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Forum Name: Bone trauma and fractures

Question: Hurt Wrist, Thumb, and Hand


 cmasse - Sat Jul 05, 2008 11:08 am

It has been seven weeks since I fell in the shower and my Wrist, hand, and thumb are still sore. I fell on an outstretched hand. I got soap in my eyes and as I tried to turn around I slipped while I had both hands on the wall. My right one in back of me and my left on the side of me and as I fell, both hands went all the way down until I reached the tub surround. The pain immediately begun and it was awful. Do you think it might be more than just a sprain? It also hurts in the Scaphoid area where a bruise is there.

I got it checked out and they diagnosed me as a sprained wrist and hand. But it is still sore, swollen, and bruised, so I got a referral to Orthopedics. It is swollen on the palm side of my hand where the thumb is and near the wrist and there is a bump also on one of my thumb bones.

This was because when I got surgery on my ankle in April, a few weeks later, I tried to take a shower and not put alot of weight on my ankle and that is how I fell. As I turned around I slipped.
 John Kenyon, CNA - Tue Jul 15, 2008 9:26 pm

User avatar Hello -

While the initial diagnosis of sprain was no doubt correct, seven weeks along you shouldn't be having so many ongoing symptoms based on a sprain alone. Unfortunately the affected area contains some pretty sensitive and much-used tendons and I strongly suspect you have developed a sequel of tendinitis in the wrist, especially based on your detailed description of the way you fell. Your mention a bruise in the scaphoid area. Is the bruse still present? If so this could represent a significant tendinitis with swelling, discoloration (bruise) and pretty severe pain. You probably should be wearing a wrist brace and limiting the amount of work you do with the affected hand until it has healed. Anti-inflammatory medication would probably also be in order. I am assuming there were initial x-rays taken? Or at least during the orthopedic followup? This would likely demonstrate any fracture.

I'm still betting on severe tendinitis. Please do let us know how things go.
 cmasse - Wed Jul 16, 2008 8:39 am

The bruise on the Scaphoid area is still present and when moving my thumb around or pressing on that area, I have alot of pain. It has more than seven weeks now, about eight weeks since I injured it and it is still swollen, ruised, and sore. Can a fall in the shower cause tendinitis?

Cassie
 John Kenyon, CNA - Wed Jul 16, 2008 2:52 pm

User avatar Hi Cassie -

Yes, a fall such as you describe could definitely cause severe tendinitis -- and reflex sympathetic (RSD) which leads to complex regional pain syndrome (two types) can also result from this sort of injury. In fact, some of what you describe does sound like CRPS, since some of the cardinal signs are pain (often severe), local swelling, sensitivity to touch/pressure, and changes in local bone structures. I suspect you have a combination going on, and treatment would depend on which is the case or if it is both. Tendinitis is easier to treat, mainly with non-steroidal anti-inflammatory drugs, possible local site injection of steroids, and bracing or immobilization of the part as with a brace. If it is found to be RSD/CRPS only, this is treated largely by physical therapy.

I'd definitely bring this to the attention of your doctor and perhaps get a referral to an orthopedist or physiotherapist. It's not normal for an injury like this to continue on this long based on the initial trauma alone. A secondary inflammatory process of some sort has taken place and needs attention.

I hope you can find some relief from this condition sooner than later. Please do stay in touch with us and keep us updated.
 cmasse - Wed Jul 16, 2008 3:55 pm

Can a fall in the shower cause a Scaphoid fracture or maybe ligament/temdon damage? Cause of the way I fell on it, maybe it might be either of those?
 cmasse - Thu Jul 17, 2008 12:11 pm

Can a fall in the shower like that cause a Scaphoid fracture? I know I fell somewhat hard. After I fell that day, the pain immediately began and it was awful. It is still bruised, swollen, and sore, and after eight weeks, I am still in pain. There must be something wrong with it. Also, can a fall like that also cause ligament/tendon damage?

Cassie
 John Kenyon, CNA - Fri Jul 25, 2008 11:01 pm

User avatar Hi there -

Yes, a fall such as you decribed could definitely cause a scaphoid fracture and also could cause tendon irritation or even rupture. If there is a fracture it has taken a long time to resolve, but that may be because it's not been immobilized properly and if there is an injured or ruptured tendon it would require at least anti-inflammatory pain relievers and/or surgical repair. After eight weeks this needs an aggressive look for sure.

