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Mathias Masem, M.D.
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Hand Safety Tips

Gardeners should take proper precautions to prevent hand-related injuries before digging or planting in the garden. According to the Consumer Product Safety Commission (CPSC), emergency rooms treat more than 400,000 outdoor garden-tool-related accidents each year. With proper gardening safety techniques, you can stay away from the hospital and avoid becoming a statistic.

Lawnmower and snowblower injuries are seasonal injuries that can cause severe damage to the hands. This usually involves faulty equipment or equipment that has jammed. Please review lawnmower and snowblower safety tips to avoid serious trauma to the hands.

Skiing and snowboarding are among the most popular winter sports. Injuries to the upper extremity occur in a relatively predictable pattern. Fortunately, there are some ways to help decrease the chance for injury.

Gardening Safety Tips

What can you do to keep your hands safe?

Follow these precautions to avoid injury, pain, and discomfort:

  • Wear gloves when working outside. Wearing the proper gloves will not only reduce blistering, but will also protect your skin from fertilizers and pesticides as well as bacteria and fungus which live in the soil. When exposed to soil, even the smallest cut or lesion runs the risk of developing into a major hand infection. Leather gloves offer protection from thorny objects; snake, rodent, and insect bites; poison ivy; and other skin irritants in the garden. Gloves also prevent sunburn and fingernail damage.
  • Avoid prolonged repetitive motions. Unless you are preconditioned or accustomed to the activity, repetitive motions, such as digging, raking, trimming hedges, pruning bushes, or planting bulbs, may cause skin, tendon or nerve irritation. Make sure your gardening activities are varied and tasks are rotated every 15 minutes with a brief rest in-between so that the same muscles are not used over and over again.
  • When digging, watch for buried objects. Sharp objects and debris buried in the soil may cause tendon lacerations or punctures. Use a hand shovel or rake rather than your hand, itself, for digging.
  • Use the right tool for the right job. Avoid accidents by using tools for their intended purposes. When purchasing pruners, loppers, or shears, look for brands featuring a safety lock, and keep sharp tools away from children at all times.
  • Use proper ergonomic posture. "Postures" refers not only to your whole body position, but also to such things as the angle of your wrist while using hand tools. Grip strength is at its maximum when the wrist is in a relaxed or neutral position. Testing has shown that people lose up to 25% of their grip strength when their wrist is bent
  • Avoid products with form-fitting, contoured handles. Many tools are made with finger grips molded into the handle to provide better slip resistance. These "form-fitting" grooves, however, only fit one size of hand perfectly. People with larger hands will find that their fingers overlap the ridges, causing pain, soreness, and calluses. Those with smaller hands will have to spread their fingers to match the grooves. Strength testing has shown that this spreading of the fingers significantly reduces grip strength, requiring more pressure to maintain control of the tool.

What to do in case of injury?

Should you cut your finger or hand, bleeding from minor cuts will often stop on their own by applying direct pressure to the wound with a clean cloth.

When to Seek Help?

Visit an emergency room or a hand surgeon if:

  • Continuous pressure does not stop the bleeding after 15 minutes
  • You notice persistent numbness or tingling in the fingertip
  • You are unsure of your tetanus immunization status
  • You are unable to thoroughly cleanse the wound by rinsing with a mild soap and plenty of clean water.

Lawnmower and Snowblower Injuries and Safety Tips

Lawnmower and snowblower injuries are seasonal injuries that can cause severe damage to the hands. They generally occur when a patient tries to remove an object in the way of the machine or an object that is stuck in the machine. Lawnmower and snowblower can cut and crush multiple fingers with injury to the bones, joints, tendons, nerves, arteries, veins, and skin. Tendons attach muscles to bones and help move the fingers. Nerves are necessary for the feeling and movement of the fingers. Arteries and veins move the blood to and from the fingers. Injuries from these machines can result in amputations of fingers and the hand.

How to avoid injury

Never put your hand or fingers near the moving parts or intake or output areas of Lawnmower and snowblower. If there is an object in the way of any part of the machine, the machine should be turned off and spark plug disconnected, or power cord unplugged for electric models, before attempting to remove the object. Objects should then be removed with a tool and not the hand or fingers. Lawnmower and snowblower should also be turned off, spark plug disconnected, and unplugged when they are being moved or picked up.

Occasionally patients slip and a hand or foot gets caught under the lawnmower and snowblower. Proper hand and footwear should be used; non-slip, non-open toe shoes should be worn. Protective gloves can give some protection, but the force from the machine can still cause extensive damage despite the gloves.

What to expect if you sustain a lawnmower and snowblower injury

These injuries are extremely severe and often lead to multiple finger amputations. Infections are common; antibiotic medicines are usually necessary. Frequently, multiple surgeries are needed to adequately clean wounds. As stated above, multiple soft tissues and bone may be injured. Surgery is usually required to repair or reconstruct multiple structures. Unfortunately, most patients with these severe injuries never recover full, normal use of the hand. Oftentimes, fingers have been partially or completely amputated, and remaining parts may not have full motion or feeling. Multiple surgeries and many months of hand, occupational, and physical therapy are usually necessary to maximize movement and function.

Skiing and Snowboarding Injuries and Safety Tips

Skiing Injury

The most common upper extremity skiing injury is to a thumb ligament called the ulnar collateral ligament (UCL) of the metacarpophalangeal joint. A ligament is the soft tissue that connects bones to bones. In this instance, it is the ligament on the inner aspect of the thumb at the second joint from the thumb tip. The injury occurs when the ski pole does not release from the hand and the pole places a bending stress to the thumb.

If you fall while skiing and your inner thumb hurts, it may be from a "skier's thumb," or UCL injury, and you should see a hand surgeon. Your surgeon will determine whether it is a partial or complete ligament tear. A partial tear is usually treated with a cast or splint, whereas a complete tear is treated with surgery to repair the ligament since the torn end of the ligament often gets trapped behind a muscle.

The chance of getting a "skier's thumb" injury may be decreased by NOT using your ski pole strap around your wrist. Using ski poles without platforms or saber handles decreases your chance of injury. The main goal is that you want the ski poles to release from your hands when you fall. If the ski pole stays in your hand throughout your fall, the pole can act as a long lever arm to put a large stress load on the thumb joint. If you fall, it is better to lose your poles and protect your thumbs.

Snowboarding Injury

The most common snowboarding injury is to the wrist. This may be in the form of a fracture (broken bone), dislocation, and/or ligament injury. This usually occurs when the rider falls backwards or forwards and puts his or her hands out in front of himself or herself to brace the fall. If you have this injury, your doctor should examine your wrist and possibly get more studies such as x-rays and/or an MRI or CT scan. Depending on the positions of the bones and the integrity of the ligaments, treatment may consist of a splint, cast, or even surgery. Occasionally special devices are needed such as metal pins, plates, screws, or a combination of devices to stabilize wrist fractures and/or ligament injuries.

The chance of suffering a snowboard wrist injury may be decreased by using wrist guards or gloves that have guards built into them. There are medical studies that have shown such protective gear to be effective at decreasing the potential for injury. Regarding protective gear, helmets have also been shown to decrease head injury and their use should be encouraged.