I know a lot of folks must have acquired a hand fracture, but nobody stops in to share knowledge with a fractured bone noob.
Perhaps some keywords may help me...
Boxer's Fracture/Break, Brawler's Fracture/Break, Fifth Metacarpal Fracture/Break, Broken Pinky Bone
That is all I can think of for search engine meta-tags.
I feel lonely with a gimped hand, more so with no advice. Some things are hard to learn on your own with limited web tips. Throw me some 'real' knowledge to gain in my plight. I would surely appreciate it. :-)
Thursday, August 28, 2008
Still waiting...
Well up to this point, indeed the swelling has gone down reasonably well. Although there still is the bruising on my pinky finger.
Oddly the bruising surrounds the scar tissue near my pinky knuckle that I got from punching a rear-view mirror (around 2003) because some moron was behind me and blinding my forward vision with high beams and driving lights, in the fricken city with already well lit streets of course.
I do not use the half-brace asides from nighttime or outings. My right hand still seems deformed with the big lump and minor swelling across the top of the hand.
I can almost coil my right fingers to assume a mid-knuckle type of straight fist, not that I am expecting to be combative or whack the floor again. I can almost assume mobility asides from an actual fist that includes the damaged pinky. I can't seem to grasp small items/handles that are smaller than say, the circumference of a glass. The stress on the pinky is just too great. Obviously, I can run the keyboard at full steam though and actually write again along with other tasks that were taken for granted.
I do wonder though. I was comparing the main knuckle joint movement of my left hand pinky versus the right, in regards to flexing motion and whatnot, and I do not like what I noticed. What concerns me is that the right pinky does not seem to flex via the actual knuckle or so it appears. I am aware that the skeletal structure is somewhat free floating in principal. However, it would seem that the fusing area moves instead of the actual knuckle (where ever it may be under there). This worries me as I wish to isolate the fusing area from the knuckle when utilizing the pinky. Perhaps I am impeding the fusing process while trying to moderately rehabilitate my hand. Ah well, I will have to leave it to my own discretion because there is diddly squat over the web to find answers.
All that matters to me is to have my hand back up to speed, without damaging it by stress or negative motion. Ah yes, perhaps I should simply leave it be and hope for the best. Patience is a virtue, but idle motion can also be hazardous to other components. Let it be, let it be.
Oddly the bruising surrounds the scar tissue near my pinky knuckle that I got from punching a rear-view mirror (around 2003) because some moron was behind me and blinding my forward vision with high beams and driving lights, in the fricken city with already well lit streets of course.
I do not use the half-brace asides from nighttime or outings. My right hand still seems deformed with the big lump and minor swelling across the top of the hand.
I can almost coil my right fingers to assume a mid-knuckle type of straight fist, not that I am expecting to be combative or whack the floor again. I can almost assume mobility asides from an actual fist that includes the damaged pinky. I can't seem to grasp small items/handles that are smaller than say, the circumference of a glass. The stress on the pinky is just too great. Obviously, I can run the keyboard at full steam though and actually write again along with other tasks that were taken for granted.
I do wonder though. I was comparing the main knuckle joint movement of my left hand pinky versus the right, in regards to flexing motion and whatnot, and I do not like what I noticed. What concerns me is that the right pinky does not seem to flex via the actual knuckle or so it appears. I am aware that the skeletal structure is somewhat free floating in principal. However, it would seem that the fusing area moves instead of the actual knuckle (where ever it may be under there). This worries me as I wish to isolate the fusing area from the knuckle when utilizing the pinky. Perhaps I am impeding the fusing process while trying to moderately rehabilitate my hand. Ah well, I will have to leave it to my own discretion because there is diddly squat over the web to find answers.
All that matters to me is to have my hand back up to speed, without damaging it by stress or negative motion. Ah yes, perhaps I should simply leave it be and hope for the best. Patience is a virtue, but idle motion can also be hazardous to other components. Let it be, let it be.
Sunday, August 17, 2008
Nothing really new at this point
I have been very nice to my hand and freeing it during the day, most of the day actually. I can almost run the keyboard up to par with both hands. My right hand tendons are getting a work-out, my hand often cramps.
The swelling from the thumb to the ring finger has subsided. There is obviously still a big lump over the fracture site. My hand still does not want to stretch out straight nor make anywhere close to a fist, I am certainly not going to force it.
