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.



Lifelong Athlete Stays That Way, Thanks to ONS

Jeffrey B. Mendell has been active his entire life and he plans to remain that way for as long as he can.

At 64, the athletic Bedford resident and real estate developer still plows down mountain moguls in Colorado several times a year, bikes more than 50 miles per week along the backcountry roads of Greenwich and Bedford, and plays 50+ rounds of golf each season.

“I just love being active outdoors,” he said.

Over the years, however, Jeff’s intense athletic pursuits have taken a toll on his body.  In each instance, he turned to the specialists at Orthopaedic & Neurosurgery Specialists (ONS) to repair his injuries. “I’ve had two rotator cuff surgeries, meniscus surgeries on both knees and on the first ski day of 2016 I caught an edge and broke my wrist,” he explains.  “I know I’m going to have to slow down at some point…. but I’m just not ready to yet.”

Jeff said he thoroughly researched the best orthopedic surgeons in the NY area when he suffered his first injury several years ago. He consulted with orthopedic surgeons in New York City and, on a friend’s recommendation, he checked out Dr. Paul Sethi’s qualifications on the ONS website,  Jeff was immediately impressed.  “I watched videos of Dr. Sethi speaking at medical conferences about complex knee and shoulder surgeries. I was attracted to both his intelligence and surgical experience. We met at ONS and after a thorough discussion, I was convinced that he was an especially talented surgeon and the right doctor for me.”

Dr. Sethi performed a very sophisticated procedure to repair Jeff’s severely damaged right rotator cuff and torn bicep tendon. This injury happened in a high speed fall while skiing. The procedure included the use of a synthetic patch to reattach the rotator cuff to the bone. The outcome was flawless. From that point on, Jeff has turned to ONS physicians and physical therapists to help him recover from his sports injuries.

“I’ve had outstanding outcomes from the surgeries I’ve had with the ONS team,” he said. “I send my family to ONS when they get hurt and I tell all my friends to go there when they suffer an orthopedic injury.  Personally, I wouldn’t consider going anywhere else.”