification sometimes occurs, making the muscles hard, less functional, and requiring surgery.

One of the types of pathology of the distal parts of the hand is a bruised fist. It occurs due to direct contact of a limb in a compressed state with a solid object. As a result, a sharply painful lump forms on the back of the hand below the wrist joint. This bump lasts a long time after an impact, as it is a consequence of crushing soft tissues and resulting local swelling. As a result, ossifications form at this site, which are removed surgically.

How to distinguish the manifestations of a hand bruise from a fracture

The first question facing a person who has been injured is to rule out a fracture. The table below shows the main distinctive features these pathological processes.

It is often impossible to accurately determine whether a fracture is present based on clinical data alone. Due to the individual sensitivity of the body, pain can be very difficult to bear, and tissue compaction after a bruise can simulate a fracture. Therefore, it is imperative to contact the emergency room as soon as possible for a full diagnosis of the problem.

Diagnosis of hand bruises

In most cases, the bruise is not life-threatening for the patient. However, during the diagnostic process, it is important to distinguish it from other serious injuries - fractures, sprains or ruptures of muscles and tendons. Therefore, in addition to a clinical examination and studying the details of injury, it is indicated instrumental examination. The main stages of the diagnostic search are discussed below.

X-ray of the forearm. Helps the doctor understand whether there is a bruise or fracture of a limb, since bone structures are clearly visible during the examination.
Ultrasound. The method provides diagnostics of the condition of soft tissues - the presence of hematomas, muscle or tendon ruptures.
CT scan. If, during an X-ray examination, questions remain regarding problems with bone structures, then they should be examined layer by layer. This is ensured through CT scanning of the forearm.
MRI. This precise method is rarely used, but it is indispensable in diagnosing processes occurring in soft tissues. MRI helps to understand whether there is a bruise or muscle strain, small tendon ruptures and hidden hematomas.

Additionally, blood tests are used to assess hemoglobin levels and acute phase parameters. The entire diagnostic search is carried out within a short time, as it is necessary to assess the severity of the injury.

Emergency care: general principles of treatment for a bruised hand

Since the body’s reaction to an injury develops especially strongly in a matter of minutes, it is necessary to quickly provide qualified first aid. It includes the following points:

free your hand from clothes;
apply cold - if it is ice, then not on the skin, but through a towel or bandage;
ensure immobilization, since visually distinguishing signs of a bruise from a fracture is very problematic;
give painkillers - diagnosis in a medical facility is not based on subjective feelings patient, therefore taking analgesics is justified;
transported to the hospital for examination by a doctor and x-rays.

To ensure cold, it is better to use compresses with water, periodically changing the bandage.

Traditional treatment for a bruised hand at home

Typically, a hand bruise requires treatment at home, since only patients with suspected serious injury or when it is impossible to exclude damage to the great vessels are hospitalized. General principles treatments include:

taking analgesics, often from the NSAID group (diclofenac, naproxen, nimesulide);
elastic bandage to improve hematoma resorption;
external therapy to relieve the tumor - anticoagulants and reparants (heparin, dexpanthenol);
if there is damage nervous system– vitamins and antispastic agents;
in the presence of a pronounced emotional reaction of the patient, sedatives are used.

If a child’s hand is swollen and hurts, then it is necessary to short time restore its activity. Compresses with cold saline solution, external gels for resorption of hematomas and analgesics from the paracetamol group will help. If they are not very effective, then only ibuprofen can be used among non-steroidal anti-inflammatory drugs.

The principles of treatment for hand bruises caused by a fall or after a strong blow are practically the same. The most important condition A speedy recovery is achieved by using cold in the first minutes after injury. This will limit the size of the hematoma, which will allow for rapid treatment and restoration of activity of the upper limb.

Recovery after a hand injury and possible consequences

The problem does not apply to severe injuries, so convalescence occurs within days. Bruises resolve, as rehabilitation progresses, they become yellowish, and then only a hyperpigmented area on the skin remains.