I can sign my name though, much easier without the brace would be the secret behind that. I am also thankful that my right hand is able to run the trackball. My wrist aches so I coil up gauze underneath the rise of the wrist to level out my arm and it seems to help.
Ah yes, I had not seen the hand specialist because of politics. I was sure I wrote down August 12 as my appointment. Well, I had a message on my phone on the 7th... seems I missed my appointment. I am stubborn and decided to leave it as is. I really hope I did not make a mistake, but I have a feeling all will be well and I will take responsibility if not. I already had the follow-up X-ray from my 'double check' decision and apparently everything was fine. As far as hand rehabilitation exercises, I will figure out some methods. I will get squeeze balls and the likes. If you have tips... I will take then. Thanks.
The swelling from the thumb to the ring finger has subsided. There is obviously still a big lump over the fracture site. My hand still does not want to stretch out straight nor make anywhere close to a fist, I am certainly not going to force it.
I can sign my name though, much easier without the brace would be the secret behind that. I am also thankful that my right hand is able to run the trackball. My wrist aches so I coil up gauze underneath the rise of the wrist to level out my arm and it seems to help.
Ah yes, I had not seen the hand specialist because of politics. I was sure I wrote down August 12 as my appointment. Well, I had a message on my phone on the 7th... seems I missed my appointment. I am stubborn and decided to leave it as is. I really hope I did not make a mistake, but I have a feeling all will be well and I will take responsibility if not. I already had the follow-up X-ray from my 'double check' decision and apparently everything was fine. As far as hand rehabilitation exercises, I will figure out some methods. I will get squeeze balls and the likes. If you have tips... I will take then. Thanks.
Friday, August 8, 2008
I am granting more freedom
My right hand felt good yesterday to be free. As I type this, my right hand is helping asides from being restricted to use the pinky. Also, the right hand ran the trackball today. My left hand is most gracious for the break (bad ironic pun indeed). I certainly will not leave home without placing the brace back on and I am most certainly careful of overly exerting the freed hand. I can do without the brace for a period of time, but I will not risk angulating the fracture by a re-fracture while it is in the delicate fusing stage...
Quoted from Wiki
Eh, the smoking issue has not subsided. Damn my weak will power, I must try to quit again to speed up the healing process. My Hat is off to the body for working around nicotine to rebuild the fractured metacarpal at a seemingly quick rate for my age. But there are still months to go yet, and that has to be respected as I really do not wish to reverse the entire process. Imagine that, more negligence on my part. Speaking of which, it is time to put my right hand back into solitary confinement.
Quoted from Wiki
The natural process of healing a fracture starts when the injured bone and surrounding tissues bleed. The blood coagulates to form a blood clot situated between the broken fragments. Within a few days blood vessels grow into the jelly-like matrix of the blood clot. The new blood vessels bring white blood cells to the area, which gradually remove the non-viable material. The blood vessels also bring fibroblasts in the walls of the vessels and these multiply and produce collagen fibres. In this way the blood clot is replaced by a matrix of collagen. Collagen's rubbery consistency allows bone fragments to move only a small amount unless severe or persistent force is applied.
At this stage, some of the fibroblasts begin to lay down bone matrix (calcium hydroxyapatite) in the form of insoluble crystals. This mineralization of the collagen matrix stiffens it and transforms it into bone. In fact, bone is a mineralized collagen matrix; if the mineral is dissolved out of bone, it becomes rubbery. Healing bone callus is on average sufficiently mineralized to show up on X-ray within 6 weeks in adults and less in children. This initial "woven" bone does not have the strong mechanical properties of mature bone. By a process of remodeling, the woven bone is replaced by mature "lamellar" bone. The whole process can take up to 18 months, but in adults the strength of the healing bone is usually 80% of normal by 3 months after the injury.
Several factors can help or hinder the bone healing process. For example, any form of nicotine hinders the process of bone healing, and adequate nutrition (including calcium intake) will help the bone healing process. Weight-bearing stress on bone, after the bone has healed sufficiently to bear the weight, also builds bone strength.
Eh, the smoking issue has not subsided. Damn my weak will power, I must try to quit again to speed up the healing process. My Hat is off to the body for working around nicotine to rebuild the fractured metacarpal at a seemingly quick rate for my age. But there are still months to go yet, and that has to be respected as I really do not wish to reverse the entire process. Imagine that, more negligence on my part. Speaking of which, it is time to put my right hand back into solitary confinement.
