Management of hand injuries in a professional football team. Review of 15 years of experience with one team.

Thirty-eight players from one professional football team suffered 46 major hand and wrist injuries during a 15-year period. Twenty-one of the injuries occurred in offensive players and 25 occurred in defensive players. The injuries included fractures, dislocations, fracture dislocations, and soft tissue injuries of the phalanges, metacarpals, carpals (particularly the navicular), and distal radius/ulna, including intra-articular injuries. Twelve surgical procedures were performed. Open reduction, internal fixation, and Lightcast immobilization devices (3M Company, Atlanta, Georgia) allowed the players to return to active participation with a minimum loss of practice time and virtually no loss of Sunday game availability. Early aggressive surgery for intra-articular and certain metacarpal fractures is the correct course of treatment, according to our analysis, in order to achieve the best possible functional results.

Stabilization of comminuted fractures of the distal inch of the radius: percutaneous pinning.

Comminuted fractures of the distal inch of the radius have always been difficult to stabilize. Closed reduction and plaster cast fixation frequently result in recurring deformity and some loss of wrist function. A method of closed pinning with proper placement of multiple small Kirschner wires to supplement plaster cast fixation in selected comminuted fractures helps retain anatomical position of the major fragments of the distal end of the radius. This method is sound in principle and we recommend its use in the treatment of severly comminuted fractures of the distal end of the radius.