The purpose of this study is to identify the most common type of fractures to the hand and fingers in the sport of surfing.

All surfing related hand injuries that were reported to our hospital between January 2008 and June 2014 were analysed.

Twenty-six patient files held a clear description of a trauma related to the surf sport. We found 18 digital fractures, of which 16 (89%) at the distal phalanx. Thirteen of these fractures (72%) concerned the fourth finger. The fracture type was the same in 14 patients: an open extra-articular transverse fracture of the distal phalanx. Three patients needed an amputation of the distal phalanx. Seventeen of 18 injuries were caused by the leash of the surfboard.

Surfing may lead to significant trauma to the fingers, mainly due to the leash. This can be caused when grasping the leash while it snaps to tension, which may lead to hyperflexion of the distal phalanx, resulting in a typical transphalangeal fracture. Also, when the leash is wrapped around a finger or grasped near the attachment of the leash to the board, ring avulsion-like trauma may occur, leading to open fractures or (partial) amputations. Clinical relevance – recognizing that surf leash trauma causes a particular type of fracture to the distal phalanx, may lead to better education of both surfers and emergency ward staff. In addition, with increased knowledge of the underlying mechanism, this type of trauma might easily be prevented.