Outstretched hand injury 6 months ago - help beeded

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Hi

I'm getting down with pain and no answers and wonderednif anyone had any ideas?

So 6 months ago I was sitting in the floor with my left hand behind my back to support me. My five year old so. Tan unexpectedly to me for a hug and my wrist bent 'too far'. There was a pop sound and a gringing feeling and some pain. Instantly the injury produced a ganglion cyst on the back of my wrist.

The pain was not 'bad enough to be a fracture' but after seeing the protrusion I went to a&e. Wrist X-ray all clear and they didn't even mention the ganglion.

I then saw different gps about 5 or 6 times because the pain was worsening and og anything more noticeable. I had noticed I wasn't using my left hand as much and couldn't grip or hold much weight. Holding take away cups or any dexterous work seems very hard and I have to concentrate. Driving is awful and using the handbrake and gear stick really flare it up.

My thumb now has a protrusion to the base and the middle joint also feels increasingly unstable. I think there is at least tendon damage because the thumb is hyper mobile although I have less control.

Gp so far have concentrated on the ganglion but I kept saying I wasn't worried about the ganglion; I was worried the underlying injury was more than a sprain.

I got a fever set of standard writay X-rays taken about 3 weeks ago and the feedback was that it was normal.

I'm now waiting until November to see an orthopaedic surgeon but I just wish I had some advice on how careful I should be or how to not increase the injury or cause long term damage. I'm a bit worried there is already some lasting damage given te wait I've had. The thumb issues seem to either be a dislocation or tendon damage or potentially the start of arrhiritis.

I have tenderness in my snuff box but if worsens and improves although is often pretty painful.

I also get numbness on and off on my ring and little fingers which extends up to my hand and shoots pain up to my elbow.

Am I crazy or has anyone else sudfwr d similar??

Has anyone got any good advice on how best to care for myself until I am reviewed?

Ice seems to help a lot and a wrist support has been good but I'm conscious for trying to keep moving to reduce swelling and stiffness.

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14 Replies

  • Posted

    I have pain in my left hand and it's a little swollen. The doctor told me it's arthritis and to put ice on it. I did once and it did feel better. I guess I should keep putting ice on it.  I've also had problems with my knees and had surgery on both. They still hurt! I've used pain cream on them. That seems to help. So, I know what it's like to be in pain! 

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  • Posted

    Wobblywrist, Yes I do know what you are talking about I recently had a fall went to a workforce clinic and they did x-rays and told me I had a Intra-Articular Distal Radius Fracture and tried to get me set up with Ortho that day but being the Friday before the 4th of July none of them were in. was referred to Ortho and seen 12 days later, He took x-rays and said no Fracture said fall caused Arthritic Episode and it didn't feel like Arthritis since I was diagnosed with OsteoArthritis last year of the thumb. Basal Joint Arthritis was restricted to not using my thumb and followed orders, of course I wish it were that simple. saw doctor again 14 days later did x-rays and said same thing this time he put me in CMC brace which allowed me to have more movement and he also gave Cortisone Injection which had it been Arthritis it would've helped but it felt like he hit something when he gave the injection things have went down hill ever since. went back on Aug 10th told him things had gotten worse instead of the pain just being in and around my thumb the whole palm of my hand feels like it's been repeatedly slammed in a door and I noticed pain was going across my wrist and up my arm and I feel like my last 3 fingers from bird to pinky fingers aren't right it's like when I straighten them out they cramp and feel like they spasm a little, seems like the only finger not affected is my pointing finger. I've had an MRI, EMG the EMG was done yesterday to check my nerves the doctor had idea that I may have Carpel Tunnel Syndrome but was negative for that. Neurologist said I did have some slight problems with the nerve that runs up the side of arm on outside at the elbow and that was causing the feeling in my fingers but he said hand was fine when it comes to the nerves said it would have to be muscles or bones not nerves. I requested a second opinion because I know I had a hairline fracture in scaphoid bone I was shown the fracture even though it was a slight fracture it was there and I went from just limiting my thumb to no use of arm at work until further notice and the doc ask me had I heard anything about the second opinion yet when I went back on Sept 6th and I finally got an email from my Workers Comp case worker yesterday telling me she heard back from the second opinion doctor and I'm scheduled to be seen in November unless they have a cancellation then they'll get me in sooner. I know exactly where your coming from. I have tried to use my arm as little as possible but I don't use it at all at work as per doctor and I can't use it much at home because I have no grip I keep some kind of brace on at all times unless I'm in the shower and that even hurts I usually wash my hair with one hand because it hurts too bad to use the other one that much but I don't want it to freeze up either as long as this has been going on and the doctor I have doesn't seem to have a clue he just knows that what he see's on x-rays isn't a fracture but I have a couple of friends who are doctors and both of them have been dealing with the bones for years and they both saw the fracture and said to make sure whoever my second opinion was knew how to read an x-ray and I think from me doing things I shouldn't have been doing in the beginning of all this something has happened along with the injection where it seemed like he hit something that's why I want the second opinion because I wanted a different doctor because I have heard horror stories about the first one I picked from a panel that I didn't know any of them. second opinion doctor had good reviews though. first doc had one and it wasn't good but like luck goes I don't have any of that lol.  Hang in there and keep pressing on because something is definetely wrong and I can't do much because it's a workers comp case I can't even get the doctor that i would prefer because it would kick my insurance out and I'd have to pay outta pocket and I sure can't afford to do that... Keep me posted and go back and get something done for yourself.