However, as a result of the bruise, long-term consequences may persist. These include:

hematoma suppuration;
compression of the midline structures of the arm, which leads to impaired blood circulation and innervation of the limb;
muscle ossification - painful compaction in soft tissues that makes active movements difficult;
damage to nerves and blood vessels.

The consequences of a hand injury more often occur after a fall, since the mechanism of injury is associated with the impact of body weight on upper limb. All complications are curable, but rehabilitation sometimes increases to 6 months. The therapy process includes drugs that increase blood flow to the limb, as well as improve the trophism of nervous tissue (peripheral vasodilators, muscle relaxants and vitamins). Sometimes surgical treatment is necessary to eliminate ossified areas.

Conclusion

Thus, a hand bruise is a painful injury that can deprive a person of his ability to work for a long time. The consequences of damage to the forearm can remain for many years, affecting the function of the limb. Muscle ossification is especially dangerous, leading to the appearance of rough, painful lumps at the site of injury. In the absence of complications, a hand bruise disappears within 2 weeks, and severe cases last up to 3 months. The sooner the patient is provided qualified assistance, the faster the favorable outcome of the injury will occur. In most cases, conservative treatment gives a positive result and provides a good prognosis for a speedy recovery.

Bruised hand

A hand bruise is most often the result of a blow or fall. The injury is quite common. It is a soft tissue bruise. In this case, there is no violation of the integrity of the skin, and the bones are also not injured. Statistics say that it is the hands that are injured most often. This can be explained as follows: when falling or colliding, any person puts them forward at the level of instincts, trying to protect themselves.

Trauma code according to ICD 10

According to the international classification of diseases ICD, the classifier code for hand contusion is S60.2. Class S60 describes multiple superficial and unspecified injuries of the wrist and hand.

Causes

Bruising of the hand from a fall or impact occurs most often, but there is a possibility of injury for other reasons:

Hand squeezing (in the door).

Sudden collision with various objects and objects.

Injuries resulting from sports activities.

In a child, damage can occur if the baby falls, as well as during play.

There are quite a lot of reasons why the population visits medical institutions due to damage to the knuckle, metacarpal bone and other types of injuries. Most often this occurs due to the influence of external causes, which can lead to various consequences.

Symptoms

A bruise of the palm, metacarpal bones, left or right hand has certain signs:

Pain in the hand area. It can be transferred to the forearm or to the fingers.

Hematomas and subcutaneous hemorrhages. They do not appear immediately, but after a few hours.

Problems with motor function.

Edema.

Feeling numb.

Redness of the skin.

Reduced sensitivity indicators.

One of the symptoms that distinguishes a bruise from a fracture is the preservation of the functionality of the hand, despite possible difficulties. Any attempts to fully move the hand cause severe pain. If the bruise is very severe, throbbing, burning and cramping may be felt. There is a possibility of fainting due to severe pain.

First aid

First aid for a bruised hand is to apply a cold compress. It is recommended to do this as quickly as possible - within 15 minutes after injury. If you omit this recommendation, subsequent treatment of the hematoma and removal of swelling will take a long time.

A cold compress can be any item you have. If the incident occurred on the street, you should run into a store or cafe and ask for ice. You can also use ordinary cabbage. You need to tear off the leaves and apply them to the damaged area. You can make an “ice compress” (ice wrapped in a cloth) at home.

What to do if you have a hand injury

If the wrist joint (wrist) is bruised, the victim is provided with first aid. After this, he must be urgently taken to the nearest hospital. In case of severe injury, first aid is as follows:

A cold compress is applied to the injury site.

The damaged area is washed with cold water. Next it is dried.

You can apply a bandage to the injury site. A specialist should bandage the bruise.

To prevent the hand from becoming even more swollen, and also to reduce bleeding due to bruising of the joint, it is recommended to hold it vertically.

Some people are interested in what to do if they bruise their hand if the pain does not subside within an hour. This may indicate a fracture. It is important to see a doctor promptly. If a specialist diagnoses a bruise, treatment is allowed at home.

To do this correctly, you need to consider the following recommendations:

Cold compresses are placed on the injured area, holding them for no more than 10 minutes every two hours.

