Grey's Anatomy Made-For-TV Case of the Month
"Nice to meet you — you need urgent surgery"
Ok, so here's a weird one.
Did you know that treating a broken wrist without surgery can lead to rupture of the tendon that straightens your thumb?
That's right, the correct response to reading that last sentence is...huh?
Just ask the patient who came to see me this winter. She reported that about a month earlier, she fell skiing and landed on their wrist. She said that it hurt pretty badly for a few days, so she used a wrist brace from the pharmacy.
But soon it began to feel better, and she found herself using the brace less and less. So much so that she shoveled her driveway three weeks later. Only to note that this really made her wrist start to hurt again.
What's more, she woke up the next morning completely unable to straighten her thumb. She could bend it, but it just stayed bent down in her palm...despite her stubborn efforts to extend it.
So she decided it was time to finally check it out. She walked into my office and was promptly hit by a brick wall of bad news from...yours truly.
I had to tell this poor patient that their wrist was broken (from the fall four weeks prior). And then, as her body tried to heal it on its own, it made a tremendous amount of immature bone, called callus. The more unstable a fracture is, the more the body makes in an attempt to stabilize the broken bone ends.
Unfortunately, due to the local anatomy, abundant callus in the wrist can grow over the tunnel that houses the tendon that straightens the thumb. And in rare cases, this healing bone will completely suffocate the blood supply to that tendon until...SNAP.
Can you imagine going to the doctor for wrist pain only to be told you have both a broken wrist AND a surgical tendon rupture that requires a tendon transfer repair to fix??
Needless to say, it was a difficult encounter for both the patient and me.
But we got through it, and she'll be back on the slopes in no time.
