Cricketers at particular risk of damaging their hands

With the cricket season well underway, A&E doctors will be dealing with an increase in injuries caused by impact with a wooden, leather-covered ball. Alongside the inevitable painful bruises, cricketers, in particular, are at risk of damaging their wrists and hands.

Among those called upon to fix the damage is Nuffield Health’s Consultant Orthopaedic Surgeon, Raj Bhatia, who works at the Nuffield Health hospital in Clifton and Spire hospital in Redland, specialising in hands and wrists.

He says: “The hand and wrist are complex structures consisting of multiple bones and joints, tendons, ligaments and nerves, all of which can be injured and require surgery. The commonest problems are fractures and ligament injuries. Fractures are easily identified on X-ray, however, ligament injuries can be overlooked and can lead to chronic pain or instability.

I treat numerous professional and amateur sportsmen and women. Recently, I treated a wicketkeeper who was hit on his fingertip by a cricket ball. He sustained a fracture-dislocation of the proximal interphalangeal joint (between the knuckle and tip) of the finger. He required surgery in the form of ligament repair and joint stabilisation, followed by intensive physiotherapy. He has regained an excellent joint range of motion and returned to professional cricket.

Mr Bhatia recently audited hand injuries that he has treated in professional cricketers over the past five seasons and found that the little and ring fingers were the most commonly injured.

Such injuries commonly happened during fielding and my recommendation is that cricketers buddy-strap their ring and little fingers during this period of the match. Mr Bhatia’s findings were presented at the British Society for Surgery of the Hand meeting this year.

Numerous articles written by Mr Bhatia have been published and he has also been instrumental in championing fixation of wrist fractures with new-generation locking plates in Bristol. After publishing the results of the first 111 patients he treated in this way, locking plate fixation has become standard.

Besides sporting injuries, Mr Bhatia also treats other common problems such as Carpal Tunnel Syndrome, which is nerve compression in the wrist leading to tingling and numbness mainly in the thumb and index fingers, especially at night.

He might also deal with Dupuytren’s disease, or contracture of the finger, which is very common and often requires surgery.

So Mr Bhatia sees people with fingertip injuries or finger fractures, young adults with sporting-related fractures and ligament injuries and elderly people with arthritis. The commonest sites for arthritis are the base of the thumb, small finger joints and the wrist.

Whatever the problem, post-operative care is vital. Mr Bhatia explains: “I work very closely with the hand physiotherapists at Nuffield Health hospital since the outcome of all hand surgery is dependent upon good physiotherapy. All patients undergoing surgery are subsequently seen by the physiotherapist.

“At Nuffield Health, I work as part of a team comprising nurses, theatre staff, physiotherapists, radiographers, receptionists and excellent managers, who understand the importance of delivering high-quality patient-centred care.

“Nuffield Health and Spire hospitals are fantastic places to work in. Nuffield Health has a relaxing, modern ambience with state-of-the-art technology and the staff are always pleasant and helpful. I have always had positive feedback from my patients.”

Most hand or wrist surgery is performed as a day case and recovery time varies depending upon the nature of the surgery but is about two to four weeks.