Sports injuries of the hand and wrist.

One in four of all fractures involves the hand or wrist. This is true of sports injuries too. Even if fractures of the distal radius are excluded, injuries to the carpus, metacarpals, and phalanges are common in sport. Soft tissue injuries to joints are almost as common. The use of the hand and wrist in different sports affects the way they may be injured. Soccer players (except the goalkeeper) are not allowed to handle the ball, but in rugby football and its American and Australian derivatives players grasp not only the ball but their opponents, so hand injuries are more common. In basketball, netball, volleyball, handball, and fives the moving ball is struck directly by the hand, which is therefore at considerable risk of injury.' However, even propelling a ball at a moment of your choice in ten-pin bowling can cause problems; other throwing sports are more likely to damage the elbow or shoulder. In golf a stationary ball is struck by a club, whereas in racket games the ball is moving; in hockey and ice-hockey there are also direct clashes between players. In cricket, baseball, and rounders, while only one player uses a bat, the others may or may not wear protective gloves. Gloves are also used in boxing, but not in other fighting sports such as judo or karate. Falling on to the outstretched hand is the main risk in athletic sports, particularly jumping, gymnastics, climbing, skating, and ski-ing. Sportsmen should therefore be taught to fall in the safest way, rolling as they hit the ground.2 In some sports, the hands are used to provide propulsion, as in rowing, but more often they guide the machine, whether it be a bicycle, car, or boat (sailing or motor). Many sports injuries to the hand are minor ones, but some are more serious than they seem and need correct diagnosis and treatment. A "dislocation" may really be a fracturedislocation so radiographs must be taken. Wrist injuries are often serious, even with apparently normal radiographs.