Thursday, August 7, 2008
An old friend reunited for a short time
I had a pleasant visit from my right hand today. We hung out for quite some time and rehashed the good ol' days. Like peas in a pod, it was a grand time asides from some aching moments. Unfortunately, my friendly hand resumed it's now more comfortable bend. There will be more days like this to come and soon we will be reunited to spend our time together in harmony.
Seeing how the fracture is within the two week stage, I decided it was time for my hand to join me in a bath. I filled the tub and field stripped my half-brace and gauze. I took some pictures with my phone. Then carefully climbed into the tub and submerged my right hand into the tepid water for a half an hour. For about an hour, I did very light and non-exerting motions to guard against the pinky tendon being caught up within the mess. I managed half-fist arcs and basic finger straightening.
The half-fist motion was relatively easy, but not for trying to combat the half-brace arc. I took my left hand and gently placed the fingertips into the palm of my right hand. Gently, I began to assume the praying position while gently forcing my rigid digits of the left to straighten the bent right digits while slowly gliding the left hand into the palm of the right hand. I have yet to be able to hold the digits straight on the damaged hand, but there are still plenty of healing and rehabilitation days to come.
True, I did expect a miracle as I miss my hand and desire it to be a big part of my life again. I can just be glad that everything is seemingly alright at this stage. After all, my hand is still battered and sore, but the pinky does not attempt to scissor and that is a huge stumbling block removed as surgery and/or a re-break are definitely not required.
I also treated my right hand to facial scrub and a good dose of skin cream after the mobility exercise. It is definitely one fine looking appendage now, well asides from looking like it was run over. Aside from being pruned like the other hand from too much time underwater, there was a lot of peeling skin that needed to be shed. Somewhat disgusting, but there was lots of skin flakes that coated the top of the water and one heck of a tub ring at the end.
I suspect I will treat my right hand to some freedom every odd day for mobility exercises. A 2L bottle of pop is a good tool. I put the bottle onto the table while pressing down on the top cap with the palm of my left. I cup my right hand palm to the middle of the bottle and then gently pull my right hand away while the bottle keeps the digits straight upon passing the curve, I try to keep my digits straight for a very short time while they are not touching the bottle.
I will NOT perform any strengthening or full-fist clenching tasks until the hand specialist sees me on the 12th. The main thing to remember is that if it hurts or is painful, back the hell off... it is not a video game injury that is instantly solved with a med pack or akin to a real time sprained ankle injury. Perhaps even I should not rush with these motion exercises, but I have a feeling that it is important in regards to dexterity. I will relay my either prudent or stupid thoughts in a week when I see the specialist. I do not endorse any ideals, statements, or beliefs within this blog. Always consult medical staff and not rely on the Internet for 'truth'.
My left hand is now sore from picking up the slack of tip-tapping the keyboard and running the mouse for these past two weeks. I had better slow down before my left hand ends up in a brace from carpo and/or tendinitis. I just thought to update during my bout of boredom and recuperation to keep the blog alive.
Of course, at the end, I will strive to deal with anger management and perhaps build a foam 'beat the living hell out of' device. I just figured to remind all you other rage punchers out there that these fractures should be avoided at all costs. NOTHING is worth wrecking your hands over, it solves nothing at all... except realizing there is an emotional problem that also needs tending. For shame, I had no idea these "Boxer's Fractures" were so common until I obtained one myself. Then again, who really Google's for "Boxer's/Brawler's Fracture" if unbeknown in the first place?
I have only been in physical combat a few times in my youth so I will look forward to avoiding it into the future if I can indeed avoid it. Although fighting did not cause my injury, live and learn. I have. I will never punch something out of rage again due to this poor choice memory of life. Violence is never a problem solver and you will likely end up with a blade or bullet in your chest anyways. Hmmm... sounds like a public service message from Health Canada, but oh bloody well.
Seeing how the fracture is within the two week stage, I decided it was time for my hand to join me in a bath. I filled the tub and field stripped my half-brace and gauze. I took some pictures with my phone. Then carefully climbed into the tub and submerged my right hand into the tepid water for a half an hour. For about an hour, I did very light and non-exerting motions to guard against the pinky tendon being caught up within the mess. I managed half-fist arcs and basic finger straightening.
