Winter Hand and Wrist Injuries

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.

 

 

Will Your Knees Be Ready to Ski? Tips from ONS to Avoid Injury

Although the forecasts are not yet predicting snow, skiers and snowboarders would be wise to take up a targeted conditioning program now to avoid the aches and injuries that often plague them on KatherineVadasdiMD300x398the slopes. Winter activities tend to tax muscles and muscle groups that are used very little during the rest of the year. As a result, even the best athletes can suffer when taking on the extreme stresses of downhill sports.

Orthopedic surgeon Steven Hindman, MD of Orthopaedic and Neurosurgery Specialsts (ONS) in Greenwich and Stamford, CT, suggests that preseason conditioning exercises can help avert pain and the most feared knee injury of all – a season-ending tear to the ACL (anterior cruciate ligament) .

“Ideally, people should start a conditioning program two to three months before they get near the mountain,” said Dr. Hindman. “But it’s never to late to benefit from a preventive exercise routine.” Too often, he noted, people go from their car to the ski lift without a single stretch. Such lack of preparation greatly increases the risk of injury.

One of four ligaments that provide stability to the knee, the ACL can tear when there is a sudden strain, abrupt change of direction, or twisting of the knee joint while the feet remain in a single direction. Skiers are at greatest risk to strain the ACL to the point of tearing when they try to recover from a fall with their body weight in back of the skis, if they don’t land a jump correctly, or if improperly set ski bindings don’t release during a a critical moment. ACL tears usually require surgery and a lengthy recuperation to repair.

Since the major leg muscles work the hardest when skiing and snowboarding, exercises should focus on strengthening thighs, hamstrings, calves and hips. Workouts that incorporate these muscle groups will help maintain good balance, stabilize the knee during stress situations and build endurance for a full day on the mountain. Adding practices such as yoga and Pilates will also develop strength and balance while improving the body’s flexibility and core fitness.

As important as conditioning is off the slopes, knowing your body’s limit is key on the slopes. Studies show that the majority of injuries happen at the end of the day with the combination of fatigue, flat light, and deteriorating snow conditions. “When you get tired, stop,” said Dr. Hindman.

 

Ever Injured Yourself Skiing or Snowboarding?

Have you ever injured yourself skiing or snowboarding? Injuries on the slopes can ruin a good season, even for the pros. Just last week, we posted Dr. Katie Vadasdi’s discussion about the knee injury of Olympic Gold Medalist, Lindsey Vonn whose injury forced her to pull out of the upcoming Sochi 2014 Winter Olympics. Recently, another famed Olympian suffered an ankle injury.

SKIERS_iStock_000023582367Large

Two-time Olympic Gold Medalist, Shaun White suffered a sprained left ankle Thursday during the Slopestyle qualifiers. He landed the Olympic spot in Slopestyle but decided not to attend the X Games in Aspen this coming weekend.  “So far, the plan is still not to attend X,” White said Friday. “Especially considering how much work this has been to qualify for the Olympics. It’s that time of, what do I really want to work on before the Olympics and you’ve only got one week to really crank it out.”

ONS orthopedic and trauma specialist surgeon Steven Hindman, MD, who specializes in foot and ankle surgery and is a panel speaker for topics such as ski and snowboarding injuries shared his expert opinion on Shaun’s decision saying, “I think he made the right decision in taking a break this weekend and not attending the X Games. Shaun White, being one of the best, if not, the best athlete in his sport, knows what he can and cannot handle. He knows he can push the very difficult tricks and moves that he does. The Olympics are once every 4 years, it is critical to prepare and not over-do it especially when healing a previous injury.”

Hindman_web

Another expert opinion came from ONS orthopedic surgeon Michael Clain, MD, who specializes in foot and ankle surgery and sports medicine. Dr. Clain said “most ankle sprains are fine with rest, immobilization and rehab. I’d expect him to be able to compete just fine at the level for which he qualified for.”

Clain_web

When you have a mild sprain, remember rest, immobilization and rehab are best before you head back to the slopes.

For more on ski and snowboarding injury prevention, click below
http://bit.ly/1bDVuy9

For more on foot and ankle conditions and treatments, click below https://onsmd.com/specialty/foot-and-ankle/

Orthopaedic and Neurosurgery Specialists, PC (ONS) physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. The main office is located at 6 Greenwich Office Park on Valley Road, Greenwich, CT. For more information, visit www.onsmd.com or call 203.869.1145.