Though most hand sprains and strains heal after several weeks of immobilization or occupational therapy, some injuries may require surgery. Your NYU Langone doctor may recommend immediate surgery if you have a fully torn ligament or tendon, or if symptoms persist, disrupting your sleep and restricting daily activities, despite more conservative treatment.
Surgery may be required for a rupture of the ligaments of the thumb’s metacarpophalangeal joint, or knuckle. Sometimes called “skier’s thumb,” this injury can occur when the strap on a ski pole pulls the thumb away from the hand during a fall. Usually, it occurs when the thumb impacts hardpacked snow or ice.
Another hand injury that may require surgery is a tear to a tendon in the finger. It typically occurs when a finger, usually the ring finger, gets caught in another player’s jersey during a sporting event, such as a soccer game, leading to the tearing of a tendon in that finger.
Your hand surgeon determines the type of procedure that’s necessary based on the location and extent of the injury and whether it affects a tendon, ligament, or bone, which can be forced out of place.
Surgery may be recommended for people who, in addition to a hand sprain or strain, also have arthritis in the affected joints or bones. Arthritis can cause chronic symptoms, such as pain and stiffness, that affect quality of life.
Surgery is performed with general anesthesia in the hospital. Surgical procedures for hand sprains or strains include percutaneous pinning, in which a dislocated bone is manipulated into its proper position and held in place by wires inserted into the skin. Another type of surgery is joint fusion—called arthrodesis—in which bones on either side of a joint are fused, or joined, together using metal plates, screws, or wires.
Other procedures include joint reconstruction, or arthroplasty, with or without artificial joint replacement, and the reattachment of torn ligaments or tendons.
One to two weeks after surgery, you visit your NYU Langone doctor, who monitors your healing. If stitches were used, the doctor removes them during this visit.
Your doctor may schedule a second follow-up visit for four to six weeks later and recommend occupational therapy at this time. Together, you and your doctor discuss the next steps based on the extent of the injury and how quickly it is healing.
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