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Michael Vick of the Eagles Breaks Hand

The third week of the NFL continues to bring drama to the field due to injuries.  Week 2 saw Michael Vick exit the game from a concussion. Today, he left the game because of a broken right hand.  Will he play next week?

ANATOMY

The hand is made up of 27 bones.  In each finger there are 3 phalanges, whereas the thumb has 2.  In the palm of the hand, corresponding to each finger is a metacarpal.  In the wrist there are an additional 8 bones.  These bones work in concert to allow motion and stability to the hand.

Michael Vick reportedly is suffering from a “hand” fracture.  It is unclear which exact bone is injured, however the fact that a CT scan is being ordered suggests that the base of one of the metacarpals, or perhaps one of the wrist bones was fractured.

CAUSES

A fracture of the hand is usually caused by a trauma.  This can be in the form of sporting activities where something or someone crushes the hand or drops or twists on the hand. A punch, a fall on an outstretched hand, or even a gunshot can lead to a fracture of the hand.

SYMPTOMS

Individuals who break their hand will have pain, swelling, loss of motion, and bruising.  Depending on the location and position of the break, the finger may turn one way or the other when the fingers are flexed.  This is one of the reasons for surgery.

WHEN TO SEEK MEDICAL CARE

If you suspect that you are suffering from a broken hand, you should seek medical attention within a week of the injury, A physical exam and x-rays are usually performed. A CT scan at times may be needed.

TREATMENT

Many hand fractures can be treated without surgery.  If one metacarpal is fractured, oftentimes a removable brace or splint can be worn for about 4 weeks.  If two or more metacarpals are fractured, but are located in the correct position, a short arm cast can be worn for 4 to 8 weeks.

Surgery is considered if multiple metacarpals are broken, if the break is in the base of the metacarpal where it interacts with the wrist bones, if there is shortening of the metacarpal bone, or if one of the wrist bones is fractured.  Surgery can be as simple as the placement of 1 or 2 wires into the bone, holding it where it belongs, to placing plates and screws on the bone.  In any of these surgical situations, pressure is usually not allowed through the hand for 4 to 8 weeks.

OUTCOMES

Most athletes with a hand fracture have no long lasting issues.

RETURN TO ACTIVITIES

From the current reports, it is unclear of the nature of Vick’s injury.  Given that this is his non-dominant, non-throwing hand, if a metacarpal is fractured he should be able to play next week.  A special cast may be made for him to protect the hand during play.  However, if one of his wrist bones is fractured, he could be out of action for 6-8 weeks.  The CT scan that he is scheduled to get on Monday should give us a lot of insight into the nature of his injury and the time to return to play.

VIDEO/ANIMATIONS

 

Dr. P

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All material published through this blog/website is for informational and entertainment purposes only. Readers are encouraged to confirm the information contained herein with other sources. Patients and consumers should review the information carefully with their professional health care provider. The information is not intended to replace medical advice offered by physicians. Dr. Parekh and Duke University will not be liable for any direct, indirect, consequential, special, exemplary, or other damages arising from the discussions in this blog.   For more information on the North Carolina Orthopaedic Clinic, go to: http://www.ncorthoclinic.com/  For more information on Duke Orthopaedics, go to: http://www.dukehealth.org/orthopaedics

 

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