Intermetacarpal Sprain

What is Intermetacarpal Sprain

Intermetacarpal sprain is a condition resulting due to the rupture or the overstretching of the metacarpals.

Metacarpals are the structures between the bones in the hand

An intermetacarpal sprain refers to a sprain or injury to the ligaments that connect the metacarpal bones in the hand. The metacarpals are the long bones that make up the palm of the hand, and they connect to the bones of the fingers (phalanges).

The pain due to this Intermetacarpal sprains could be mild to severe.

With the timely and proper treatment, this condition completely heals around 2 to 10 weeks of time.

What are the causes?

The most common cause of Intermetacarpal Sprain is due to hand injuries

This hand injury might be caused by excess pressure or strain that is applied to the intermetacarpal ligaments.

The excess pressure or strain often happens because of certain type of hand injuries like a hard, direct hit or injury (trauma) to the hand.

What increases the risk?

The following factors more likely increases the risk to develop Intermetacarpal Sprain:

• A previous injured hand.
• Movements in sports or heavy labor which involves doing repetitive motions with your hands
• Intermetacarpal Sprain might result from poor strength and flexibility in your hands.

What are the symptoms of Intermetacarpal Sprain?

Symptoms of Intermetacarpal Sprain may include the below:

• A feeling of popping or tearing inside the hand.
• Pain in the knuckles.
• Swelling of knuckles
• Bruising.
• Restriction of movements of the hand.

Anatomy of the intermetacarpal ligaments

The interosseous metacarpal ligaments consist of short, thick fibers, and are limited to one part of the carpometacarpal articulation; they connect the contiguous inferior angles of the capitate and hamate with the adjacent surfaces of the third and fourth metacarpal bones

A study was conducted by performing the anatomic dissections on 10 fresh cadavers

The structure of the retaining ligaments between the proximal metacarpal bones of the fingers was defined In these cadavers.

Four separate ligaments were found in these cadavers:

• a dorsal metacarpal ligament
• a palmar metacarpal ligament
• 2 interosseous ligaments oriented in a V-shaped configuration

The strongest of the ligaments is the the V-shaped interosseous ligaments; along with the palmar and dorsal intermetacarpal ligaments

These ligaments form a very strong connection between the bases of the adjacent metacarpals.

The bases of the second, third, fourth and fifth metacarpal bones articulate with one another by small surfaces covered with cartilage, and are connected together by dorsal, volar, and interosseous ligaments : the intermetacarpal joints.

The dorsal (ligamenta basium oss. metacarp. dorsalia) and volar ligaments (ligamenta basium oss. metacarp. volaria; palmar ligaments) pass transversely from one bone to another on the dorsal and volar surfaces. The interosseous ligaments (ligamenta basium oss. metacarp. interossea) connect their contiguous surfaces, just distal to their collateral articular facets.

The synovial membrane for these joints is continuous with that of the carpometacarpal articulations

How is Intermetacarpal Sprain diagnosed?

Intermetacarpal Sprain is diagnosed based on a physical examination and your medical history.

The sprain may be rated in degrees, based on the severity. 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.

X-rays need to be done to check for breaks (fractures) in the bones.

How is Intermetacarpal Sprain treated?

Intermetacarpal Sprain 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.

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.

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.

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.