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Preventing Vibration White Finger

If you use vibrating power tools, such as jackhammers, sanders, chainsaws, and lawnmowers, you may be susceptible to a condition known as vibration white finger (VWF). Those who suffer from VWF experience a loss or change of color in their fingers, tingling, and throbbing.

white finger preventionWhen someone is experiencing an occurrence of VWF, the tiny blood vessels in the fingers constrict (called a vasospasm), causing a reduction of blood supply to the fingers. This lack of blood initially turns the fingers white. After the oxygen in the remaining blood is used up, the fingers turn blue (a condition known as cyanosis). Once the spasms subside, the fingers turn red as oxygen-rich blood rushes back to the fingers.

To help prevent VWF, the following should be considered:

•    Stay warm and dry when operating machinery
•    Take regular breaks
•    If possible, use a tool that has some form of vibration-damping technology
•    Ensure tools are properly maintained (poorly maintained tools may vibrate more or at a different frequency)
•    Ensure that the right tool is used for a particular job (the wrong tool may take longer, exposing you to more vibration)

Preventing Frostbite

Exposure to cold temperatures for a prolonged time can result in frostbite, which causes the skin and surrounding tissues to freeze. Frostbite commonly occurs in the fingers, which may lead to loss of feeling and skin discoloration. In severe cases, frostbite can also cause permanent damage and/or loss of fingers. If you’re going to be outside in the cold weather, be sure to protect your hands.

Frostbite can occur even when the temperature is above 32 degrees fahrenheit. Wind chill and moisture contribute to frostbite conditions. Dress in layers, including warm insulated gloves and always carry a pair in your car in case you become stranded or encounter car trouble.

Recognize frostbite symptoms

• Numbness/tingling feeling
• Skin discoloration
• Hard or waxy skin
• Blisters or blackened skin

If you suspect frostbite, follow these guidelines and seek immediate medical attention:

• Go immediately to a warm place.
• Carefully remove wet gloves.
• Refrain from rubbing or scratching the affected area.
• Carefully submerse affected affected fingers in warm (not hot) water for 30 minutes until medical care is available.
• Cover the area with a warm towel or blanket to thaw.
• If available wrap each frostbitten finger loosely with sterile gauze.
• Thaw a frostbitten area only if it can be kept warm. Refreezing a frostbitten finger can result in permanent loss.
• Do not touch blisters occurring from frostbite.

Coping With a Cast

After a bone is broken, either accidentally or for a surgical procedure, a cast is often used to let the bone heal properly. While uncomfortable and cumbersome, casts are extremely important in the treatment of fractures and preventing further problems. And caring for that cast is an essential part of that healing process. So how do you deal with a cast – especially when it starts to itch?

Keep the cast dry: Keep the cast and the cotton wrap around the injury dry at all times. If you want to wash, carefully wrap the cast in plastic and protect the cast from any water.

Don’t stick anything under the cast: Try to keep objects out from under the cast, and especially avoid the urge to stick coat hangers under the cast-this can damage both your skin and the cast material.

Trim rough edges: Rough edges of the cast can be trimmed with an emery board. Do not cut the cast with scissors or attempt to break off rough edges.

Relieve itching the right way: To relieve itching under the cast, try pointing a hairdryer on a cool-air setting down the cast to relieve the itch. Over-the-counter medications such as Benadryl can sometimes help.

Inspect the cast carefully: Examine the cast regularly and alert your doctor if it cracks, breaks, or becomes loose. Also look for reddened or raw skin around the cast edges-your doctor can pad these areas to prevent problems.

Tips for comfort:
• Elevate the injured extremity to prevent swelling in the initial days following the injury.
• Exercise the extremity. Even if your arm is in a cast, don’t neglect the fingers. Alert your doctor if the exercise causes pain.
• Apply an ice bag to the cast to help reduce swelling. If you attempt to ice the broken bone, be certain you keep the cast dry.

Fireworks Safety

The American Society for Surgery of the Hand (ASSH) Urges Firework Safety in an Effort to Reduce the Number of Injuries Each Year

Fireworks are a part of many seasonal celebrations, but many people fail to realize just how dangerous they really are. Many accidents each year result in life-altering injuries for people of all ages. Firework injuries can be particularly difficult to treat because they involve both burns and blast injuries, which damage tissues from the skin through the bone and can even cause partial or complete hand amputation.

Fireworks caused over 11,000 injuries in 2016, most commonly damaging hands and fingers. Sparklers, which many parents consider to be safe, burn at greater than 1,000 degrees F and can quickly cause serious injury. Injuries to the hand may include disfigurement and permanent disability, affecting jobs and life satisfaction.

Many states recognize the danger and limit the use of consumer fireworks at varying levels. As hand surgeons who specialize in this type of injury, ASSH urges the public to understand that:

– All fireworks are inherently dangerous.
– Firework use should be limited to professional display; explosive materials should only be handled by professionals.
– Firework injuries to the hand can be devastating and have large personal and economic costs.

