HAND AND WRIST INJURY

Injury 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

See More Appropriate Topic (instead of this one) If

WHEN TO CALL YOUR DOCTOR FOR HAND AND WRIST INJURY

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
  • First Aid: Apply direct pressure to the entire wound with a clean cloth.

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)
  • You are over age 54, have osteoporosis, or use steroid medications routinely

Call Your Doctor Within 24 Hours (between 9am and 4pm) 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

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
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HOME CARE ADVICE FOR MINOR INJURIES OF HAND AND WRIST

  1. Treatment of Bruise (e.g. direct blow to hand or wrist):
    • Apply an ice bag or massage the area with ice for 20 minutes each hour for 4 consecutive hours.  (20 minutes of ice bag massage 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 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 every 4-6 hours (e.g. Tylenol; adult dosage 650 mg) OR ibuprofen every 6-8 hours (e.g. Advil, Motrin; adult dosage 400 mg).
    • 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.
    • 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 or develop any of the "Call Your Doctor" symptoms.
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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.

Adult HouseCalls Online. Copyright © 2000-2003 David Thompson, M.D. FACEP

Reviewed 8/2003

Revised 7/2002

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