4 Common Types of Soft Tissue Injuries in the Hand

Soft tissue refers to the tendons, ligaments, nerves, blood vessels, and muscles that support bones and joints throughout the body. Sprains and strains are common examples of soft tissue injuries. These injuries are usually caused by either chronic overuse or physical trauma to the hand. Soft tissue injuries will often heal with rest and time, but it’s important to have a professional evaluate, diagnose, and treat them properly so you don’t overlook a serious problem.

Tendons are the fibrous bands of tissue that attach your muscles to your bones. Your hands have two sets of tendons:

• Flexor tendons: A set of nine tendons along the palm of your hand that help your fingers and thumb bend, allowing you to make a fist and pick up objects.
• Extensor tendons: A set of 12 tendons along the back of your hand that straighten your thumb and fingers, allowing you to loosen a grip and release objects.

Tendon injuries are the second most common form of injury to the hand. There are many types of tendon injuries that you might sustain. Some of the most common include:

• Jersey fingerTypically caused by impact injuries in contact sports, such as football or rugby.
• LacerationsCaused by sharp objects that cut through your skin to your tendons.
• Mallet fingerHappens when something hard hits the tip of your finger, causing it to droop downward.

Ligaments are the fibrous cord-like tissues that connect bones to one another. The primary ligaments in the hand are the collateral, volar, and dorsal ligaments.

Ligament injuries are usually the result of a sudden fall or impact that causes the fingers or wrist to bend sharply, leading to sprain, strain, or tear. Common ligament injuries include:

• Scapholunate ligament injury: A type of wrist trauma usually caused by falling on your hand.
• Ulnar collateral ligament injury: Known as skier’s thumb, this injury occurs when the thumb is bent sharply and can make it difficult to pinch or grip items.

Nerves convey messages between the brain and body. They sense pressure, pain, and temperature, so you can react appropriately. Many of the nerves in the hand start at the shoulder, controlling reflexes all along the arm. Nerve injuries occur due to trauma or illness when nerves are compressed, stretched, or severed. Underlying conditions such as Guillain-Barré syndrome, diabetes, and cancer may cause nerve damage as well.

Carpal tunnel syndrome is the most common nerve injury in the hand. This occurs when the median nerve is compressed where it passes through the carpal tunnel in the wrist.

Six arteries feed into the hand, including:

• Deep palmar archSupplies blood to the index finger and thumb.
• Superficial palmar archSupplies blood to the palm and fingers.
• Common digital arteriesSmall blood vessels that branch from the superficial palmar arch and supply blood to the fingers.
• Digital arteries to the thumbArteries that supply blood to the thumb and the radial side of the index finger.
• Proper digital arteriesBranches from the common digital arteries supply blood to the fingers. Each finger has two proper digital arteries that run on either side.

Many hand injuries can also cause vascular trauma. Blood vessels can become pinched, punctured, or severed. Blood vessel injuries often accompany another type of injury. An exception is hand ischemia, which is the formation of a blockage in a blood vessel.

Soft tissue injuries are often the result of a trauma that makes them immediately noticeable. You may even hear a popping sound at the time of the injury. Soft tissue injuries of the hand typically cause symptoms such as:

• Pain with movement
• Swelling
• Bruising
• Finger drooping
• Joint instability
• Stiffness
• Weakness
• Inability to straighten or bend a finger or thumb

Nerve injuries have distinctive symptoms that include:

• Decreased muscle tone
• Changes in sweating patterns
• Loss of sensation
• Tingling or numbness

Blood vessel injuries are often accompanied by bleeding that makes them especially obvious. However, if the skin isn’t broken or the blood vessel is only compressed, you may experience symptoms such as:

• Sensitivity to cold temperatures
• Cold fingers or hands
• Color changes in the fingertips

Your doctor will typically begin with a physical examination of the hand. They might manipulate your fingers, thumb, or wrist to assess the range of motion. Imaging such as X-rays, CT scans, MRI scans, and ultrasounds is often required to determine the extent of the injury.

You can often treat soft tissue injuries with the RICE method:

• RestLimit movement of the injured hand.
• IceApply ice for 10 to 15 minutes at a time.
• CompressionWrap the injured area to apply pressure.
• ElevationPlace the injured hand above your heart to reduce swelling.

In some cases, as with tendon injuries, you’ll need to immobilize the joint while the tissue heals using a splint. Some soft tissue injuries require surgery.

If you suspect a soft tissue injury to your hand, it’s important to have it properly diagnosed. At The Hand and Wrist Institute, we focus exclusively on this part of the body. Visit our Southlake or Dallas office for a skilled diagnosis and expert treatment plan for your hand or wrist injury. Contact us today to schedule an appointment.