Hand and Wrist Injury

Hand and Wrist Injury

Is this your symptom?

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

Some Basics...

  • There are many ways that people can injure their hand or wrist.
  • There are also many types of hand and wrist injuries. There are bones, tendons, ligaments, cartilage, and muscles in the hand and wrist. These can all be injured.
  • Treatment depends on the type of injury.

Types of Injuries

  • Abrasion: This is the medical term for scraped skin. This happens when an injury scrapes off the top layer of the skin. An example is when people "scrape" their knuckles. Pain is usually mild. This can usually be treated at home.
  • Contusion: This is the medical term for bruise. It is caused by a direct blow to the skin and muscles. The skin is not broken and there is no cut. The bruised skin may first look red, then purple, and finally orange-yellow. These skin color changes are from blood that leaked from tiny torn blood vessels in the bruised area. The skin may also be swollen. Pain is usually mild to moderate. Bruises are tender to touch. Most often this can be treated at home.
  • Cut - Superficial: Superficial cuts (scratches) only go part of the way through the skin and rarely become infected. A scratch is an injury to the skin made by a sharp edge. For example, scratches can be caused by fingernails, a sharp nail, a piece of metal, or a branch of a tree or bush. A paper cut is a scratch from the edge of a piece of paper. This can usually be treated at home.
  • Cut - Deep: Deep cuts (lacerations) go through the skin. A laceration is caused by cutting the skin with the sharp edge of an object. Lacerations longer than ½ inch (12 mm) usually need sutures (stitches).
  • Dislocation: This is when a bone comes out of the joint. The joint always looks crooked or deformed. The pain can be severe. A person with this problem should go to the doctor right away. A doctor will treat this by putting the bone back into the joint socket.
  • Fracture: This is the medical term for a broken bone. It means the same thing as a break or crack in the bone. The pain is severe and there is often marked swelling. The type of treatment needed depends on the type of fracture. Sometimes a person with a fracture just needs a splint or a cast. A person with a more severe fracture may need surgery.
  • Sprain: A sprain is the medical term used when ligaments are torn or over-stretched. Ligaments are the bands of tissue that connect bones to each other. These are common injuries from falling, heavy lifting, and sports. Pain and swelling can range from mild to severe. Minor sprains heal themselves with time and rest. More severe sprains need a splint or a cast and take 4-6 weeks to heal. Surgery is rarely needed for a sprain. A person who hurts his or her wrist or hand and cannot hold a cup of water should see a doctor.
  • Strain: A strain is the medical term used when muscles are torn or over-stretched. A more common term for this is a "pulled muscle." Strains may heal themselves with time and rest. Surgery is rarely needed for a muscle strain.

Pain Scale

  • None: No pain. Pain score is 0 on a scale of 0 to 10.
  • Mild: The pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
  • Moderate: The pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
  • Severe: The pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

When to Call for Hand and Wrist Injury

Call 911 Now

  • Major bleeding (nonstop bleeding or spurting)
  • Limb has been partially or completely amputated
  • You think you have a life-threatening emergency

Call Doctor Now or Go to ER

  • Severe pain
  • Severe swelling
  • Skin is split open or gaping and may need stitches
  • You think you have a serious injury
  • You think you need to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Can't use hand normally (make a fist, open the hand, hold a glass)
  • Very large bruise follows a minor injury (2 inches or wider, 5 cm or wider)
  • Many bruises without any known injury
  • Have osteoporosis and pain lasts more than 24 hours
  • Take steroid medicine and pain lasts more than 24 hours
  • You think you need to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Last tetanus shot was over 10 years ago, for CLEAN cut or scrape
  • Last tetanus shot was over 5 years ago, for DIRTY cut or scrape
  • Pain from injury keeps you from working or going to school
  • Pain from injury is not better after 3 days
  • Injury is still painful or swollen after 2 weeks
  • You have other questions or concerns

Self Care at Home

  • Minor bruise
  • Minor strained (pulled) muscle or sprained (stretched) ligament

