The Upper Hand for Winter SafetyInjury Prevention
Winter weather conditions increase the risk of an upper extremity injury.
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 and ice accumulate, according to Matthew Cantlon, MD, hand, wrist and elbow specialist at ONS.
“The most common upper extremity injuries in the winter months occur 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. Cantlon, who noted that this is an important reflexive action. Landing on our outstretched hands protects more severe injuries to our head, face, and hips.
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 rupture has occurred and the thumb is unstable.
Compression, or buckle, fractures of the wrist can also result from landing an outstretched arm during a fall. If this occurs near the growth plate in a child, a wrist brace or cast will allow the bone to heal in 3-4 weeks. In comparison, for adults, fractures generally take about 6-8 weeks. If a more complicated fracture occurs, where both bones of the forearm break, the entire arm — including the elbow — may need a cast.
Dr. Cantlon said the most important way to minimize the risk for these injuries is through prevention. He advises people of all ages to wear appropriate footwear, use assistive devices, if needed, and practice vigilance to avoid icy patches. Moreover, skiers and snowboarders should refrain from attempting terrain that is above their ability. Wrist guards may also provide additional protection during these activities. Finally, when fatigued, winter athletes should take frequent breaks or call it quits.
When to go to the ER
Dr. Cantlon noted that many of these injuries can be treated at an orthopedic urgent care facility. ONS offers after-hours, urgent orthopedic care at its Greenwich office from Monday through Friday, 4:00 – 7:00 pm, and on Saturday from 12:00 to 4:00 pm. Urgent ortho care is available during regular business hours at the Stamford, CT and Harrison, NY offices.
However, serious injuries such as complicated fractures and deep lacerations may require treatment from a hospital emergency medical team. Injuries resulting from improper use of a snow blower, for instance, usually require a trip to the ER.
“The rotor at the bottom of the blower can get jammed from debris, such as a newspaper covered by snow in a driveway,” said Dr. Cantlon. “People can sustain severe injuries, and even 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, Dr. Cantlon said 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,” Dr. Cantlon noted.