To reduce pain, you can apply ointments and take painkillers.

24 hours after injury, thermal procedures can be performed. They will speed up recovery, promoting the resorption of the hematoma and the restoration of damaged tissue.

Diagnosis and treatment

A severe bruise of the hand requires mandatory diagnosis by a doctor and subsequent qualified treatment of the bruise of the hand. Many people are concerned about the question of how to determine a fracture, because the symptoms of these two injuries are very similar. You can accurately understand whether it is a bruise or a fracture of the arm only with the help of an x-ray. Treatment is prescribed after diagnosis. However, if the hand is very swollen, there is a high chance that the bone may be affected. However, there is swelling that subsides quite quickly, most likely it is a dislocation or bruise.

Remember that it is impossible to distinguish a fracture from a bruise on your own. The doctor makes a diagnosis based on examination and x-rays. The main signs of a wrist fracture include:

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Acute pain and complete loss of hand functionality.

Presence of subcutaneous bleeding.

The inability to take something in the hand if the hand is fractured, to rotate the hand or move the fingers if they are also injured.

Inability to lean on a broken arm.

Unnatural mobility of the hand, it feels like it’s just dangling.

It is important for the victim to learn how to quickly heal a bruise or sprain. To relieve puffiness it is worth using medications– creams, gels and ointments. You can choose Ketotifen, Diclofenac sodium, Ibuprofen, which are considered the most popular. It is recommended to smear them injured hand 3 times a day. In this case, application to open wounds is invalid.

If you have hematomas and bruises, you can use Badyaga. It is applied to the hand in layers and bandaged. After a day, the use of camphor oil is allowed, which is used to lubricate the hand. Twice a day it is recommended to rub the bruised area with an alcohol tincture of wild rosemary, which has the ability to relieve swelling.

If the bruise hurts for a long time, you should consult your doctor again. With such injuries, there is a possibility of developing complications that take longer to resolve and require additional treatment, for example, physiotherapy or reflexology.

How to treat a hand bruise at home

Interested in how to treat a bruised hand, many choose treatment at home folk remedies. A compress is called a good remedy; it can help even in the first day if applied cold. It contains equal proportions of water, vinegar and vegetable oil. The resulting medicinal product is smeared on the hand and bandaged. The procedure is repeated three times a day. It is important not to hold the cold compress on for more than 10 minutes. Three days after injury, you can use a warm compress.

Chlorophyll will help relieve inflammation. To do this, you need to take the leaves and grind them to a paste. The resulting composition is lubricated on the injured area, excluding open wounds. Sea salt baths will help relieve or reduce pain. For 5 liters of water, 200 grams of salt is enough. After preparing the bath, put your hand in it for half an hour. If the liquid cools down, it is necessary to add hot water.

Famous healing properties and aloe. At home, you can make an ointment from this plant. It is enough to take honey and aloe in equal quantities. The resulting mixture is applied to the damaged area of the hand. This composition has an excellent ability to relieve pain.

Rehabilitation

After a bruise, the hand needs restoration. To do this, you need to develop it through simple exercises:

You need to place your palm on the table and drum your fingers on its surface. The exercise is very similar to imitation of playing the piano.

You need to sit down and straighten your back. The palms are folded together and swung from side to side according to the principle of a metronome. In this case, during the exercise you should act carefully so as not to damage the hand.

The injured hand is placed on the table surface and pressed tightly without excessive pressure. The exercise consists of trying to lift your fingers up from the tabletop.

The hand is turned with the palm towards you. A small object is placed in the palm, for example, an eraser or a matchbox. It is gently squeezed with your fingers.

Small balls that are moved between the fingers to restore blood circulation are also recommended.

If you cannot restore the functionality of your hand on your own, you can sign up for a professional massage course. Self-massage also helps. It involves gradually kneading the hand from the fingertips to the wrist. This helps get rid of swelling faster.

At severe bruises The doctor prescribes additional acupuncture. Sensitivity in the hand is usually restored after several procedures. Compliance with the recommendations is the key to returning the functionality of the hind limb.

