Puffy wrist weeks after a fall?
It’s not uncommon to throw out a hand when you fall over, we call this a FOOSH injury, short for “Fall On Out Stretched Hand”. It is also not uncommon to be sore and stiff in the wrist for a few days after you use it to stop your fall. Most of the time, this will self correct. If however, you’re still puffy and sore in your wrist 2 weeks after you stuck out your hand to stop your fall then you need to go get it checked.
Although most things in your wrist will get better with a little time and rest there is one little bone at the base of your thumb which may not. This bone is called the scaphoid bone and it’s very hard to tell when it’s been fractured. Very often a scaphoid fracture will not appear on an x-ray until 2 weeks after it’s broken. You may see it on a CT scan or an MRI but those are expensive tests and as we said most of the time your puffy wrist will go away by itself.
So why do we care so much about the scaphoid bone? It’s because this bone has a tiny little blood supply, and this tiny little blood vessel actually goes right through the middle of the bone. A fracture of the scaphoid can sever the blood supply to the bone and then you get bony death in it. Bony death is bad because the bone shrinks, hardens and becomes much more pain sensitive and much less easy to move around. The surgeons call this scenario SNAC, short for Scaphoid Non union Advanced Collapse. But it in short it’s basically a nasty arthritic wrist, very early in life. Nobody wants an arthritic wrist at any age let alone when they’re only 20 or 30 years old.
The possibility of bony death and arthritis with this injury makes it a surgical emergency. A surgeon can repair the scaphoid bone, and if it is spotted early enough and sometimes it may only require a cast for 6 weeks. If It’s not picked up for a long time post injury, or if it has a lot of fragments or jagged edges it might require a complex surgery involving a bone graft and then casting for 6-12 weeks.
The important thing is to get checked late enough to detect the injury but early enough to correct it, because you don’t want be the person that has a SNAC with their FOOSH!
Author bio: Michael O’Doherty is a Doctor of Chiropractic at Chiropractic Moves, He’s dedicated to providing the most effective and up to date treatment techniques available in a friendly and relaxed environment and passionate about the role of chiropractic care in the management of sports injuries and optimising performance.