If you’ve fallen on an outstretched hand, you may have suffered one of a variety of injuries, known as FOOSH injuries (fall on an outstretched hand). The most common FOOSH injury is a scaphoid fracture, so we’ll focus on this type of injury in this article, and also touch on two other injuries that can occur, including scapholunate ligament injury and Triangular Fibrocartilage Complex Injury (TFCC).
The scaphoid bone is found in the wrist, near the thumb. Scaphoid fractures result when the wrist is hyperextended and placed in radial deviation during a traumatic fall. Symptoms of scaphoid fracture include pain at the wrist on the thumb side; tenderness to palpation over the scaphoid and/or compression of the thumb; bruising, swelling, deformity, stiffness of the thumb and/or fingers; and numbness in the thumb and/or fingers following a fall on an outstretched hand.
Scaphoid fractures are categorized based on the severity of scaphoid displacement from its normal position:
A scapholunate ligament injury or tear can result when there is a sudden load placed on the wrist. Symptoms of a scapholunate ligament injury include dorsal wrist pain and swelling on the thumb side, as well as a painful “clunk” when pressure is removed from the area following a fall on an outstretched hand.
A triangular fibrocartilage complex injury can result when there is excessive rotation of the forearm that causes pain on the pinky-side of the wrist, as well as painful clicking of the wrist, swelling, and decreased grip strength following a fall on an outstretched hand.
Once the underlying cause of your wrist pain is determined, treatment will be tailored specifically for your condition.
For scaphoid fractures located closer to the thumb, your forearm and hand may be placed in a cast or splint that covers the thumb to just below the elbow, and you’ll be monitored with periodic imaging of the area. These fractures tend to heal rather well with adequate protection and restricted activity because this part of the scaphoid bone has a good blood supply which helps to encourage healing.
Scaphoid fractures located in the middle of the bone or closer to the forearm are often casted to cover the thumb to above the elbow, which helps to stabilize the fracture. These types of fractures are more difficult to treat because this area of the scaphoid doesn’t have a good blood supply, and therefore healing is often delayed.
In some cases of scaphoid fracture, surgical repair may be necessary to realign and stabilize the fracture.
Whether your scaphoid fracture includes non-surgical or surgical repair, you may have to wear a splint or cast for up to 6 months until the fracture has healed. During this time, there are various activities that should be avoided including:
During your recovery time, it’s important to maintain full range of motion of your fingers. Treatment with a trained physical therapist is also essential after a scaphoid fracture to help improve your range of motion and strength following an injury. It’s important to also continue with your rehabilitation program exercises at home, to help optimize your recovery.
Wrist injuries often result from falling, so it’s essential that you’re cautious when walking on wet and slippery surfaces. Additionally, wearing protective gear such as wrist guards and tape, when participating in sports that have a high risk of falling, such as rollerblading, skating, or skateboarding, can help to minimize your risk of falling and suffering a wrist injury.
If you’ve recently suffered a fall on an outstretched hand and are suffering with wrist pain, an assessment with one of the physical therapists at Blue Hills Sports & Spine Rehabilitation can help to determine the underlying cause of your pain. Once the underlying cause of your pain is determined, the physical therapists can develop an appropriate treatment plan that will help to decrease your symptoms and get you back to your normal activities in as little time as possible.