Sprains by Body Part

1. Finger Sprain

Common ligament injuries in the finger (digit) joints include injuries caused by lateral force and hyperextension injuries that occur when the finger is bent backward toward the back of the hand during sports involving a ball. These injuries are most common in sports, especially in the index finger and little finger, and acute ligament rupture can be easily diagnosed by tenderness and swelling.

If proper treatment is not provided after the injury, chronic instability, swelling, and movement limitation due to ligament rupture may occur. After an acute injury, a side prominence appears in the injured finger joint, which is due to proliferation of scar tissue and is called a ligament callus. It takes more than a year for it to shrink somewhat, and it does not disappear completely.

2. Thumb Sprain (Gamekeeper’s Thumb, Skier’s Thumb)

Ligament injuries of the thumb’s metacarpophalangeal joint, especially to the ulnar collateral ligament, are increasing due to various sports activities, and skiing is known to be the most common cause.

If not treated properly, it is accompanied by weakened grip strength and pain, and in chronic cases it develops into joint instability and causes arthritis. In such ligament ruptures, surgical treatment is generally performed when there is more than 2 mm of displacement in an avulsion fracture caused by the ligament. However, when there is instability without a fracture, the treatment plan is determined by considering the degree of ligament rupture and the degree of instability.

3. Elbow Sprain

Because the elbow joint has many surrounding muscles, many problems occur in the muscle area, but injuries to the medial and lateral collateral ligaments are rare.

After a subluxation caused by an elbow joint sprain, instability of the elbow joint may occur after insufficient treatment of the damaged ligament. Because persistent and recurrent instability can lead to post-traumatic arthritis, appropriate treatment should be provided.

4. Shoulder Joint Sprain

The shoulder is a joint that consists of the humerus, scapula (shoulder blade), and clavicle (collarbone) and serves to attach the arm to the trunk. Among these, the shoulder joint formed by the humerus and scapula has a wide range of motion but is unstable, shaped like a golf ball resting on a tee. Therefore, joint stability relies heavily on the joint capsule, ligaments, and rotator cuff tendons.

Around the shoulder, in addition to the shoulder joint, there is the acromioclavicular joint where the clavicle meets the scapula. Most injuries to the acromioclavicular joint occur when the shoulder area directly hits the ground during a fall, and depending on the degree of coracoclavicular ligament injury, the injury can range from a partial tear to a dislocation caused by a complete tear.

5. Ankle Sprain

Ankle ligament injuries are very common and can, in severe cases, cause joint dislocation or subluxation. In most cases they heal without major problems, but if proper treatment is not received, they can easily progress to chronic recurrent sprains. Therefore, early diagnosis and treatment are needed to shorten the healing period, prevent sequelae, and allow complete recovery.

The injured area depends on the direction in which the ankle twists. If it twists inward, the lateral ligaments are injured; if it twists outward, the medial ligaments are injured. Since inward twisting force commonly occurs even while walking or running, lateral ligament injuries are very common, and among these, the anterior talofibular ligament is the most commonly injured.

After twisting the ankle, if pain occurs with swelling in the injured area and pain appears when the injured area is pressed, along with subcutaneous bleeding, ligament injury should be suspected. Most ankle sprains require a period of conservative treatment before surgery is considered. Chronic complications that may occur after an ankle sprain include instability, impingement syndrome, articular cartilage damage, and loose bodies within the joint.

6. Knee Sprain

The knee consists of the femur, tibia, fibula, and patella. For stability, the medial and lateral collateral ligaments are located outside the joint, and the anterior and posterior cruciate ligaments are inside the joint.

Among these, the medial collateral ligament resists valgus force, which tends to bend the knee joint outward, while the lateral collateral ligament resists varus force, which tends to bend it inward. However, when skiing or playing soccer, if both legs are spread apart and the person falls so that the knee opens outward, injury to the medial collateral ligament occurs.

When the ligament injury is severe enough to cause a rupture, the patient may feel a tearing sound such as "pzzz," and pain occurs on the inner side of the knee, along with bleeding and swelling due to the ligament injury. After the acute phase, pain and swelling subside to some extent, but because incomplete treatment is provided, valgus instability develops due to chronic injury.

7. Acute Cervical and Lumbar Sprains

In the early stage, severe pain occurs when trying to move the neck, and pain may appear over a wide area around the neck even in a comfortable position. Because it can progress to chronic neck pain, accurate diagnosis and treatment are needed early.

The pain worsens with movement, and radiating pain may occur from the lower back to the buttocks or thighs; however, it does not show the pattern of sciatica caused by a disc. In most cases, the lumbar muscles are very stiff and tender, and since there are no specific changes on radiographic examination, the diagnosis is made after ruling out other causes of lower back pain.

So far, I have explained sprains by body part.

In the next installment, we will learn about fatty liver.

Source: Korea Disease Control and Prevention Agency, National Health Information Portal