Complications and consequences

If you bruise your hand, there is a possibility of complications. Most often they are the result of incorrect or untimely treatment. The most common types of consequences include:

Today, almost all complications are treated. However, they can be avoided if you consult a specialist in a timely manner and follow further treatment recommendations.

Dear readers of the 1MedHelp website, if you still have questions on this topic, we will be happy to answer them. Leave your reviews, comments, share stories of how you experienced a similar trauma and successfully dealt with the consequences! Your life experience may be useful to other readers.

After a strong blow with a fist, weakness of the fingers is often felt when straightening them, pain in the joint area, the damaged areas may be swollen, and the extensor muscle tendons may be displaced. If the blow is too strong, the tendon may rupture completely, causing the corresponding fingers to become unable to straighten without assistance. The tricky thing about broken knuckles is that swelling in the acute phase of the injury makes it almost impossible to diagnose tendon displacement and rupture of the joint capsule. This leads to a lack adequate treatment, and after the pain passes, problems with the joints of the fingers begin.

The most common effect of damaged knuckles is permanent pain in the area of the finger joints.

If there are atypical clinical manifestations, representing the absence visible displacement tendons upon palpation, as well as the full range of motion of the fingers, a person most often ignores the injury. As a result, the tendon, after the damage passes into the chronic phase, can re-displace and become inflamed, and treatment will be significantly complicated by its cicatricial tightening. To avoid this, it is necessary to visit the trauma department immediately after receiving an injury and have an X-ray of the hand and wrist joint taken.

Fast treatment

In order for broken knuckles to heal as quickly as possible, it is necessary to lubricate them several times a day with Indovazin ointment for ten days. As an additional treatment, you can use Nise tablets, as well as a special pharmaceutical salt, which must be diluted in a bowl of warm water and the damaged hand should be placed there for ten minutes, while massaging it. It is also recommended to do such salt baths for ten days.

The clinic offers physiotherapeutic procedures and small UHF treatments for the treatment of knuckles.

In case of severe bleeding, you can moisten the wounds with a few drops of hydrogen peroxide every five to ten minutes for an hour, after which the knuckles can be lubricated with “Rescuer” ointment. For severe hematomas and tumors, you should lubricate them with camphor oil - or lightly pierce the bruises with a sterilized thin needle and release the thickened blood. This will allow the knuckles to heal faster, grow new skin and take on a normal appearance.

Boxer's knuckle syndrome

, ligament and tendon injury, rupture of the joint capsule (Drapé, 1994). " is a term known in sports medicine, used in the literature to describe one of the most serious and frequent injuries of the hand: damage to the joint capsule of the metacarpophalangeal joint, the tendon of the extensor muscle of the fingers and the sagittal bundles (radial and ulnar), which hold the tendon in a central position (Hame, 2000).When one of the sagittal fascicles is torn, the extensor digitorum tendon is displaced to the opposite side (Lopez-Ben, 2003; Posner, 1989).Partial rupture of the joint capsule and longitudinal dissection of the tendon may also be present.First Gladenn in 1957 described this injury in four boxers and coined the term "boxer's knuckle""(Gladden, 1957). Since then, this injury has been called that, regardless of where and how it was received - in boxing or other martial arts, or when a person who had never practiced martial arts fell to the ground (Drapé, 1994 ) Anatomy of the metacarpophalangeal joints

	tendon of the second lumbrical muscle extensor retinaculum deep transverse metacarpal ligament medial sagittal bundle tendon of the second dorsal interosseous muscle head of the third metacarpal bone intertendinous junction extensor digitorum tendon extensor tendon of the index finger dorsal interosseous muscles extensor tendon of the little finger
Rice. 1 - Back of the right hand, area of the metacarpophalangeal joints		Rice. 2 - Dorsal side of the 3rd metacarpophalangeal joint of the right hand

The metacarpophalangeal joint is formed by the head of the metacarpal bone and the base of the proximal

phalanx. The joint is strengthened by collateral ligaments located on the sides of it. On the palmar side, the joint is stabilized by the palmar ligament. Its fibers are intertwined with the fibers of the deep transverse metacarpal ligaments, which prevent the heads of the metacarpal bones from diverging to the sides. (see Anatomy of the hand).

