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Published on December 18, 2017

icy sidewalk

Healing the Hurt From Winter Falls

Displaced wrists, broken hips, ruptured shoulders – these are not the fun stuff of the season for sure. But these injuries happen in winter when we hurry along in low-traction walking conditions.

When a fall on the ice leads to a fracture, what happens next depends on you, your overall health and the injury itself, according to Avera Orthopedic surgeon Brian Kampmann, MD.

“Surgery for a more severe orthopedic injury can be the best remedy, but not every patient is healthy enough for surgery,” said the Mitchell-based surgeon. “And not every injury is so severe it calls for surgery. Immobilizing some fractures or soft-tissue injuries with a cast or splint can be the best approach.”

Common Conditions Coming With Winter

Falls can lead to injuries – just like December days will bring snow, sleet and scratching wind. Kampmann said some of the most common fall-related injuries strike your wrists, shoulders and hips. No one is exactly like you – just like no two orthopedic injuries are quite the same.

“In each case, the first place you’ll go is probably an urgent-care clinic or emergency room. If the injury is not too severe, all you may need is a splint,” said Kampmann. “But in cases with dislocated joints or displaced fractures, surgery may help you the most.”

What Gets Hurt, How They Get Fixed

Hips, wrists and shoulders tend to absorb the impact when we fall on snow or ice, and these injuries can strike bones as well as the intricate network of softer tissues like tendons, ligaments and cartilage that give your joints their unique capabilities.

Hip fractures can be particularly painful and in many cases, they require surgery to heal properly, due in part to the hip’s unique complexity.

“A hip can actually break in a few different areas and the location of the fracture will make a difference in how we treat it. The neck of the femur can be damaged in a fall, which can heal very poorly,” Kampmann said. “With this type of fracture we will consider hip replacement to surgically address the trauma. Again, the situation depends on the patient’s health, as well as the location and type of fracture.”

Kampmann said that other hip fractures from falls may require the surgeon to use large rods or plate-and-screw constructs to stabilize your bones. While the timing of surgery depends on many factors, Kampmann reminds patients that the sooner the fracture is fixed, the less time they will spend in bed. That is a difference-making approach, due to complications that can arise.

“There’s less chance of pneumonia or blood clots to occur when we can repair the damage and get a person up and walking. That movement helps them regain their overall health after a fracture,” Kampmann said. “The condition of the patient, along with the severity of the injury, determines our next steps.”

The Largest Range of Motion

Your shoulder has the most range of motion of any of your body’s joints, so there are many moving parts and connections that can be torn and ruptured by a fall on the ice.

“With patients with shoulder injuries, we’ll get an X-ray to look for broken bones, and if there are none, we’ll immobilize the shoulder and have the patient come to the orthopedic clinic for evaluation,” said Kampmann. “We may use additional imaging, such as MRI, because injuries like a rotator cuff tear will not appear on the X-ray.”

Treatment for shoulder injuries like a rotator-cuff tear many times begins with immobilization of the joint, but frequently requires arthroscopy for repair. Care teams, including orthopedic surgeons and physical therapists, devise the patient-tailored approaches as the situation dictates.

Nature’s Bottleneck

Three large nerves along with 23 tendons descend from your forearm through your wrist, so when you brace your fall and fracture bones there, which is another common group of winter injuries, Kampmann said.

“These injuries are common and if the wrist is not displaced, a cast can be the best approach, allowing the injured bones to be immobilized during the healing process,” he said. “Displacement or fragmented bone cases may call for a more robust treatment approach, including surgery.”

Sprains to the many ligaments and tendons in the area may be so painful they “feel broken” but may only require rest, ice and a splint. Getting an orthopedic evaluation is the best approach because, like the other joints injured in falls, this part of the body does include a tangle of important nerves, small bones and connective tissue.

Get It Looked At

Kampmann said bones tend to heal faster than injured tendons, like the rotator cuff. Surgery can address almost all injuries, but the recovery time can range from a few months to nearly a year for a complete return to health and full function.

Falls happen so fast, it’s almost impossible to brace yourself or “fall properly” Kampmann noted. He said upper-body injuries tend to strike the wrist and shoulder, including fractures of the bones of the wrist and arm, as well as ruptures to tendons like the rotator cuff.

“The bracing we do when we fall comes instinctively, and we’d all be better off if we could roll through the fall, but it’s not something we naturally do,” he said. “If you fall and fracture a bone, get it looked at – we can help you get back to health.”

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