As the temperatures begin to rise here in Arizona so do the number of finger injuries that we see at Cactus Pediatric Orthopaedics. This occurs as kids come out of winter hibernation and transition back into organized sports, mainly ball sports. It can be difficult to initially differentiate a minor injury (sprain) from a major injury (fracture), so we’d like to present some helpful information to navigate your child’s injury.

A sprain is an injury to a joint that causes a stretch or small tear in a ligament. Ligaments are strong bands of tissue that connect one bone to another. It is common in ball games such as football, basketball, volleyball, etc. Typically these injuries present with pain, swelling, decreased motion, tenderness, and eventually can cause bruising. In general, these injuries do not cause a deformity of the finger and tend to show improvement within days of injury.

Types of Sprains:

• Finger Sprain (Jammed Finger) – sprain of collateral ligaments at the interphalangeal (finger) joint
• Thumb Sprain (Gamekeeper’s or Skiers Thumb) – an injury typically to the ulnar collateral ligament at the base of the thumb. Often caused by hyperextension/radial deviation of the thumb with a fall or impact

A fracture is a break in a bone. When you break your finger the break may be small or large, straight or crooked, and may go into the joint. A finger fracture usually occurs from hitting a hard object with your finger, being hit by a ball, getting slammed in a door, or falling onto your hand. Much like sprains, fractures present with pain, swelling, decreased motion, bruising and tenderness; but may be set apart from sprains by the presence of angulation (crooked finger)or deformity. Finger fractures are not all created equally, and can vary greatly in characteristics and location. These injuries typically have lingering symptoms that might get worse before they get better.

Treatment for sprains is straight forward and can be remembered by the mnemonic RICE.

• R- Rest: Patients need to be restricted from all activities until symptoms resolve and they have full range of motion without pain
• I – Ice and Ibuprofen: Ice can be applied to the injured finger for 10-15 mins 3 times daily for the first few days. Ibuprofen (if tolerated and allowed) can be administered
• C- Compression: The finger can be placed into a splint or buddy taped to the adjacent finger.
• E – Elevation: Elevating the injured finger and hand above the heart helps eliminate pain and swelling.
• Treatment for a fracture can initially be much like treating a sprain but requires an x-ray for diagnosis. Once diagnosed as a finger fracture, the treatment may take different forms depending on the characteristics of the fracture. Fractures can be treated minimally by buddy taping and simple splints but may require a cast or even surgical intervention (rare). Your orthopedic provider will help inform you on proper treatment for great outcomes.

So next time your little one has an injury and you “just can’t seem to put your finger on the problem”, hopefully this info will help you navigate the injury and lead to a great outcome. And always remember that if swelling and pain symptoms don’t improve over a few short days then a consultation may be best to exclude a fracture from a severe sprain injury.