The ski season is nearly here and hopefully everybody will stay injury free. However, there are a number of orthopaedic and injuries that can occur while skiing require expert assessment. Is often difficult decision whether to have treatment abroad or be patched up and have an assessment and treatment back in the UK.
The majority of hand and wrist problems can be safely transferred back to UK for treatment and generally speaking need assessing within the first seven days post injury.
Indications for immediate intervention include those injuries that have an open wound, severely displaced fractures that require manipulation in to an improved position and injuries such as dislocations.
Distal radial fractures around the wrist, when displaced, may need a manipulation to an improved position and then temporary back slab made of Plaster of Paris. Most fractures can wait until approximately 10 days before definitive treatment. After 10 days the fracture becomes increasingly sticky and starts to heal. Displaced distal radial fractures can be treated with a manipulation and fixation using either K wires or increasingly internal fixation using specialised plates and screws. The advantage of plates and screws is that it permits early mobilisation and avoids exposed K wires which can be irritating and inconvenient. K wire fixation also requires supplementing stability with plaster cast mobilisation for six weeks. The literature is very confusing as to which form of treatment ( K wires or internal fixation) is of best for you and you should discuss this with your treating surgeon.
The other common skiing injury is in the Skier’s thumb. This is an injury where the ligaments on the inside of the thumb becomes pulled off the bone and the thumb becomes sloppy and unstable. This injury when it occurs can wait for fixation back in for approximately two weeks. The ligament is reattached to the bone using small bone anchors and the repair is then protected with a temporary removable splint. My experience treating professional sports people with this injury is that they return to their professional sport on average just over four weeks post injury in a protected removable splint.
In summary therefore, the majority of injuries can wait to get UK only to be assessed by a hand surgeon within the first 10 days.
Mike is more than happy to communicate by email / face time to give advice on your injury and you would be able to upload your x-rays and images securely via his website with prior agreement. Alternatively, you may be happy to take a photograph on your phone and send them via WhatsApp understanding the data security implications.