Hand-Injury Feedback/Solicitation

[JackBauer44]

All the injury talk on the football recruiting forum led me thinking it couldn't be a bad idea to see if anyone here is either a doctor or has experience with hand injures. As a tennis coach and teaching pro - my right hand is my lifeline.

Over the summer while teaching some tennis - I hit my ring finger on a net post chasing down a wide volley and trying to do something i shouldn't have. It swelled up pretty nicely and I shrugged it off as a jam. All summer and fall, the swelling never really went away and I can no longer close my ring finger to make a fist. I could still swing a racket and golf club, so I just continued to go on. Jump to November now and I hit my finger again when playing platform tennis and it was some of the worst pain I've felt in my hand. I decided to finally go see a hand specialist here in Albany and I'm kicking myself now for not doing anything sooner.

I have a fracture just below the knuckle that has loose bone spurs. The kicker is that the joint around the knuckle has been damaged and essentially is on the opposite side of my hand now. A simple fix is not possible. Here are the options:

1. Do Nothing.

2. Do a surgery called a hemi-hamate resurfacing procedure that involves trying to shave down the bone spurs, restabilizing the joint, and having some bone taken/harvested from the hamate in my wrist to stabilize the joint. It's not a guarantee to work - but would give me the best chance at a normal recovery. Recovery time is around 6-8 months with some pretty intense PT.

3. A Joint fusion that would not allow me to move my ring finger from the knuckle up. My finger would have to be fused in a way that would allow a tennis racket to fit underneath it. Not ideal by any means. I'm here now questioning how much of my ring finger I actually use in tennis and golf and if that would make a difference in my grip.

So now that the long-winded preamble is complete - anyone have any experience with something like this? I've posted on every tennis-pro network I have access on, and I can't find anyone in my field that has endured something like this, so I'm a bit nervous on which option to choose. The doctor has performed the surgery numerous times but never on someone that swings a racket every day of his life. I know we have some smart people on this board who have helped me in the past - so I'm once again hoping someone can talk me off the ledge.

 

[OttoinGrotto]

I think you have a rare opportunity to get a hook hand.

 

[SUFaninNJ]

SU in Hershey any suggestions?

 

[JackBauer44]

I think you have a rare opportunity to get a hook hand.

So funny story - one of the first girls I coached at the college level was this young woman. As you can see, prosthetic from the elbow down on her right hand and still had a two handed backhand. She had a little hook inside the arm that allowed her to strengthen the prosthetic grip. It had different attachments for lifting weights and school. Hand to god - still the best reason for being late ti practice this far in my career. “Coach, sorry, I grabbed the wrong arm and didn’t realize until I got up the hill.” I helped her create a system where she could easily identify which arm was which. It was centered around a specific nail polish color on the artificial hand.

Thanks for bringing me down memory lane.

 

[MCC]

All the injury talk on the football recruiting forum led me thinking it couldn't be a bad idea to see if anyone here is either a doctor or has experience with hand injures. As a tennis coach and teaching pro - my right hand is my lifeline.

Over the summer while teaching some tennis - I hit my ring finger on a net post chasing down a wide volley and trying to do something i shouldn't have. It swelled up pretty nicely and I shrugged it off as a jam. All summer and fall, the swelling never really went away and I can no longer close my ring finger to make a fist. I could still swing a racket and golf club, so I just continued to go on. Jump to November now and I hit my finger again when playing platform tennis and it was some of the worst pain I've felt in my hand. I decided to finally go see a hand specialist here in Albany and I'm kicking myself now for not doing anything sooner.

I have a fracture just below the knuckle that has loose bone spurs. The kicker is that the joint around the knuckle has been damaged and essentially is on the opposite side of my hand now. A simple fix is not possible. Here are the options:

1. Do Nothing.

2. Do a surgery called a hemi-hamate resurfacing procedure that involves trying to shave down the bone spurs, restabilizing the joint, and having some bone taken/harvested from the hamate in my wrist to stabilize the joint. It's not a guarantee to work - but would give me the best chance at a normal recovery. Recovery time is around 6-8 months with some pretty intense PT.

3. A Joint fusion that would not allow me to move my ring finger from the knuckle up. My finger would have to be fused in a way that would allow a tennis racket to fit underneath it. Not ideal by any means. I'm here now questioning how much of my ring finger I actually use in tennis and golf and if that would make a difference in my grip.

So now that the long-winded preamble is complete - anyone have any experience with something like this? I've posted on every tennis-pro network I have access on, and I can't find anyone in my field that has endured something like this, so I'm a bit nervous on which option to choose. The doctor has performed the surgery numerous times but never on someone that swings a racket every day of his life. I know we have some smart people on this board who have helped me in the past - so I'm once again hoping someone can talk me off the ledge.

I'd go with the hemi-hamate procedure. Reasonably robust body of data in the literature indicating patients recover considerable ROM (range of motion) and grip strength (85-95%) compared to the contralateral hand. I'm not a fan of joint fusions unless the intention is to avoid more inimical sequelae (i.e. more severe injury - often the case with lower extremities (feet)) or chronic pain.

I suspect that given your athletic training and inherent grip strength as a tennis player, you'd adhere assiduously to the PT plan and see favorable outcomes post hamate procedure. Best wishes for optimal resolution here.

 

[JackBauer44]

I'd go with the hemi-hamate procedure. Reasonably robust body of data in the literature indicating patients recover considerable ROM (range of motion) and grip strength (85-95%) compared to the contralateral hand. I'm not a fan of joint fusions unless the intention is to avoid more inimical sequelae (i.e. more severe injury - often the case with lower extremities (feet)) or chronic pain.

I suspect that given your athletic training and inherent grip strength as a tennis player, you'd adhere assiduously to the PT plan and see favorable outcomes post hamate procedure. Best wishes for optimal resolution here.

This is very helpful. Thank you very much for the detailed information. You confirmed what I was leaning towards.

 

[temery]

Reddit has several subs to ask medical questions. It's hit or mis as to whether you get an any from a doctor or someone with the same experience.

Reed to margin before posting. Some, mostly Askdoc, require detailed background info (nothing identifiable).

As a 30 tennis coach and player the only think that took me out the longest was broken toe. First diagnosis was cellulitis. Antibiotics helped a big, but I ended up at a podiatrist who said it was gout. The pain was incredible when anything, including moving air, touched the toe. Even a bed sheet was excruciating.

• /r/AskDocs (General health issues & questions)
• /r/DiagnoseMe (Similar to AskDocs)
• /r/Medical_Advice (Similar to AskDocs)