The half-fist motion was relatively easy, but not for trying to combat the half-brace arc. I took my left hand and gently placed the fingertips into the palm of my right hand. Gently, I began to assume the praying position while gently forcing my rigid digits of the left to straighten the bent right digits while slowly gliding the left hand into the palm of the right hand. I have yet to be able to hold the digits straight on the damaged hand, but there are still plenty of healing and rehabilitation days to come.
True, I did expect a miracle as I miss my hand and desire it to be a big part of my life again. I can just be glad that everything is seemingly alright at this stage. After all, my hand is still battered and sore, but the pinky does not attempt to scissor and that is a huge stumbling block removed as surgery and/or a re-break are definitely not required.
I also treated my right hand to facial scrub and a good dose of skin cream after the mobility exercise. It is definitely one fine looking appendage now, well asides from looking like it was run over. Aside from being pruned like the other hand from too much time underwater, there was a lot of peeling skin that needed to be shed. Somewhat disgusting, but there was lots of skin flakes that coated the top of the water and one heck of a tub ring at the end.
I suspect I will treat my right hand to some freedom every odd day for mobility exercises. A 2L bottle of pop is a good tool. I put the bottle onto the table while pressing down on the top cap with the palm of my left. I cup my right hand palm to the middle of the bottle and then gently pull my right hand away while the bottle keeps the digits straight upon passing the curve, I try to keep my digits straight for a very short time while they are not touching the bottle.
I will NOT perform any strengthening or full-fist clenching tasks until the hand specialist sees me on the 12th. The main thing to remember is that if it hurts or is painful, back the hell off... it is not a video game injury that is instantly solved with a med pack or akin to a real time sprained ankle injury. Perhaps even I should not rush with these motion exercises, but I have a feeling that it is important in regards to dexterity. I will relay my either prudent or stupid thoughts in a week when I see the specialist. I do not endorse any ideals, statements, or beliefs within this blog. Always consult medical staff and not rely on the Internet for 'truth'.
My left hand is now sore from picking up the slack of tip-tapping the keyboard and running the mouse for these past two weeks. I had better slow down before my left hand ends up in a brace from carpo and/or tendinitis. I just thought to update during my bout of boredom and recuperation to keep the blog alive.
Of course, at the end, I will strive to deal with anger management and perhaps build a foam 'beat the living hell out of' device. I just figured to remind all you other rage punchers out there that these fractures should be avoided at all costs. NOTHING is worth wrecking your hands over, it solves nothing at all... except realizing there is an emotional problem that also needs tending. For shame, I had no idea these "Boxer's Fractures" were so common until I obtained one myself. Then again, who really Google's for "Boxer's/Brawler's Fracture" if unbeknown in the first place?
I have only been in physical combat a few times in my youth so I will look forward to avoiding it into the future if I can indeed avoid it. Although fighting did not cause my injury, live and learn. I have. I will never punch something out of rage again due to this poor choice memory of life. Violence is never a problem solver and you will likely end up with a blade or bullet in your chest anyways. Hmmm... sounds like a public service message from Health Canada, but oh bloody well.
Monday, August 4, 2008
Prognoses at square one - Seems alright so far
Aug. 03. After spending about four to five hours at another ER (free parking!), I felt little compassion for my paranoia. The medical staff seemed annoyed about assessing the break. The triage nurse tried to immediately send me packing, but I stood my ground all the way. After all, it's my right and after I compile a link list to all the disabilities concerning the Brawler's Fracture, you will be enlightened. I rarely visit the hospital and I paid my fair share into the Health Care fund. They made me feel guilty, but I could not care any less. It is my hand and not theirs.
The Doogie Howser-type doctor seemed annoyed at me also. I guess they take offense to double checking. The Doc looked fresh out of University or just very young. After some coaxing from me, he checked everything out and kept repeating that everything looked alright. I kept playing the 'negative angulation' card up to the point of getting X-Rays at the very end, which were not shown to me... oddly enough. However, the Doc did take off my half-brace which was oddly easy to do without pain. Then I was instructed to make a fist. I was able to make a partial arc, but I think my mind held back further arcing. I figured it was too early to be fully clenching a fist and putting pressure on the fracture. I think the Doc expected much more to blatantly make a point. I sort of wished I tried a bit harder to make a full fist to check the pinky metacarpal knuckle joint alignment, but I also worried that the fracture may become unfused. This was the conundrum of it all. I sort of regret overcoming the fear. It also may have been prudent to listen to my mind and not overly disturb ground zero.
