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Hand and Wrist Injury  
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Bruise from Coumadin
Bruise from Coumadin

First Aid - Bleeding Arm
First Aid - Bleeding Arm

First Aid - R.I.C.E.
First Aid - R.I.C.E.

First Aid - Sling - How to Put On
First Aid - Sling - How to Put On

First Aid - Splint for Wrist Injury
First Aid - Splint for Wrist Injury

X-Ray - Wrist Fracture
X-Ray - Wrist Fracture

Wrist Fracture with Deformity
Wrist Fracture with Deformity

Definition
  • Injury to a bone, muscle, joint or ligament of the hand and wrist

Types of Injuries

  • Fractures (broken bones)
  • Dislocations (bone out of joint)
  • Sprains - Stretches and tears of ligaments
  • Strains - Stretches and tears of muscles (pulled muscle)
  • Contusion (bruise) - A direct blow or crushing injury


If not, see these topics

First Aid:

FIRST AID Advice for Bleeding: Apply direct pressure to the entire wound with a clean cloth.

FIRST AID Advice for Penetrating Object: If penetrating object still in place, don't remove it (Reason: removal could increase bleeding).

FIRST AID Advice for Shock: Lie down with feet elevated.

FIRST AID Advice for a Sprain or Twisting Injury of Hand or Wrist:

  • Apply a cold pack or an ice bag (wrapped in a moist towel) to the area for 20 minutes.
  • Wrap area with an elastic bandage.

FIRST AID Advice for Suspected Fracture or Dislocation of Hand or Wrist:

  • Immobilize the hand and wrist by placing them on a rigid splint (e.g., small board, magazine folded in half, folded up newspaper).
  • Tie several cloth strips around hand/wrist to keep the splint in place.
  • Place injured arm in a sling. If no sling is available, victim can support the injured arm with the other non-injured hand.
  • Option - Soft Splint: Immobilize the hand and wrist by wrapping them with a soft splint (e.g., a pillow, a rolled-up blanket, a towel). Use tape to keep this splint in place.

Transport of an Amputated Body Part:

  • Briefly rinse amputated part with water (to remove any dirt).
  • Place amputated part in plastic bag (to protect and keep clean).
  • Place plastic bag containing part in a container of ice (to keep cool and preserve tissue).
When to Call Your Doctor

Call 911 Now (you may need an ambulance) If
  • Major bleeding (actively bleeding or spurting) that can't be stopped
  • Limb has been partially or completely amputated
  • NOTE: For bleeding, see First Aid
Call Your Doctor Now (night or day) If
  • You think you have a serious injury
  • Injury looks like a dislocated joint (crooked or deformed)
  • Severe pain
  • High pressure injection injury (e.g., from paint gun, usually work-related)
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think you need to be seen
  • Can't use injured hand normally (e.g., make a fist, open fully, hold a glass of water)
  • Very large bruise follows a minor injury (wider than 2 inches)
  • Several bruises occur without any known injury
  • You are over age 54, have osteoporosis, or use steroid medications routinely
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Injury interferes with work or school
  • Injury and pain have not improved after 3 days
  • Injury is still painful and swollen after 2 weeks
Self Care at Home If
  • Minor bruise
  • Minor strained (pulled) muscle or sprained (stretched) ligament
HOME CARE ADVICE FOR MINOR INJURIES OF HAND AND WRIST

  1. Treatment of Bruise (e.g., direct blow to hand or wrist):
    • Apply a cold pack or an ice pack (wrapped in a moist towel) to the area for 20 minutes each hour for 4 consecutive hours. (20 minutes of cooling followed by 40 minutes of rest for 4 hours in a row).
    • 48 hours after the injury, use local heat for 10 minutes 3 times each day to help reabsorb the blood.
    • Rest the injured part as much as possible for 48 hours.
  2. Treatment of Sprains and Strains:
    • FIRST AID - Wrap with a snug elastic bandage. Apply an ice pack (crushed ice in a plastic bag covered with a moist towel) to reduce bleeding, swelling, and pain.
    • Treat with R.I.C.E. (rest, ice, compression, and elevation) for the first 24 to 48 hours.
      • REST the injured part for 24 hours. You may return to normal activity after 24 hours of rest if the activity does not cause pain.
      • Continue to apply crushed ICE packs for 10-20 minutes every hour for the first 4 hours. Then apply ice for 10-20 minutes 4 times a day for the first two days.
      • Apply COMPRESSION by wrapping the injured part with a snug, elastic bandage for 48 hours. If you experience numbness, tingling, or increased pain in the injured part, the bandage may be too tight. Loosen the bandage wrap.
      • Keep injured hand or wrist ELEVATED and at rest for 24 hours. Put your hand and wrist on a pillow positioned above heart level.
  3. Pain Medication:
    • For pain relief, take acetaminophen or ibuprofen.
    • Acetaminophen (e.g., Tylenol): The dose is 650 mg by mouth every 4 hours or 1000 mg by mouth every 6 hours. Maximum dose per day = 4000 mg.
    • Ibuprofen (e.g., Motrin, Advil): The dose is 400 mg by mouth every 6 hours or 600 mg by mouth every 8 hours.
    • People who are over 65 Years of age: Acetaminophen is generally considered safer than ibuprofen. Acetaminophen dosing interval should be increased to every 8 hours because of reduced liver metabolism. Maximum dose per day = 3000 mg.
    • CAUTION: Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
    • CAUTION: Do not take acetaminophen if you have liver disease.
    • Read the package instructions thoroughly on all medications that you take.
  4. Expected Course: Pain and swelling usually begin to improve 2 or 3 days after an injury. Swelling is usually gone in 7 days. Pain may take 2 weeks to completely resolve.
  5. Call Your Doctor If:
    • Pain becomes severe
    • Pain does not improve after 3 days
    • Pain or swelling lasts more than 2 weeks
    • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: David A. Thompson, M.D.

Last Reviewed: 1/19/2009

Last Revised: 11/3/2008

Content Set: Adult HouseCalls Online

Portions Copyright 2000-2009 Self Care Decisions LLC; Copyright LMS, Inc.

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