Care Advice for Minor Injuries of Hand and Wrist

  1. What You Should Know:
    • There are many ways that people can injure their hand or wrist.
    • There are also many types of hand and wrist injuries. There are bones, tendons, ligaments, cartilage, and muscles in the hand and wrist. These can all be injured.
    • You can treat a minor bruise, sprain, and strain at home.
    • Here is some care advice that should help.
  2. Treatment of Bruise (direct blow to hand or wrist):
    • Cold Pack: For pain or swelling, use a cold pack or ice wrapped in a wet cloth. Put it on the sore area for 20 minutes. Repeat 4 times on the first day, then as needed.
    • Heat Pack:
      • If the pain lasts over 2 days, apply heat to the sore area. Use a heat pack, heating pad, or warm wet washcloth. Do this for 10 minutes, then as needed.
      • For widespread stiffness, take a hot bath or hot shower instead. Move the sore area under the warm water.
    • Rest the injured part as much as you can for 48 hours.
  3. Treatment of Sprains and Strains:
    • FIRST AID: Wrap with a snug elastic bandage. Put an ice pack on it to reduce bleeding, swelling and pain. Wrap the ice pack in a moist towel.
    • Treat with rest, ice, compression, and elevation (R.I.C.E.). Do this for the first 24 to 48 hours.
      • REST the injured part for 24 hours. You can then return to normal activity if it is not too painful.
      • Keep using crushed ICE packs for 10-20 minutes every hour for the first 4 hours. Then use ice for 10-20 minutes 4 times a day for the first 2 days.
      • Apply COMPRESSION by wrapping the injured part with a snug, elastic bandage for 48 hours. If you feel numbness, tingling, or more pain, the bandage may be too tight. Loosen the bandage wrap.
      • Keep injured hand or wrist ELEVATED and at rest for 24 hours. Keep your hand and wrist up on a pillow above your heart level.
  4. Pain Medicine:
    • You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
    • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
    • Use the lowest amount of a drug that makes your pain feel better.
    • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
    • Read the instructions and warnings on the package insert for all medicines you take.
  5. What to Expect: Pain and swelling most often get better 2 to 3 days after an injury. Swelling is most often gone in 7 days. Pain may take 2 weeks to go away.
  6. Call Your Doctor If:
    • Pain becomes severe
    • Pain is not better after 3 days
    • Pain or swelling lasts more than 2 weeks
    • You think you need to be seen
    • You get worse

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

Disclaimer: This information is not intended to 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.


Last Reviewed: 12/14/2017 1:32:39 AM
Last Updated: 5/7/2017 1:36:07 PM

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First Aid - Sling - How to Put On

To put on a sling you first need to have a triangular bandage. Many first aid kits have a triangular bandage.

  • Find the two ends of the triangle that are farthest apart. These are the ends that you will tie around the neck.
  • Lay the arm down the middle of the triangle.
  • Take the two ends of the triangle that are farthest apart and tie them behind the neck. (a square knot is best, but any knot will do).
Bruise from Coumadin

This 74 year old female did not recall hurting her hand. She takes the blood thinner Coumadin.

The picture shows a large amount of bruising (ecchymosis) of the left hand. There is no broken bone (fracture).

Wrist Fracture with Deformity

This 72 year old female tripped and fell injuring her left wrist. The picture shows a deformed left wrist. She went to the emergency department. Treatment included pain medications, reduction (putting the bones back into line), and casting.

First Aid Care Advice for Suspected Fracture or Dislocation:

  • Splint: 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.
  • Apply a cold pack or an ice pack (wrapped in a towel) to the area.
First Aid - Bleeding Arm
  • Apply direct pressure to the entire wound with a sterile gauze dressing or a clean cloth.
First Aid - Splint for Wrist Injury
  • Immobilize the hand and wrist by placing them on a rigid splint (see drawing).
  • Tie several cloth strips around hand/wrist to keep the splint in place. You can use a roll of gauze or tape instead of cloth strips.

Notes:

  • You can make a splint from: a wooden board, magazine folded in half, folded-up newspaper, cardboard, or a pillow.
  • If you have no splinting materials, then support the injured arm by resting it on a pillow or folded up blanket.
  • After putting on the splint, apply a cold pack or an ice pack (wrapped in a towel) to the area.
First Aid - R.I.C.E.

RICE is an acronym for how to take care of a sprain, strain, or bruise. There are four things you should do:

  • REST the injured part of your body for 24 hours. Can return to normal activity after 24 hours of rest if the activity does not cause severe pain.
  • Apply a cold pack or an ICE bag (wrapped in a moist towel) to the area for 20 minutes. Repeat in 1 hour, then every 4 hours while awake.
  • Apply COMPRESSION by wrapping the injured part with a snug, elastic bandage for 48 hours. If numbness, tingling, or increased pain occurs in the injured part, the bandage may be too tight. Loosen the bandage wrap.
  • Keep the injured part of the body ELEVATED and at rest for 24 hours. For example, for an injured ankle, place that leg up on a pillow and stay off the feet as much as possible.