Fireworks are unpredictable, and even trained technicians are susceptible to injury. Yet, we understand that consumers may continue to use fireworks, so we recommend additional safety precautions should always be taken:

1. Use personal protective equipment, including eye protection, when handling any flammable material.
2. Ensure that people nearby are aware of any plan to ignite fireworks and are in a safe area.
3. If attending a public display, pay close attention and obey all rules and regulations established by the authorities and crew in charge of safety.
4. Do not consume alcohol or use other drugs when choosing to use a firework, as it may impair judgment and dexterity.
5. ASSH’s full position statement includes additional safety recommendations from the National Council on Firework Safety.

Hands are our primary tools for exploring the world; an injury can permanently impact your home and work life. Please be safe this season!

“As a young child, I clearly remember asking my mother to buy fireworks for the 4th of July. She told me about her childhood classmate who lost an eye due to a firework injury and told me ‘no,’” recalls hand surgeon Steven H. Goldberg, MD. “Now, as a hand surgeon, I’ve had to treat multiple patients with injuries so severe that their fingers required amputation or were already missing. It is not easy news to share, and it’s not easy for patients to hear. In a split second, their hand, their life, their employment is changed forever. Listen to my mom, and say ‘no’ to the personal use of fireworks this summer.”

For more information visit:…/…/ASSH-Position-Statement-on-Fireworks

Prevent Unnecessary Injuries with these Winter Safety Tips

fb-snowblowerEvery year the board certified orthopedic surgeons at the Indiana Hand to Shoulder Center see patients with injuries due to careless use of snowblowers, frostbite and falls on ice.  If you’re spending time outdoors in the cold winter weather, please remember these tips to help prevent an unnecessary trip to the doctor’s office or emergency room due to injury.

Use your snowblower safely

Snowblowers are a great way to quickly clear snow from your driveway and sidewalks, but they can also cause serious injury if used improperly.  Avoid dangerous situations and unnecessary accidents while using your snowblower.

Please remember…

• Snow can clog a snowblower, causing it to temporarily malfunction.
• Propeller blades can still be in motion, even when the machine is turned off.
• Making contact with moving blades or parts can result in severe injury.
• Never remove and safety devices on the snowblower.
• Fill snowblowers with gas outdoors – not in an enclosed area.  If using electric snowblower, be careful not to trip on or run over the cord.

Beware of Icy Sidewalks and Parking Lots

When you’re taking a crisp winter stroll in your neighborhood or walking through the parking lot at work, use caution after snow has fallen.  Sidewalks and pavement can be slippery resulting in falls that cause serious injuries to the shoulder, elbow, wrist and hands.  Follow these tips.

• Wear sensible boots with thick, non-tread soles and low heels. Keep these in your car in case you become stranded or encounter car trouble.
• Thoroughly salt or sand your driveway, walkways and sidewalks.
•Wait until snow/ice has melted before walking on salted surfaces.
• Look before you walk.  Surfaces can re-freeze during nighttime hours, making sidewalks and parking lots slippery in the morning.
• Walk slowly and carefully, taking small steps.

Hoverboard Injuries Segment on FOX59 News with Jeffrey A. Greenberg, MD

FOX59 News reporter Kyle Inskeep visited the Indiana Hand to Shoulder Center to do a segment on hoverboards and the dangers of using them.  Jeffrey A. Greenberg, MD provides information on how to prevent injuries and what type of injuries we are seeing at the Indiana Hand to Shoulder Center.


Hoverboards Causing Large Number of Broken Wrists and Other Injuries

One of the best selling gifts of the holidays were hoverboards (also called FloBoards or Handsfree Segway) and they are landing children and parents in the emergency room.  Hoverboards are a hands free device that riders balance on and are propelled by two wheels.  As of December 28 there were 70 reports of emergency room visits due to hover boards, according to the U.S. Consumer Product Safety Commission in a CNN article. Common injures from hoverboard accidents include fractures, strains, contusions and lacerations.

Hoverboards have been in the news after being banned from airlines and causing a variety of explosions and fires.  Amazon stopped selling some models due to quality concerns.  However, despite the bad press they remained one of the top selling must have gifts for Christmas this year.  The post Christmas novice hoverboard riders are flying off the somewhat mercurial boards, landing on their wrists, and then landing the patient a visit to the emergency room.  One emergency room in Indianapolis had 7 broken wrists from hoverboards the day after Christmas.  Comedian Stan Boardman , Boxer Mike Tyson and Congressman Carlos Curbelo are the better known adults who have fallen victim to hoverboard accidents. A search of the hashtag #hoverboardfail on social media is a trending topic on Twitter and Instagram.

“The Indiana Hand to Shoulder Center is seeing a significant number of these injuries locally.  We are an internationally recognized center for upper extremity care and would like to make sure parents and their children aware of the increased number of injuries from this new toy.” says Greg A. Merrell, M.D.

Dr. Merrell suggest the following precautions:

  • Wear a helmet
  • Wear wrist braces, elbow and knee pads
  • Have a spotter with you as you learn to ride
  • Practice on a carpeted surface to learn the feel of the board