You’ve FOOSHed before and probably didn’t even realize you were doing it! In my world this stands for one of the most common events which result in injuries to the hand, wrist and arm. It’s a natural reflex to protect your head and face!
We have all done it and thankfully we are usually able to protect ourselves without significant injury. Occasionally the FOOSHer ends up sacrificing certain body parts to protect other parts. Such falls can result in sprains, breaks and dislocations… A significant portion of upper extremity Orthopedic trauma and reconstruction can be traced to such injuries! Thought I’d introduce the subject and branch out to talk about specific fractures and dislocations of the wrist. I think we’ll start with Scaphoid fractures (one of the bones of the wrist, also known as the carpal navicular)…. easy to break and sometimes slow to heal! …then perhaps move on to even more complicated injuries of the wrist such as this extreme FOOSH!. – Greg Balourdas, MD
Ok now that professional basketball season in underway.. I seem to be seeing an increase in “jammed” fingers. Probably just coincidence but when my son jammed his finger playing goalie it prompted me to start thinking about these injuries which do occur when flying spherical objects contact extended fingers as in “ball” sports (basketball, volleyball and soccer). I never fail to cringe when I see a patient who says there finger was jammed and crooked so they (or a teammate) pulled on it to straighten it! While this frequently works (there are a lot of jammed fingers out there that thankfully don’t make it to a surgeon’s office) when it doesn’t it can become a major problem. The joints of the fingers are actually quite complex and in delicate balance. One of the giants of Hand Surgery, J. Littler, called the extensor tendon function a “fugue of motion”, denoting a very complicated interaction of forces each dependent on the other to maintain balance and precise function.
Suffice to say that some these structure and certain injury patterns are very benign and heal without problem but others do not.
So look out the following “Red flags” that suggest problems may be lurking:
1. Obvious, even slight, persistent angulation or lack of finger extension (doesn’t stay straight)
2. Significant restriction in joint motion that does not improve over a few days.
3. Grating or clicking sensation with motion.
4. Pain that persists and if simple (“popsicle stick” splint) immobilization doesn’t give you relief.
5. Numbness or tingling in the fingertip.
By the way, Happy New Year and be careful out there!
– Greg Balourdas, MD