Intermetacarpal Sprain

What is Intermetacarpal Sprain

Intermetacarpal sprain happens when tissues between bones in the hand (metacarpals) become overstretched or torn (ruptured). This usually happens because of an injury to the hand.

Intermetacarpal sprains range from mild to severe. They can take up to 2–12 weeks to heal, with proper treatment.

What are the causes?

This injury is caused by excess pressure or strain (stress) that is applied to the intermetacarpal ligaments. This often happens because of a hard, direct hit or injury (trauma) to the hand.

What increases the risk?

The following factors may make you more likely to develop this injury:

  • A previous hand injury.
  • Doing repetitive motions with your hands, such as movements in sports or heavy labor.
  • Having poor strength and flexibility in your hands.

What are the signs or symptoms?

Symptoms of this injury may include:

  • A feeling of popping or tearing inside the hand.
  • Pain and inflammation, especially in the knuckles.
  • Bruising.
  • Limited range of motion of the hand.

How is this diagnosed?

This injury is diagnosed based on a physical exam and your medical history. You may have X-rays to check for breaks (fractures) in your bones.

Your sprain may be rated in degrees, based on how severe it is. The ratings include:

  • First-degree. A ligament is stretched but it still has its normal shape.
  • Second-degree. A ligament is partially ruptured, and you may have some difficulty moving your hand normally.
  • Third-degree. A ligament is completely ruptured, and you may not be able to move the affected hand.

How is this treated?

This injury is treated by resting, icing, raising (elevating), and applying pressure (compression) to the injured area. Depending on the severity of your sprain, treatment may also include:

  • Medicines that help to relieve pain.
  • Keeping your hand in a fixed position (immobilization) for a period of time. This may be done using a bandage (dressing), a cast, or a splint.
  • Exercises to strengthen and stretch your hand. You may be referred to a physical therapist.
  • Surgery. This is rare.

Follow these instructions at home:

If you have a cast:

  • Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
  • Check the skin around the cast every day. Report any concerns to your health care provider. You may put lotion on dry skin around the edges of the cast. Do not apply lotion to the skin underneath the cast.
  • Do not let your cast get wet if it is not waterproof.
  • Keep the cast clean.

If you have a splint:

  • Wear the splint as told by your health care provider. Remove it only as told by your health care provider.
  • Loosen the splint if your fingers tingle, become numb, or turn cold and blue.
  • Do not let your splint get wet if it is not waterproof.
  • Keep the splint clean.

Bathing

  • If you have a cast, splint, or dressing, do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
  • If you have a cast or splint that is not waterproof, cover it with a watertight plastic bag when you take a bath or a shower.

Managing pain, stiffness, and swelling

  • If directed, apply ice to the injured area:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times per day.
  • Move your fingers often to avoid stiffness and to lessen swelling.
  • Elevate your hand above the level of your heart while you are sitting or lying down.
  • Wear a compression wrap only as told by your health care provider.

Driving

  • Do not drive or operate heavy machinery while taking prescription pain medicine.
  • Ask your health care provider when it is safe to drive if you have a cast or splint on a hand that you use for driving.

Activity

  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Avoid activities that cause pain or make your condition worse.
  • Do exercises as told by your health care provider or physical therapist.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you have a cast or a splint, do not put pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
  • Do not wear rings on the fingers of your injured hand.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have symptoms that do not get better after 2 weeks of treatment.
  • You have more redness, swelling, or pain in your injured area.
  • You have a fever.
  • Your cast or splint gets damaged.

Get help right away if:

  • You have severe pain.
  • You develop numbness in your hand or fingers.
  • You cannot move your hand or fingers.
  • Your hand or fingers feel unusually cold.
  • Your hand or fingers turn blue.
  • Your fingernails turn a dark color, such as blue or gray.
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