(ulnar) and medial(ray). The fibers of each fascicle form a thin superficial layer that extends over the tendon of the extensor digitorum muscle and unites with the fibers of the opposite sagittal fascicle of the fascicle; and a thicker, deeper layer that lies underneath the tendon and forms a depression, a kind of channel, that stabilizes and holds the tendon in place. The intertendinous junctions (Fig. 1 (3)), connecting the tendon bundles of the index-middle finger, middle-ring finger and ring finger and little finger and located near the metacarpophalangeal joints, also help in stabilizing the tendons of the extensor digitorum muscle. The common digital extensor tendon at the level of the metacarpophalangeal joint consists of the superficial extensor tendon located centrally and the deep extensor tendon located on the sides.

Mechanism of injury and symptoms of boxer's knuckle

Rice. 3 - Damaged articular capsule of the 3rd metacarpophalangeal joint of the right hand, back side. Medial rupture sagittal bundle and the nearest fibers of the extensor retinaculum leads to a displacement of the tendon to the ulnar side

Rice. 4 - Boxer's knuckle injury"in the area of the 5th metacarpophalangeal joint of the right hand, dorsum. These two tendons are separated. The head of the metacarpal bone is located between the tendons. The sagittal bundles are not torn.
1 - rupture of the extensor retinaculum, 2 - head of the fifth metacarpal bone, 3 - tendon of the extensor muscle of the little finger, 4 - tendon of the muscle of the general extensor muscle of the fingers, 5 - muscle abductor of the little finger

Rice. 5 - Damaged “retainer” of the extensor in the bent position of the joint. The head of the metacarpal bone is located under the area of \u200b\u200bthe tear and contraction in the joint further increases the displacement of the tendon

), which weaken and destroy the fibers of the sagittal fascicles, as well as in people with congenitally imperfect or absent sagittal fascicles. joint Therefore, often the injury is not treated properly and after a while, when the pain goes away, repeated displacements and renewed inflammation are possible. Posner and Ambrose (1989) described 5 boxing cases, in each of which the pain went away after a few days, but after each sparring the pain and swelling reappeared (Posner, 1989). Also, untreated injury can subsequently lead to constant clicking in the joint area. After the tumor has subsided, determining instability and dislocation of the tendon is usually not difficult (with the exception of atypical cases), but treatment is complicated due to cicatricial contraction. Drape J.L. et al argue that physical examination is not sufficient for an accurate diagnosis. An example is the study by Posner and Ambrose, in which a definitive diagnosis of tendon retinaculum rupture was made only during surgery (Posner, 1989). Drape J.L. et al showed that MRI diagnosis helps identify sagittal fascicular tears. Early diagnosis is warranted because early treatment leads to good results (Drapé, 1994). Pathological anatomy of the boxer's knuckle

Rupture of the sagittal bands can cause the extensor digitorum tendon to move away from the center of the metacarpal head. During flexion movement in the metacarpophalangeal joint, the interosseous and lumbrical muscles contract and strain the medial and lateral sagittal bundles, stretching them in opposite directions. If medial the bundle will be destroyed, then the lateral the bundle will pull on the extensor digitorum tendon, which will lead to its ulnar dislocation (Fig. 3). Thus, detection of tendon displacement to the ulnar side on MRI provides indirect evidence of a torn medial sagittal bundle.

The metacarpophalangeal joint of the middle finger is most commonly affected by boxer's knuckle injuries.". Dislocation of the common extensor tendon of the middle finger usually occurs in the ulnar direction. In a review of injuries in 55 people, in all but 2 cases there was displacement to the ulnar side (Araki, 1989). Normally, the metacarpophalangeal joints of the index and middle fingers are turned 10°-15° to the ulnar side, which predisposes medial sagittal bundles to an increased risk of injury. Experimentally using cadaveric material, it was determined that displacement of the extensor tendon to the ulnar side occurs when the medial sagittal bundle by two thirds, then this is only possible with complete dissection of the lateral The sagittal bundle undergoes a slight shift to the radial side (Lopez-Ben, 2003).

