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March, 2018

  1. Boxer’s fracture. Madison Bumgarner _”punches”_ baseball

    March 29, 2018 by Greg Balourdas

    The most common fracture of the hand is referred to as a “Boxer’s Fracture”.  As the name implies, this fracture is most commonly the result of a striking a solid object with knuckle of the small finger.  Usually from angrily punching a wall, other immobile object or from hitting someone else.

    San Francisco Giant’s ace pitcher finished his spring training with a new twist on this common fracture.  He found out that putting his hand in the way of a hard hit ball (off of his 101 mph pitch) is a good way to start the regular season late.  Although I haven’t seen the x-rays, it looks like he suffered an impact to the small finger side of the hand.   In this video excerpt from MLB baseball, concentrate on the ball and you can see Madison Bumgarner, in effect “punching” the ball, reportedly causing a fracture of his small finger metacarpal (bone in the hand from the knuckle to wrist bones). Find out more about fracture and sports injuries at and American Academy of Orthopaedic Surgeons.

    Depending on the fracture pattern, these fractures can be set and held in a cast. If out of position, or if the break is toward the base of the metacarpal, (closer to the wrist) pins, or even a plate and screws are needed to correct and hold the fracture in position.  In the case of a professional athlete, surgically fixing the fracture to leave nothing to chance, is the way to go.  These fractures typically heal in 3 weeks. A professional pitcher will likely miss 6 weeks to rehab his throwing hand.  Tough start for Bumgarner and the Giants.

    BTW… Opening day today!  Let’s play ball!!

    Greg Balourdas, MD

  2. Greetings!

    March 17, 2018 by Greg Balourdas

    Welcome to my blog.  Enjoy and please leave a comment.  I will do my best to reply promptly to your questions.  For more content on hand subjects check out  I encourage you to check out our other sites and 5 star reviews on yelp, google, twitter and facebook!  If you like the posts here, you can subscribe to get the latest by email.  Remember to always treat your hands with respect, the most complex and capable tool you will ever use and you only get two!  Greg Balourdas, MD

  3. Microdermal Engagement Ring Piercings

    March 17, 2018 by Greg Balourdas

    Finger-PiercingEngagement ring piercings?  Not the best way to show your love or good judgement!

    While body piercings routinely heal and do well in clean, protected areas of healthy skin with good circulation, the implantation of a metal-backed,  Microdermal ring finger piercing, is ill-advised.  Since the circulation and healing potential of the hand is good it might be tempting to conclude that this is a safe idea.  Not in this Hand Surgeon’s opinion.  I do too much surgery already treating hand infections without  introducing an implant.  Even traditional rings can get caught and cause severe degloving injuries (just ask Jimmy Fallon).  These piercings introduce a whole different level of concern.

    The lack of padding in the area of the extensor surface of the finger, and the motion of the extensor tendon immediately below the skin is a formula for tendon injury.  The tendon is at risk of damage from the procedure itself or erosion over time from constant motion of metal against extensor tendon.  The backing (anchor) can become detached and migrate either after catching the ring during activity on or wear and tear failure.  Finally, and most devastating, is the risk infection.  Our hands are not the cleanest area of our bodies and the ring piercing is unlikely to wall off (epithelialize) around the implant in the same way piercings do in other parts of the body.  Infection might be treated effectively with ring removal and a course of antibiotics, but it could also result in deep space infection requiring extensive surgery and require long term antibiotics.  Such finger infections can be hard to eradicate and result in permanent loss of motion, or even finger loss.

    I’d rather we not meet in the Emergency Department, headed to the Operating Room because you wanted to show your love with a finger ring piercing.  Show you love in another way and protect your hands!

    Greg Balourdas, MD –