Signs of a Broken Wrist
A wrist fracture should be suspected when a patient injures their wrist joint and has pain in this area. Common symptoms of a wrist fracture include wrist pain, swelling, and deformity of the wrist.
When a patient comes to the emergency room complaining of wrist pain and showing evidence of a possibly broken wrist, an x-ray will be obtained of the injured area. If there is a broken wrist, the x-rays will be carefully reviewed to determine if the fracture is in proper position, and to assess the stability of the bone fragments.
Wrist Fracture Treatment
Most often, broken wrists can be treated in a cast. The wrist is one area of your body that is very amenable to cast treatment. If the bones are out of proper position, then some light sedation or local anesthesia may be used so your doctor can reset the fracture. This is called ‘reducing’ a wrist fracture, and by performing specific maneuvers your doctor may be able to realign the broken wrist.
Which Fractures Require Surgery?
This is a difficult question to answer, and must be addressed on a case by case basis. Even on an individual basis, orthopedists may differ on their opinion of optimal treatment for a given fracture.
Among the important considerations in determining whether or not surgery is necessary for a broken wrist are: age and physical demands of the patient; bone quality; location of the fracture; displacement of the fracture; and adequacy of nonsurgical management.
As stated earlier, surgery is not usually needed for a wrist fracture, but it may be considered in some situations.
Sprained Thumb (Ligament Injury)
A stable thumb is very important for pinch and grasp activities. A thumb sprain is an injury to the main ligament in the thumb. Ligaments are soft tissue structures that connect two bones to make a stable joint. If you tear the main ligament (ulnar collateral ligament) at the base of your thumb, your pinch and grasp ability will be weak. A hockey injury like this pretty much will take you out of the game.
In this sprain, the ulnar collateral ligament is completely torn and may require surgery to heal. There may or may not be pain right away. Other symptoms include bruising, tenderness, and swelling. See a doctor as soon as possible to ensure that the injury will not cause long-term weakness, pain, and instability.
The ulnar collateral ligament of the thumb may be partially or completely torn. To help determine this, your doctor will move your thumb in different positions to test how stable your thumb joint is. Your doctor may suggest x-rays to ensure that the bone is not broken.
A special type of x-ray, called a stress x-ray, shows the joint as the doctor applies tension to the injured ligament. If the test causes pain, a shot of a local anesthetic may help. Your doctor may also take an x-ray of the uninjured thumb to compare it to the injured thumb.
If the ligament is only partially torn, your doctor will probably immobilize your thumb joint with a bandage, cast, or splint until it heals. To ease pain and swelling, you can place an ice pack on your thumb twice a day for 2 to 3 days after the injury.
For the first 3 weeks after your thumb sprain hockey injury, you will wear the splint or cast at all times. After that, you can take it off to do strengthening exercises for your thumb. The splint should be worn at all other times. This should continue for another 2 or 3 weeks, until the swelling and tenderness in the thumb are gone.
If the ulnar collateral ligament of the thumb is completely torn, surgery may be needed to regain normal movement. Surgery involves reconnecting the ligament to the bone. When the ligament tears away from the bone, sometimes fragments of bone are pulled away with it. If this is the case, during surgery the bone fragments may be removed or put back into the correct position and fixed with a pin or screw.
After surgery, a short arm cast or a splint will be necessary for 6 to 8 weeks to protect the thumb ligament while it heals.
A sprained thumb is often ignored with the hope that it will heal itself. If this ligament injury is not diagnosed and treated properly, it may lead to chronic instability, weakness, and ultimately arthritis.
If a thumb sprain leads to these late complications, it may require surgery to rebuild the ligament using tissue from another part of your upper arm. Another treatment option might be a joint fusion procedure.
Last but certainly not least is “lace bite,” a condition that affects many hockey players. The term is used to describe the pain felt on the front of the foot or ankle when skating (the medical term for this condition is tibialis anterior tendinopathy). It is caused by friction or contact between the tongue of the ice skate and the skater’s foot or ankle, which aggravates the tendon on the front of the foot. For a more comprehensive look at this often overlooked affliction, read this article: Spending a Year Testing Lace Bite Treatments for Hockey.
Note: This article is for informational purposes only and is not intended to replace medical attention. If you are injured, before proceeding with any exercise or treatment please obtain a proper diagnosis by a physician.
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