Posted on December 11, 2018

Winter sports, slippery sidewalks and snow blowers pose risks to many parts of the body, but hands and wrists in particular take a beating when temperatures plummet and snow accumulates, according to David Wei, MD, hand, wrist and elbow expert at ONS.

“The most common upper extremity injury in the winter months occurs when people extend their arms in front of them to break a fall when they slip on the ice or while engaging in a winter sport,” said Dr. Wei, who noted that several injuries can result from this reflexive action.

If the fall occurs while skiing, the skier can suffer a condition known as Skier’s Thumb if they land with the ski pole still in their hand.

When this happens, the ulnar collateral ligament of the thumb located at the base of the thumb  can get strained or tear. A simple strain can be managed with a thumb stabilization brace, over-the-counter anti-inflammatory medications and ice. Surgery may be necessary to reattach the ligament if a complete rupture has occurred and the thumb is unstable.

Compression, or buckle fractures, of the wrist can also result from an outstretched arm during a fall.  If this occurs near the growth plate in a child, a wrist cast or brace will allow the bone to heal in 3-4 weeks. In comparison, for adults fractures generally take about six weeks.  If a more complicated fracture occurs, where both bones of the forearm break and there is severe deformity of the forearm, the entire arm — including the elbow — may need to a cast.

Dr. Wei said the one way to minimize these injuries is to try to land on your forearms instead of using your hands to break a fall. Wrist guards may also provide additional protection for snowboarders and skiers. When possible, falling backwards, or uphill, may reduce the risk of higher impact injuries to the arms and hands. Finally, be mindful that skiers and snowboarders should refrain from attempting terrain that is above their ability and importantly. When fatigued, winter sportsmen should take frequent breaks or call it quits.

“Many of these injuries can be treated at an orthopedic urgent care facility,” said Dr. Wei. ONS offers after-hours, walk-in urgent orthopedic care at its Greenwich office from Monday through Friday, 5:00 – 8:00 pm, and on Saturday from 12:00 to 4:00 pm.

However, a trip to the emergency department is essential if the injury more severe, such as the ones that may occur with improper use of a snow blower. “The rotor at the bottom of the blower can get jammed from debris, such as a newspaper under the snow in a driveway,” said Dr. Wei. “People lose fingers by reaching in between the blades to remove the blockage. When the blades suddenly are free, they can continue to spin like a loaded spring injuring anything in its path.”

If such an event happens, the best course of action to save any amputated parts is to wrap them in gauze soaked with clean water and place the wrapped parts in a sealed plastic bag. The sealed bag should then be put into another bag that is filled with ice.  The patient should be transported immediately to an emergency department for evaluation and treatment by a specialty-trained hand and microvascular surgeon.