I thought of increasing the padding underneath the knuckle to offset the likelyhood of the cosmetic depression. I may still ponder this, but I should not fool with the fracture if luck has it fusing decently. I am sure this is why some doctors do the 90-90-90 type of brace for the Boxer's break. Something tells me that there is a lesser chance of pinky knuckle depression with that method, along with better pinky angulation alignment. Perhaps I got lucky with the fracture and the way the metacarpal neck snapped, the bone did not rotate that much or a semi-clean break. Well, I am not sure if I am lucky as of yet being this soon. I will have to wait until the 12th to find out with yet another opinion. I really hope my angulation is not even close to the textbook's allowable 30 degrees. I will be happy as can be with my hand being close to perfect as it was. Though, it is highly unlikely that there will not be side-effects asides from aesthetic abnormalities. Today's Doc also reminded me about the sunken pinky knuckle "deformity".
The Doogie Howser-type doctor seemed annoyed at me also. I guess they take offense to double checking. The Doc looked fresh out of University or just very young. After some coaxing from me, he checked everything out and kept repeating that everything looked alright. I kept playing the 'negative angulation' card up to the point of getting X-Rays at the very end, which were not shown to me... oddly enough. However, the Doc did take off my half-brace which was oddly easy to do without pain. Then I was instructed to make a fist. I was able to make a partial arc, but I think my mind held back further arcing. I figured it was too early to be fully clenching a fist and putting pressure on the fracture. I think the Doc expected much more to blatantly make a point. I sort of wished I tried a bit harder to make a full fist to check the pinky metacarpal knuckle joint alignment, but I also worried that the fracture may become unfused. This was the conundrum of it all. I sort of regret overcoming the fear. It also may have been prudent to listen to my mind and not overly disturb ground zero.
I thought of increasing the padding underneath the knuckle to offset the likelyhood of the cosmetic depression. I may still ponder this, but I should not fool with the fracture if luck has it fusing decently. I am sure this is why some doctors do the 90-90-90 type of brace for the Boxer's break. Something tells me that there is a lesser chance of pinky knuckle depression with that method, along with better pinky angulation alignment. Perhaps I got lucky with the fracture and the way the metacarpal neck snapped, the bone did not rotate that much or a semi-clean break. Well, I am not sure if I am lucky as of yet being this soon. I will have to wait until the 12th to find out with yet another opinion. I really hope my angulation is not even close to the textbook's allowable 30 degrees. I will be happy as can be with my hand being close to perfect as it was. Though, it is highly unlikely that there will not be side-effects asides from aesthetic abnormalities. Today's Doc also reminded me about the sunken pinky knuckle "deformity".
Sunday, August 3, 2008
The return to square one
Aug. 03 - late afternoon. I spoke with an informative woman via the Capital Health line. Compassion still lingers. During our discussion, the woman asks a series of standard questions regarding my right hand and we discussed the appearance of 'zombie hands', the darkening of the joints and the Greyish-Blue appearance of the index/middle fingers. She raised concern that there might be an issue of improper circulation. Myself, I just thought the discoloration is from internal pooling of blood. I did notice that the blood is pooling around the joints and impeding the middle finger from fully arcing, however, I noticed a lack of arc on my good left hand when I isolate the ring and pinky finger in the straight position. No matter, it is my legal and humane right to have my right hand assessed or rather double checked by another hospital. I hate to jam up ER again, but I am going to be ruthless to avoid disability and sit in line with people with dog bites, stitch removals, sprained ankles and other light instances including coughs. The waiting list is based upon urgency anyways and it is not like I am putting others at risk.
Trust me, I would take a scar over a crooked pinky any day. The hand is far too valuable of an appendage to waste from incompetence. There is no feasible reason for a crooked pinky and it's knuckle ending up a quarter way back into the top of the hand. I sure hope the triage nurse takes an X-Ray to prove the incompetence beforehand because I truly doubt the metacarpal is beginning to fuse straight in six days of being unchecked. One again I am not sure of the procedure, but most people need their primary hand as quickly as possible with little side-effect.
