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“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 such as Aleve 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 three to four weeks. In comparison, for adults fractures generally take about six weeks to heal. 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 be casted.
According to Dr. Wei, 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 you are fatigued, remember to 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 p.m. to 8 p.m. and on Saturday from noon to 4 p.m.
However, a trip to the emergency department is essential if the injury proves to be 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 by wrapping them in gauze soaked with clean water and placing them 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.
To learn more about Dr. Wei and hand, wrist and elbow conditions visit ONSMD.com