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  • Posted

    Hello.

    Thank you for replying.

    Eva I'm sorry to reqdmofmyor recent pain and struggling to get a firm diagnosis and treatment plan which helps. It's so frustrating isn't it!

    Here in ththe UK access to specialists is limited because the funding is limited and the wait is also quite long. I have somewhat fallen between the gals in departments because although I sought emergency help I was discharged as no fracture. It now seems hard to get seen again and I have ready about wrist injuries becoming permanent disability in so many cases where treatment was delayed.

    Looking on the bright side the specialist is an expert surgeon and has vast experience coming from Oxford and pioneering techniques. He ought to be experienced enough and I suspect that when I finally see an expert that he will isyantly see what I can see.

    I don't like to exaggerate but I am know it is injured and I know deep down that I need intervention. I just hope there is time left to fix it without lasting damage.

    If wristbinjuries can frequently become so severe I just don't understand why aside from a few experts, most doctors don't seem to be aware?

    Wish you both good luck with your pain and hope that you move forward steadily.

    I would definitely recommend mobilising the wrist in a controlled way. Whilst there is a fracture there you also don't want to build up further issues losing strength and further mobility. Be careful and look after yourself.

    Best wishes

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    • Posted

      Hi wobbly wrist ( what a lovely sign in name) I actually fractured my distal radius and ulna and since having surgery to plate and screw this and now out of plaster - 17 weeks post op I still have major problems. Mainly mobility in the fact I can't supinate/pronate but I also have pain when trying to do this in the ulna side- pinky finger. Having done a lot of research myself I believe I have TFCC damage. I believe the symptoms you may have could be this as well. It won't show on normal X Ray but will need an MRI. I am seeing a hand and wrist specialist end of October for a second opinion but in th mean time I'm having physio and OT to help plus I wear a wrist widget - Google it - it helps tremendously with the pain and gives me the mobility to do my excercises. Hope you get some answers from your Consultant. Is it the main ortho hospital Nuffield or the JR your gong to? Good luck

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    • Posted

      Hi Vicky

      Thank you. Can I ask what TFCC is?

      Actually I live in Kent and the surgeon is now based down here so I am seeing Dr Benson at Edenbridge clinic. He's working out of Tunbridge wells hospital.

      Weirdly I grew up in Oxford and my brother was under a different Dr Benson for a leg complaint at he Nuffield.

      I hope your second opinion goes well. None of this seems to be an exact science does it?

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    • Posted

      Sorry should have said - The triangular fibrocartilage complex (TFCC) is a cartilage structure located on the small finger side of the wrist that, cushions and supports the small carpal bones in the wrist. The TFCC keeps the forearm bones (radius and ulna) stable when the hand grasps or the forearm rotates.

      A tear etc can cause pain and immobility of the joint and gymnasts weight lifters and those that have fractured their wrist are susceptible to this. Fall on outstretched hand can damage this as well. Hope you get some answers too. Keep us informed please as good to know how things go with those that post here

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    • Posted

      Thank you so much. I will.

      My appointment is on 7th November so it is a bit of a wait but will come back and hopefully have some more days an idea what could be going on. My GP is hoping an MRI is recommended and I agree. It would be good to be more certain there isn't a hidden fracture. I hear scaphoid in particular doesn't always show on X-ray.

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    • Posted

      vicky87059, can the TFCC cause you to have pain going up the side of your forearm on the pinky side to your elbow ? I fell at work on outstretched hands and was told by first place they took x-rays that I had Intra-Articular Distal Radius Fracture, but Hand Specialist said no Fracture but 5 other doctors said it was Fractured. Hand Specialist gave Cortisone Shot 26 days after accident because he said fall had caused Arthritic Flare-up, (Episode) which it has never felt like Arthritis flare-up I've ever had but after Injection things have gotten progressively worse. Do you have any suggestions ? By the Way good luck with your second opinion, I'm waiting on my second opinion also it's in November seems like forever.

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    • Posted

      Hi Eva. Yes it does and it also causes some mobility problems, especially in supinate/pronate or palm up Palm down action. The pain I have is all on the ulna side and hurts if I try to do the above or grip anything. Not that I can as the mobility is greatly reduced. If you aren't impressed with the docs you have - and i think I understand you have to have certain doctors under your insurance scheme, I would definitely read up on TFCC injuries and if you believe you may have this then go to your second option armed with knowledge and ask for an MRI to confirm. Hope this helps?

