Hand and upper extremity trauma in high-level instrumentalists: epidemiology and outcomes

Hand and upper extremity injuries to the professional or serious amateur musician may cause significant disability and time away from one's instrument. This article reviewed 222 instrumentalists; 201 were followed to an end result of their injuries. 80% played strings or keyboard instruments. Sports or a direct fall were the most common causes of injury. The spectrum of diagnoses made was typical of hand trauma in general; fractures, sprains, muscle strains and lacerations were the most numerous. Final results after treatment in 201 patients included complete relief of symptoms in 137 (68.2%) and improvement in another 61 (30.3%). Return to performance was complete in 155 patients (77.1%) and in a modified fashion in 42 (20.9%). Only three performers had to stop playing as a result of trauma or it's sequelae. The 46 patients presenting with late sequelae of injury were less likely to achieve full restoration of function and complete return to musical activity than those who suffered acute trauma. Division of nerves or tendons, seen in 13 of 28 patients who sustained lacerations, was more likely to result in very long-term disability and/or incomplete recovery.