I suspect to be in limbo for six hours or so, but I will surely sacrifice twelve or even twenty-four hours over leaving everything 'as-is' for two weeks. Thanks, but no thanks. I have read far too many tales of woe to leave me justifying misplaced trust. I sincerely hope that luck is on my side and the fracture site could not be doing any better or so it may seem without making a fist and not finding a crooked pinky until the end... where it will all rewind for the worse.
Trust me, I would take a scar over a crooked pinky any day. The hand is far too valuable of an appendage to waste from incompetence. There is no feasible reason for a crooked pinky and it's knuckle ending up a quarter way back into the top of the hand. I sure hope the triage nurse takes an X-Ray to prove the incompetence beforehand because I truly doubt the metacarpal is beginning to fuse straight in six days of being unchecked. One again I am not sure of the procedure, but most people need their primary hand as quickly as possible with little side-effect.
I suspect to be in limbo for six hours or so, but I will surely sacrifice twelve or even twenty-four hours over leaving everything 'as-is' for two weeks. Thanks, but no thanks. I have read far too many tales of woe to leave me justifying misplaced trust. I sincerely hope that luck is on my side and the fracture site could not be doing any better or so it may seem without making a fist and not finding a crooked pinky until the end... where it will all rewind for the worse.
The Boxer's Break Photo Log
August 08. I can assure you that my hand is looking and feeling better each day. The above images are from yesterday before bathing and pampering the hand.
______________________________________________________
August 03. This is the first picture stream. I wish I had taken initial pictures, but hey... shock is a strange drug when giving birth to your first broken bone. I really wish I took one of my first X-Ray though. I could not use my good camera due to being right handed and somewhat cumbersome for single-handed use, but the crappy MOTOKRZR cam will have to do (Doesn't appear anywhere near a 2.0MP as advertised).
The dark shades at the knuckles and gauze wrap points are pools of dead blood underneath the swelling skin. I do keep my wounded hand clean as can be, but the future trimming of the ring and pinky fingernails is a no-go for quite a while.
Post Boxer's Fracture
Tuesday, July 29 2008 was the date that I forfeited the use of my right hand due to an idiotic spurt of the rage virus. I broke the fifth metacarpal's (pinky's) neck above the top knuckle. I have to refrain from detail due to pecking on the keyboard with my left hand. However, I may update every odd day. Keep in mind that it takes a lot of time even to type out a sentence void of grammatical errors.
Wednesday, July 30, 2008. I lost my job the following day as a web designer, the job that I depended upon for basic survival. I live alone and have the full brunt of monthly bills to contend with along with the mortgage. I have one month's living allowance expense via credit card self-cheques(checks), I am not sure what is going to happen after that. I received more bad news that the hand specialist cannot see me until two weeks, on August 12.
Regret is a very jagged and bitter pill to swallow. I am full of self-loathing. But hey, who hasn't done something regretful? I rarely need to go to the hospital. The last time was for stitches from glass about eight years ago. I am not one to plague hospitals from alcohol/drug induced incidents every weekend. Yes, this is my third testosterone induced visit during my life and guaranteed last time. Three strikes and I'm out, three strikes too late or at least one. Regardless and perpetually moot. I am at the mercy of medical staff and I have good reason to be scared. Read on for a shocking revelation.
During the incident and currently still, I search the web endlessly to find out what I am up against. The prognosis does not look good. It seems either most people do not have their fracture tended or it is likely a rash of medical malpractice cases. From all the personal accounts of Boxer's Fracture, everyone is slighty disabled. The popular consensus is that the pinky finger has a deficient arc and tends to fold over the ring finger thus impeding a proper formation of the fist. This occurrence can have a detrimental effect on the hand's grip and other dexterity-type of needs. The typical depressed knuckle may be aesthetic to some, but most people have rightful vanity issues. I do not really care about a depressed knuckle or bump over the metacarpal fuse, but I have to wonder if these are also the effects of shoddy medical repairs. At this point, I am thoroughly flustered and do not know what to make of anything. There is much more reading for shock value.