Weinstein (Drapé, 1994). When the metacarpophalangeal joint is in flexion, extensor tendon displacement increases (Figure 5). Therefore, diagnosis (MRI or simple physical examination) of a rupture of the joint capsule is carried out with a clenched fist. Treatment for boxer's knuckle

Some controversy surrounds the best method of treating a ruptured joint capsule of the metacarpophalangeal joint. In the work of Drapé J.L. for 1994, there are 5 papers reporting successful conservative

treatment. In the early phase, the injury was treated by splinting the fully extended joint for 47 weeks. It is reported that this treatment led to complete restoration of finger function without recurrent dislocations. However, all the cases described were quite mild (Hame, 2000). Dr. Sharon Hame believes that conservative Treatment is possible only on the condition that the person will not engage in sports in the future. If the tear is severe and the person desires to continue his sports career, most authors recommend surgical treatment. If the joint capsule is damaged, experts recommend only treating it, but not protecting it, as this will cause tension on it, which will further limit the range of motion in the joint. In the work of Posner M.A. and Ambrose L. for 1989, 5 cases were reported when, after unsuccessful conservative Treatment in all cases was surgery with a recovery period of 24 weeks or more. Dr. Hame reports surgical treatment of 7 ruptures, all of which were successful with full restoration of range of motion in the joint and return to boxing after an average of 5 months of rehabilitation (Hame, 2000).

In chronic cases, surgery may be required, consisting of weakening the opposite sagittal fascicle and autoplasty

damaged tendon. (Drapé, 1994) Prevention of boxer's knuckle injuries

When practicing striking martial arts, the athlete’s fists must be protected. First of all, the hand should be well bandaged with special bandages. Hands should be bandaged with a cotton bandage; the most convenient bandage width is 40-50 mm, length - from 3.0 to 4 m. Now all commercially available bandages are already equipped with a thumb loop at one end of the bandage and Velcro for fastening at the other. The hand should be bandaged tightly, but not overtightened, so as not to squeeze the blood vessels. When unclenched, the bandage should not press, but when the fist is clenched, it should tightly clasp the hand. Many athletes advise using inelastic bandages that do not stretch, since an elastic bandage can overly tighten the hand and lead to blood stagnation.

It will also never be superfluous to constantly undergo medical examination and draw the attention of doctors to any inflammation and pain in the area of the hand and metacarpophalangeal joints.

References

Sports injuries. Clinical practice prevention and treatment/ under general ed. Renström P.A.F.H. - Kyiv, “Olympic Literature”, 2003.
Araki S, Ohtani T, Tanaka T. Acute dislocation of the extensor digitorum communis tendon at the metacarpophalangeal joint. J Bone Joint Surg. 1987, vol.69, pp.616–619.
Arai K, Toh S, Nakahara K, Nishikawa S, Harata S. Treatment of soft tissue injuries to the dorsum of the metacarpophalangeal joint (Boxer's knuckle). J Hand Surg. 2002, vol.27, no.1, pp.90-95
Drapé JL, Dubert T, Silbermann O, Thelen P, Thivet A, Benacerraf R. Acute trauma of the extensor hood of the metacarpophalangeal joint: MR imaging evaluation. Radiology. 1994, vol.192, no.2, pp.469-476
Gladden JR. Boxer's knuckle; a preliminary report. Am J Surg. 1957, vol.93, no.3, pp.388-397
Hame SL, Melone CP Jr. Boxer's knuckle in the professional athlete. Am J Sports Med. 2000, vol.28, no.6, pp.879-82.
Lopez-Ben R, Lee DH, Nicolodi DJ. Boxer knuckle (injury of the extensor hood with extensor tendon subluxation): diagnosis with dynamic US--report of three cases. Radiology. 2003, vol.228, no.3, pp.642-646
Posner MA, Ambrose L. Boxer's knuckle - dorsal capsular rupture of the metacarpophalangeal joint of a finger. J Hand Surg. 1989, vol.14, no.2, part 1, pp.229-236