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Good morning. I learned this week that the bright yellows, oranges, and reds of the fall leaves are actually there all year. They're just hidden behind the bright green color of the chlorophyll.
As the nights grow longer, the leaves stop producing chlorophyll and the fall colors we know and love become more visible.
Huh. I had no idea.
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☝️ First Hand
When you think of diabetes complications, your hands might not be the first things that come to mind. But did you know that this common condition can silently wreak havoc on your fingers, palms, and wrists?
From the frustrating stiffness of trigger finger to the numbing pain of carpal tunnel syndrome, diabetes can dramatically impact your hand health.
This week, I will reveal the surprising ways diabetes affects your hands and explore various options for detecting and treating these conditions before they get out of control.
Whether you're living with diabetes or know someone who is, I hope this article provides a few key insights to preserving hand function and avoiding unnecessary pain.
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👀 X-ray of the Week 👀
It turns out, when you fall off a highway overpass and land on your wrist, it does a lot of damage.
In particular, you may get a rare wrist injury called a perilunate injury.
This is where the rest of the wrist essentially dislocates away from the lunate bone (the middle one in the bottom center with two pins crossing).
Takeaway? It's a terrible injury.
I have to do things like insert all these pins in the wrist, keep them there for a couple of months, and then remove them.
Even with all that, the lifetime risk of arthritis and dysfunction is extremely high...
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Rules of Thumb Q&A
**Reminder. This is not medical advice. No patient-doctor relationship is formed. This content is for educational purposes only**
Reader Question:
"Last week, I jammed my finger playing basketball. Urgent care put me in an aluminum splint until I get in to see a hand specialist. Do I really need to keep wearing this splint?"
What would I do?
- Consider this my official crusade against aluminum splints. As a hand surgeon, I see very few reasons to EVER wear one of these.
- Over 90% (probably even higher) of 'jammed fingers' are sprains or partial tears of the collateral ligaments that support your knuckles. These injuries need immediate motion to heal correctly.
- The absolute worst thing you can do is sit in a splint for a week or two (or more) and let the finger get stiff. Permanent stiffness is basically the only bad outcome I see from these injuries — in patients who wear the splint for 6 weeks before coming to see me.
- If you're uncomfortable and feel the finger just needs a little rest, 3 days of splinting is your maximum, in my mind.
- Better yet, tape the finger to its neighbor, somewhere between the bottom knuckles. This will allow the finger to move while still giving it support.
- And if you have a less common unstable fracture or complete ligament injury that needs surgery? Well, then it's appropriate to use the aluminum splint for support while waiting for surgery.
- Remember. You need an x-ray to differentiate this injury between the serious and the less serious.
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Share "Rules Of Thumb"
If you're enjoying "Rules of Thumb," it would be a huge help if you'd consider sharing.
Just forward this email to a friend or send them to rulesofthumb.nickgolinvauxmd.com/join.
The more this grows, the more I can invest in it!
-Dr. G
PS. Rules of Thumb is a completely free resource to all those who want to learn more about the human body. Support Rules of Thumb here 🙏.
**Please do not use this email to try to obtain medical advice. I cannot legally or ethically provide that. If you are having a medical emergency, please call 911 and do not attempt to contact me through email.**
Rules of Thumb Archive • www.nickgolinvauxmd.com
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Disclaimer (because, you know, lawyer stuff)
If you are having a medical emergency, call 911. Do not attempt to contact or obtain medical services through this site. This content is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this site or materials linked from this site is at the user's own risk. The content of this site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their healthcare professionals for any such conditions. The content is my own and does not necessarily reflect the views of OCC.
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