(Fig 6,7), Sprains (collateral ligament injuries) respond well to immobilisation and early motion for most digits. There is no good evidence to show if conservative vs surgical management of these fractures results in faster union times or earlier return to function, however, mal-reduction has been shown to lead to post-traumatic arthritis. Football is one of the most popular world sports, with FIFA estimating there to be around 270 million active players. Saving/ punching the ball alongside collisions with other players or the goalposts are clear aetiologies of such injuries. (5) Usage of the hands by goalkeepers in actions such as ‘shot-stopping’ gives a clear mechanism by which goalkeepers are prone to fractures and dislocations involving the hand. (1) Injuries, therefore, are extremely commonplace, with evidence to show injury incidence is around 8 injuries/1000 hours. (1) Injuries, therefore, are extremely commonplace, with evidence to show injury incidence is around 8 injuries/1000 hours. These would usually be managed by pitchside reduction and buddy strapping of the finger (Fig 4,5), however, if unstable or irreducible then surgery is required. The most frequent injury happens as a result of the ball hitting the fingers and forcing them to jam or bend incorrectly. We have previously looked at this database, studied the injury patterns and published recommended actions as a result.(13). With the current capital in professional football, these lay-offs could have large financial implications. Raj regularly treats professional sportsmen and sportswomen in his Bristol Clinic. (7), The base of thumb metacarpal fractures, which can be simple or comminuted, often result in a deformity which cannot be controlled with a splint and often lead to operative fixation. (8), Goalkeepers are also predisposed to dislocations, in particular dorsal dislocations of the phalanges owing to a hyperextension mechanism from impact to the palmar surface to the hand. As previously stated, hand injuries in goalkeepers can be significant and may result in lengthy lay-offs. Owing to this we would welcome a detailed injury database, such as that seen in professional cricket, in which research could be done to establish best treatment protocols for goalkeepers to optimise outcomes and guide physician advice for future injuries. His research interests include the prevention and treatment of hand and wrist injuries in professional sport. Finger and hand injuries are the most common goalkeeper injuries. (3) Goalkeepers require a high level of hand and wrist function in their role and injuries to these sites leads to a longer non-playing period than an outfield player. However, considering upper extremity injuries as a general entity it is known that goalkeepers are five times more likely than outfield players to suffer from one.

Phalangeal and metacarpal fractures are common and can cause goalkeepers to be on the sidelines for a median time of 26 and 55 days respectively. (9), Goalkeepers are also susceptible to soft tissue injuries of the hand.

FIFA Big Count 2006: 270 million people active in football (download pdf), Treating professional athletes and return to play, Rising acute wrist injuries in goalkeepers, Orthopaedic Surgeon of the Year 2019 South West England. This review article focuses on hand injuries goalkeepers are likely to suffer from and makes a case for an injury database to guide possible future prophylactic measures and evidence-based treatment options. Injuries include bruises, fractures, dislocations, and breaks.

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