Paul Hamm's Metacarpal Fracture: Treating an Olympian's Hand Fracture
I fully concurred with his decision to withdraw from the Olympics. Because I know he is just as perfectionistic in his sport, as we are as members of the American Society for Surgery of the Hand in our hand surgery. I can't stand mediocre hand surgery, and I don't think he can stand mediocre gymnastics.
Well, Paul was at the US men's gymnastics championship in Huston the day he broke his hand. He had heard a fracture of the fourth metacarpal, which is the bone behind the ring finger. And he caught his finger as he was doing a routine on the parallel bars which twisted it in such a way that it snapped.
So Paul's case was special because we had a very short time frame for him to get ready for the Olympics and we had to maximize every technique and trick in the hand surgery booklet to speed his healing. We had to push it as hard as we possibly could and from a sports medicine standpoint, take a calculated risk that there was a slight chance that the fracture maybe wasn't healed enough and he would do something that would totally undo the fixation and break the bone again which would have been a disaster and we were able to saftely avoid that by the way that we managed his case post-operatively. Well here I am post-surgery, everything went really well.The doctor was happy with how everything went, he said he would give himself about a 99 out of 100.
And I was pleased that the surgery went quite well. You worry that sometimes the fracture can break up into more little pieces but that didn't happen with Paul's case. And we got it back so that the x-rays really looked perfect when we got done, which got us off to a goos start and made a positive outlook for his future. Well compared to the non-athlete there were other special things that we did in Paul's case. We added bone graft, which we normally wouldn't do for metacarpal. To help get more strength quicker in his particular case because there are going to be excessive forces put on his hand earlier than most other people would who would have a metacarpal fracture.
In addition to that, and to make the bone graft heal faster, we drew blood from him and spun that down to get what's called the platelet-rich plasma. And then we mixed the platelet-rich plasma with the bone graft on top of that after surgery we added ultrasound vibration to the fracture because we know that bones heal in response to stress By putting a small vibratory stress on the bone, we're able to also speed healing. That's another technology that we would have not used in the average person. He progressed very well the first concern was swelling. If the hand swells too much, and gets big and fat, then you can't move it and it also hurts more So I put a very special dressing on his hand at the time of surgery It included almost a pound of cotton But that provides a very nice gentle but appropriate compression about the hand so that it doesn't swell to begin with. So if you can prevent the swelling, then you don't have to fight it later.
And when we took the dressing off it two days after surgery, he in essence had no swelling at that time And a lot of the was due to the dressing and just being meticulous about the surgery. So I was ecstatic because by the fourth or fifth day after surgery, we were already at the ten day time period in what we were expecting. In regards to his recovery, the after-care I feel is about fifty-percent of the quality of result. So even though we had good fortune while we were at surgery, everything went well, we were able to get the bone fixed solidly and back in anatomic alignment, that's still at most only fifty-percent of our result. And the make or break comes in the after-care. And so Paul was coming into therapy frequently to make sure that, number one, we could control the swelling number two, swelling and pain, preserve the full range of motion so he wouldn't lose motion and then start even very early on, working on strength, One of the things we wanted to do with Paul was to get him back into the gym early even though he wasn't doing gymnastics he could go in and maintain the condition of his muscles and muscle mass and bulk There were many different things we used for Paul to do to increase his grip strength during his recovery starting off with light exercises and progressing to some that had more resistance. Paul is using the Thenar glove as part of his recovery. And by the time he went to camp, in mid-to-late June, he was up to the point were he could use the strongest resistance of the Thenar gloves.
In an attempt to try to get his grip strength up, to the 135 or even 140 pound range for the Olympics which likely would have given him the strongest set of hands at the Olympics I wanted him to not have to work around his hand as being weak or symptomatic or problematic but to have his hands not only be perceived as what would have been a liability by everybody else to be perceived as his main asset or secret weapon from his point of view by the time he got to the Olympics If you worry about all the things that come at you and think you can't do anything about it It's difficult to take on the challenges that come at you. But if you go with the attitude that every liability that comes at you, your gonna turn into an asset then you can take this kind of approach and overcome many of the things in sports just as you do in life. We planned out the time that we had and a full program and tried to stay as i say, as far ahead of schedule, as we could. And we were doing great. Until he injured his shoulder.
I fully concurred with his decision to withdraw from the Olympics because I know he's just as perfectionistic in his sport as we are as members of the American Society for Surgery of the Hand in our hand surgery I can't stand mediocre hand surgery, and I don't think he can stand mediocre gymnastics. So if he's not gonna be able to compete at the highest level he felt it wise to withdraw and let somebody else take his place.
You want to know what happens when you crack your knuckles, right? Well stay tuned! I'm Nick welcome to All Our Questions where I search the internet for questions that we all want…By: AllOurQuestions
Hello, I'm Dr. Neal Schultz [pause] And welcome to DermTV. Everyone at some time has experienced a “black and blue” mark, which is actually a flat skin bruise. They can occur anywhere…By: DermTVdotcom
One of the things that makes being a hand surgeon so special is that I get to work with principals from the different disciplines of orthopedic surgery, plastic surgery, and neurosurgery.…By: OrthoSurgWUSTL
I fully concurred with his decision to withdraw from the Olympics. Because I know he is just as perfectionistic in his sport, as we are as members of the American Society for Surgery…By: TheHandSociety
Hi, everyone. I'm Ian Harvey, massage therapist. Today we're going to be working with a client who had a shoulder surgery a few years ago. It still gives her some trouble, and…By: Massage Sloth