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021 Traumatic Hand Injury : The Cyclists Knock Out

Traumatic Hand Injury : The Cyclists Knock Out

Falling off a road bike at high speed is well documented and happens unexpectedly. The problem is that the cyclist falls on the outstretched hand in order to fend off injury to the face, head and neck regions. It is a natural reflex. The big drawback to the super league cyclist is that the hand and wrist regions are intolerant to falls. Things go wrong and structures break or snap off. This impacts heavily on the cyclist's recovery; prognosis and knocks them off the bike and racing tours for periods up to three months. More than two delicate operations might be needed to mend damage. Complete recovery may never occur and the top cyclist has to retire from cycling prematurely.

Cause of falls

People who run in front of your cycle path. For instance, they might look, and run across the street to catch a taxi. You must anticipate this problem and it is your responsibility.
Stationary parked in front of you that you do not see.
Swerving for broken glass.
Swerving for a parked car only to be hit from the back or front by oncoming traffic. This is avoidable, if only the cyclist would wake up. Be alert and keep your eyes peeled. This type of injury is severe if not fatal. It happens every year before the Argus Cycle Tour.

Types of injuries

Rupture and or severance of hand tendons. Same day surgery by a hand specialist must take place.
Rupture of flexor tendons. Operative repair and reconstruction is needed. This is the method of choice but must be done by an experienced hand surgeon. Surgery may be technically demanding and the end result guarded.
Injuries of the extensor tendons. The prognosis is guarded if multiple tendons and nerves are severed. Primary repair is needed.
Extensor tendon expansion tears. These need immediate primary reconstruction.
Distal forearm fractures of both the radius and ulna. In many cases a double fracture occurs affecting the radius head. In this case it occurs in elbow joint. The cyclist is out for 12 weeks. Open reduction with screwing or plating may be the desired intervention. A general anaesthetic will be required.

Cycle tip: Avoid falling on your hands at all costs. This could prevent a tendon snapping in your hand. Costly surgery can thus be avoided. This is not always possible as in juries and falls occur in split seconds. You must anticipate dicey situations and avoid the consequences. If a tendon injury is suspected, consult a top class hand surgeon for predictable results. It is your best and only chance.

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