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    • Posted

      Vicky, I've had an MRI, and they didn't say that anything was any different than what it was a year ago when that's how they confirmed Arthritis, but I had a Nerve Conduction Study (EMG) done last Thursday and they did rule out Carpel Tunnel Syndrome but said that I had slight nerve damage in the nerve that runs up your elbow the one you feel when you hit your elbow and say you hit your funny bone so I don't know about that because a good doctor friend of mine says they're only about 50 percent accurate. I still say what I have from the beginning my Scaphoid Bone had a hairline fracture and the Specialist that I am seeing never has stated that but all of 5 other doctors see it so I don't know what the problem is with him but my doctor friend of 27 years said when I get my second opinion said to make sure the doc I go see knows how to read an x-ray, and he's straightened me up from a really bad car accident that I was in years ago. I trust his opinion he's been taking care of my medical needs for over 27 years too bad he wasn't on the panel of doctors that I had to choose from cause that would be a no brainer. I definitely know it is more than Arthritis. and I will read up on TFCC, thanks for telling me, I appreciate it...

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  • Posted

    Morning Wobblywrist;   Actually, I think you should have the Ganglion taken care of (this we used to do with just "wracking it with a heavy book" to burst the cysct etc)....bit strange hey?   but if you have something pressing on the nerves of your wrist, this would be causing the tingling in finger/s etc, and if inflammed, would also be causing some of the others issues???......yes, seeing a good orthopod (someone who specializes in wrists etc) is the best to see, and hopefully they can drain/repair the site easily for you.....if these continue and calcify, you may end up with Carpal Tunnel Syndrom, which is Very painful and does require surgery in the long-term.........hopefully this is what you are talking about, and has been helpful?................good luck,   Bron

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  • Posted

    Thank you again everyone who has replied.

    Last night I can across info on the anatomical snuffbox and how this can be very sensitive for a scaphoid fracture.

    I tried it. Initially felt nothing and then found an image online of where to press. Cripes! The pain was unreal! Admittedly impressed quite deeply but this was because I really thought I had no pain there.

    It then sett of my pain more generally over the area.

    I'm also really noticing more issues at the base of the thumb and the first joint up from the base. There is much more mobility and it feels very weak. I struggle to perform actions like opening a bag of crisps or doing buttons. I've realised I often pick up my two year old without stretching my thumb around her. I seem to use the hand as one object.

    Interestingly my ganglion is really reduced and the numbness is a lot better. The focus of the pain now is really around the base of the thumb and from that area toward the wrist. The swelling is up between what I think is my radius and thumb and out toward the ganglion on the back of the wrist in th the centre. It's sort of a triangular area.

    Roll on the 7th November!

    Although I am a little concerned that the date of my consultation is some 9 months after the initial injury. I'm already wondering if the thumb issue is arthritis developing.

    I just can't believe they didn't splint me in a&e as a precaution. I don't remember them palpating my scaphoid but presumably they did and I just don't remember.

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  • Posted

    Hi

    So I promised a reply.

    Today I had my consultation. The upshot seems to be that I have been diagnosed with basal thumb arthritis. sad imam just 35.

    My X-rays were clear although the scapholunate gap is fairly wide. As a result they are querying ligament injury and I am to have an MRI to assess the arthritis and any potential scapholunate disassociation. They were unclear on this as I suspect they do not wish to worry me unnecessarily.

    They don't care about the ganglion even though I explained some of the numbness and shooting pains do not occur when the ganglion is reduced. (It flares up and down).

    So I go back to waiting for another appointment after the MRI. They mentioned I will be given a corticosteroid injection which will be guided by the MRI findings.

    Does any of this sound reasonable?

    I'm feeling quite cross that I wasn't looked st properly in A&E and that it's taken 9 months to get here. I'm fairly sure the arthritis is caused by underlying injury and I've been 'shouting' about this since the original injury.

    All I can do is watch this space and hope that there's nothing too sinister going on underneath.

    Thanks for listening and I hope everyone is getting from well.

    Wobblywrist

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    • Posted

      Hi wobbly. I too have had my second consultation and she thinks my lack of movement is due to the stiffness of the CRPS plus possible soft tissue damage i.e. Ligament TFCC ?? I am having a CT scan and then possible examination under anaesthetic with injections. It all depends on the CT scan really and what they find.

      I'm so distressed with it all. Writing this at 02.30am as haven't been to sleep and can't sleep!! The future looks bleak and I probably will not be able to return to work. It's nothing but bad news and I'm getting tired of it all. Not sure how much I can take.

      Hope your MRI does not show anything too bad for you. Oh and by the way I also have been diagnosed with arthritis at the base of my thumb but my thumb looks like it Hyper extends. Not nice and again this is something I didn't have/felt prior to the accident. All doom

      And gloom for me :-(

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