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 TheHandDoctor.com 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.
I indicated that I’d be covering the many injuries that can occur when you fall forward, sacrificing the health of your hand and wrist to protect your face! I introduced you to FOOSH injuries which are common and usually heal in days to weeks. However the occurrence of fractures and dislocations of the wrist are very common.
The most common wrist fracture is a fracture to the scaphoid bone (peanut shaped bone at the base of thumb and also called the carpal navicular). These fractures are common and notorious for problems in healing. There a number of reasons wrist injuries are missed:
• Contrary to popular wisdom you can still move the wrist even if it fractured
• Scaphoid fractures occur without visible signs, sometimes even swelling is absent
• Even when x-rays are taken in the first few days a fracture can be missed
And why fractures of the scaphoid are slow to heal:
• The bone is nearly completely covered by cartilage and therefor the blood supply is limited
• Even stable scaphoid fractures, unlike finger and hand fractures must be immobilized for an extended time
• The cast must include the thumb and many times requiring the elbow, making compliance difficult
Certain fractures do not heal and require surgery with an embedded, headless screw.
Here is an awesome video by Dr. Nabil Ebraheim in Toronto.
For more information or assistance please contact our office and the educational page on this subject. TheHandDoctor.com
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