Please do stay in touch.
 cmasse - Thu Sep 18, 2008 11:17 am

My left hand, wrist, and thumb are still sore from when I fell in the shower on the outstretched hand. It has been four months since I injured it and it is still swollen and sore. The scaphoid area also still hurts. I got referred to a hand specialist and hopefully he can find out what is wrong. The x-ray showed a possible hairline fracture when I went to the doctors a couple months ago, so the Orthopedist can verify that. What I don't understand is why it is still sore and not healing?

Any suggestions would be appreciated. Thanks in advance!

Cassie
 John Kenyon, CNA - Thu Sep 18, 2008 4:00 pm

User avatar Hi Cassie -

If there is, indeed, a fracture, it may need some stabilization, even though it's not displaced. Sometimes using an unbraced hand that's been injured can keep it irritated even though there's nothing that seems grossly out of line. The hand specialist should be able to throw a lot more light on this, since you've had this going on for quite a long time. Hopefully the specialist will be able to determine just what's going on and help it begin to heal properly.

Thanks for the update. We'll be interested to hear what you learn.
 cmasse - Tue Sep 23, 2008 10:51 am

Thank you for replying. I went to a hand specialist and got a cortisone shot. He said if that doesn't work than I will need surgery. The cortisone shot made the pain worse and I can hardly move my wrist and hand so I will call the surgeon soon and schedule the surgery. My diagnosis: I have a hairline fracture and a partially torn ligament. I also have clicking in my wrist when I move it. The doctor said that it is from the torn ligament.

Cassie
 John Kenyon, CNA - Wed Sep 24, 2008 2:13 pm

User avatar Hi Cassie -

You're very welcome. All this now makes total sense. I'm sorry to hear the cortisone shot didn't help (and effectively made things worse), but with the fracture it probably was going to contiue to bother you, and the surgery should be relatively simple and hopefully will make everything right again. Best of luck to you with that and please let us know how things turn out.
 cmasse - Wed Sep 24, 2008 3:16 pm

Will the Cortisone shot repair the torn ligaments? I know I will need surgery but why did he give me the Cortisone shot if it doesn't repair anything?

Cassie
 John Kenyon, CNA - Wed Sep 24, 2008 7:46 pm

User avatar Hi -

OK, this is where it can get confusing. The cortisone shot will reduce pain, swelling, and inflammation at the site of the injury. This may actually allow the tear to heal on its own, but probably not, since steroids paradoxically impede the body's ability to heal on its own, so you'll very likely need the surgical repair anyway. Meanwhile, though, the discomfort should be a lot less and with the swelling and inflammation reduced, the surgery will be far more easy to accomplish properly.

Hope this explains that. Good luck to you.
 cmasse - Wed Sep 24, 2008 8:32 pm

Thank you for replying. I understand it a little more now. I did get the Cortisone shot a few days ago and it didn't help at all. In fact, the pain got worse. It is still hard to move my wrist and thumb and hard to do easy tasks like: typing on the computer, driving, etc. Why did the pain get worse and not better? I know sometimes Cortisone shots don't work all the time. I injured it back in May so it turned into a Chronic injury, I don't know if that has anything to do with the Cortisone shot not working I will schedule the surgery with the surgeon and that will definitely take care of the hairline fracture and the torn ligament.

Cassie
 John Kenyon, CNA - Fri Sep 26, 2008 10:29 am

User avatar Hi there -

No, cortisone shots don't always work, and while it was a reasonable thing to try, the duration of the injury has probably created some other problems with scarring, sclerosing, etc., which the cortisone likely wouldn't be able to touch, at least not in a good way. That's probably why it not only hasn't helped but may seem to have made things a little worse. There's also the possibility of such sensitivity in the injured hand that a bolus of cortisone simply is putting pressure on irritated nerves and cancelling out any good effect. Hopefully it will at least go back to the way it was, shortly, and then surgery will likely correct the rest of the problem.
 cmasse - Fri Sep 26, 2008 11:15 am

Thank you for replying. I am still a little confused about the cortisone shot. What I don't understand is why he gave me the cortisone shot first if it doesn't repair anything? Wouldn't it be better to get the surgery done now instead of wating untill after I get the Cortisone shot? I know that surgery will repair the torn ligament and the hairline fracture.

Cassie
 cmasse - Thu Oct 09, 2008 7:40 pm

Thank you for replying. I am still a little confused about the cortisone shot. What I don't understand is why he gave me the cortisone shot first if it doesn't repair anything? Wouldn't it be better to get the surgery done now instead of wating untill after I get the Cortisone shot? I know that surgery is the only way to repair the fracture and torn ligamnets but why did the hand specialist do the cortisone shot first?

Cassie

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