Abstract

Conservative treatment of severe, acute or microtraumatic boxers knuckle injuries may require an extended convalescence period with no certainty of full recovery. During the period 1978-1981 we have operated on 14 knuckles of 12 topranking Finnish boxers. None of the cases was in the most acute stage. The shortest history covered 5 weeks. At operation the aponeurosis (the extensor hood of the extensor digitorum communis) is cut lengthwise from the ulnar edge of the extensor tendon and the tendon is moved radially to reveal th joint. In 6 cases the joint capsule was completely ruptured and in 2 cases partly so. In 3 cases the capsule was intact but swollen and in 3 cases only the aponeurosis was ruptured. In many cases there was extensive, apparently partly necrotic granulation tissue, which was removed. The ruptures were stitched with Dexon knobs. The skin sutures were removed after 10 days. A splint was used postoperatively for 3 weeks. Results were good in 10, satisfactory in 3 (recovery some months later) and poor in 1 case. Conclusion: the treatment of choice for a boxers severe knuckle contusion is immediate exploratory surgery and repair of the damage. Swollen and painful knuckles that impede boxing are candidated for operation, even after extended conservative treatment. Verf.-Referat