I have read medical debates over the proper technique regarding the 'allowable' rotation of the fractured metacarpal and my guess is that the mainstream procedure is faulty, therefore allowing abnormal rotation to occur and is why most post fracture patients have lifelong problems. It could be that most patients abuse the healing process to offset the setting of the metacarpal alignment, but I sincerely doubt it as some patients had full arm/hand casts. In my case, there were initial X-Rays done, but none after the the bone setting was performed. I also cast doubts of uncertainty that simply straightening or motioning my hand into a half brace was proper alignment to set for the fusing stage. It is highly likely that the metacarpal neck is crooked and/or out of the 30 degree 'allowable', meaning a misalignment is fusing during the two week wait to see the hand specialist. This tends to make me think that I will be the next victim of a debilitated hand at the expense of 'splash and dash' hospital visits. If I have to get the fifth metacarpal reset in two weeks, well... I just lost two weeks of healing. Not to mention a potential loss of income from not being able to even sign a job application form. This is NOT acceptable and another testament of an already poor health care system.
This is why I am documenting what is happening. I will surely file a malpractice suit is my hand becomes partially disabled from a fracture. I have read enough information over the web to fear the worse. I understand the hand is the most delicate of the body's design other than the brain and spinal cord. As humans, we depend on the dexterity of our limbs for everyday functions. Shoddy medical attention is not excusable for a disability. Many Boxer's Fracture patients have lost the ability to play instruments up to and including the loss of careers. This does not sound like a text book fracture repair to me.
Going back to the grotesque arcing of the pinky, something my 'humorous' medical attendant echoes within my nightmares, "On a lighter note, your pinky will be easier to touch your thumb with." After reading online accounts of abnormal finger arcing, I distinctly tasted vomit in my mouth.
Wednesday, July 30, 2008. I lost my job the following day as a web designer, the job that I depended upon for basic survival. I live alone and have the full brunt of monthly bills to contend with along with the mortgage. I have one month's living allowance expense via credit card self-cheques(checks), I am not sure what is going to happen after that. I received more bad news that the hand specialist cannot see me until two weeks, on August 12.
Regret is a very jagged and bitter pill to swallow. I am full of self-loathing. But hey, who hasn't done something regretful? I rarely need to go to the hospital. The last time was for stitches from glass about eight years ago. I am not one to plague hospitals from alcohol/drug induced incidents every weekend. Yes, this is my third testosterone induced visit during my life and guaranteed last time. Three strikes and I'm out, three strikes too late or at least one. Regardless and perpetually moot. I am at the mercy of medical staff and I have good reason to be scared. Read on for a shocking revelation.
During the incident and currently still, I search the web endlessly to find out what I am up against. The prognosis does not look good. It seems either most people do not have their fracture tended or it is likely a rash of medical malpractice cases. From all the personal accounts of Boxer's Fracture, everyone is slighty disabled. The popular consensus is that the pinky finger has a deficient arc and tends to fold over the ring finger thus impeding a proper formation of the fist. This occurrence can have a detrimental effect on the hand's grip and other dexterity-type of needs. The typical depressed knuckle may be aesthetic to some, but most people have rightful vanity issues. I do not really care about a depressed knuckle or bump over the metacarpal fuse, but I have to wonder if these are also the effects of shoddy medical repairs. At this point, I am thoroughly flustered and do not know what to make of anything. There is much more reading for shock value.
I have read medical debates over the proper technique regarding the 'allowable' rotation of the fractured metacarpal and my guess is that the mainstream procedure is faulty, therefore allowing abnormal rotation to occur and is why most post fracture patients have lifelong problems. It could be that most patients abuse the healing process to offset the setting of the metacarpal alignment, but I sincerely doubt it as some patients had full arm/hand casts. In my case, there were initial X-Rays done, but none after the the bone setting was performed. I also cast doubts of uncertainty that simply straightening or motioning my hand into a half brace was proper alignment to set for the fusing stage. It is highly likely that the metacarpal neck is crooked and/or out of the 30 degree 'allowable', meaning a misalignment is fusing during the two week wait to see the hand specialist. This tends to make me think that I will be the next victim of a debilitated hand at the expense of 'splash and dash' hospital visits. If I have to get the fifth metacarpal reset in two weeks, well... I just lost two weeks of healing. Not to mention a potential loss of income from not being able to even sign a job application form. This is NOT acceptable and another testament of an already poor health care system.
This is why I am documenting what is happening. I will surely file a malpractice suit is my hand becomes partially disabled from a fracture. I have read enough information over the web to fear the worse. I understand the hand is the most delicate of the body's design other than the brain and spinal cord. As humans, we depend on the dexterity of our limbs for everyday functions. Shoddy medical attention is not excusable for a disability. Many Boxer's Fracture patients have lost the ability to play instruments up to and including the loss of careers. This does not sound like a text book fracture repair to me.
Going back to the grotesque arcing of the pinky, something my 'humorous' medical attendant echoes within my nightmares, "On a lighter note, your pinky will be easier to touch your thumb with." After reading online accounts of abnormal finger arcing, I distinctly tasted vomit in my mouth.
The Primer - Boxer's (Break) Fracture
What is it?
The Boxer's Fracture, sometimes also known as a Brawler's Fracture (and, whoops, the Boxer's Break), is a break in the fourth or fifth metacarpal bone of the hand. It is called this because it is typically incurred by punching a hard object. The use of Brawler's Fracture emphasizes the fact that trained boxers are much less likely to have this happen to them, as they both wear gloves designed to protect their hands and have been taught to hold their wrists in such a manner as to minimize the chances of this injury.
The metacarpal bones are the bones which connect the fingers to the wrist, and as such form the actual structure of the hand itself. If you look at the back of your hand, the knuckles (which are what hit whatever you've punched, usually) are in fact the heads of the metacarpal bones, or one end of them. The other ends are bunched back near the wristbone.
Why does it happen?
Take the Y Chromosome. Add alcohol. Toss in any spice like loud music or disputes over girls or...oh, sorry, you mean mechanically?
When you make a fist, the fingers curl up and the knuckles themselves are presented prominently. A proper straight punch (I believe) should strike with the knuckles of the index and middle finger, since those fingers are both the furthest extended and are backed by the strongest of the metacarpals. In addition, when the fist is made, those metacarpals are (or should be) straight on to the objective from the fist, meaning any shock taken against those knuckles is transmitted down the long axis of the bone. This is desirable, as it is the least likely to cause injury to the bone itself.
The pinky finger and ring finger, however, are not in the same position. If you look carefully, you can see that the knuckles of those fingers are actually bent 'down' slightly, as the fingers curl under and pull the metacarpal into a slight downward angle (with the fist held out level). As a result, if a misaimed punch strikes a hard object on these two knuckles, the force of the blow will actually hit the head of the metacarpal bone at an angle to the shaft of the bone behind it, not dead on. In essence, the strike will force the fingers to curl further, past their breaking point. If this happens with enough violence, the metacarpal will break - typically, it will crack just behind the head (knuckle) as that part bends down.
A slightly less common but still typical injury is for the metacarpal to crack at the back end - if the fist is rotated down at the wrist, slightly, but the knuckle strikes more straight on. This will exert force straight(er) through the knuckle, but at an angle to the back of the metacarpal where it joins the wrist, and the crack will occur at that end.
How can I tell if I have one?
Unlike many broken bones, the Boxer's Fracture doesn't produce obvious structural effects, since it's near a joint and not in the midst of a long bone. In addition, the other metacarpals will ensure the hand itself holds shape. What will happen is that the break will hurt like blazes. This isn't usually enough to make people seek attention, because of course they've just punched something like a wall (hard) and expect their hands to hurt. The thing to look for is swelling; a Boxer's Fracture will produce a severe local swelling around the break itself. Especially if the break is near the back of the hand, at the wrist, a swelling is indicative of a fracture.
Of course, if the pain after hitting something doesn't go away after a minute or two, seek help. Many people actually wake up with a hangover and a Boxer's Fracture. Imagine that.
What Should I do?
First of all, again, see a doctor. On the way, though, ice the hand, immobilize and elevate it. This will reduce the swelling and the pain, and immobilizing the hand reduces the chance of exacerbating the break or doing further damage. Your doctor will determine what needs to be done. Sometimes the best thing to do is simply splint the hand to prevent its use and allow the break to heal; casts are almost never needed.
What will happen to my hand?
Assuming you realize it's a break and see a doctor relatively quickly, probably nothing long term. The bones of the hand evolved to deal with damage. If the hand isn't properly immobilized, the fracture can sometimes heal with the metacarpal bent slightly in the direction of the break, which will result in the hand having a noticeable angle behind the knuckle that was affected. In extreme cases, this may have an impact on range of motion and increase the risk of tendonitis in nearby joints.
Taken from: http://everything2.com/index.pl?node_id=1816460
Subscribe to:
Posts (Atom)