The scaphoid bone is located between the forearm and the wrist near the base of the thumb. It becomes suddenly and violently compressed when a bicyclist falls on outstretched hands. After the fall, the rider will complain of pain between the wrist and thumb, obvious swelling and loss of range of motion of the thumb. Pain might increase when the person tries to hold an object or pinch something. This type of fracture might not be immediately visible on x-rays. A doctor might just splint the hand and wrist for a week or two until more x-rays can be taken to rule out a fracture. If a fracture is confirmed, treatment can range from applying a cast to surgical repair. Surgery might involve manually manipulating the bone into position or using screws and wires to hold the bone in place.
A bicyclist might suffer a Bennett fracture and dislocation at the base of the thumb from falling on a hand with a thumb sticking out to the side. Swelling from the fracture is immediate and the thumb and hand might actually appear to be deformed. Surgery is usually required for purposes of realigning the bones back in place and fixation of the break with wires. After surgery, a plaster cast is usually applied for about six weeks.
This type of fracture is more severe than a Bennett fracture because the base of the thumb is broken into two or more bone fragments. Those fragments need to be put back together with plates, pins or screws, so surgery is required. After surgically realigning the bones, a plaster cast will usually be applied for six weeks.
Fingers are more vulnerable to injury than other parts of the hand. They’re at a high risk of fracturing in most falls off of a bicycle. Finger fractures are categorized as:
- Avulsion fractures when a ligament or tendon and the bone that they’re attached to pull away from they belong
- Impacted fractures when one bone fragment is driven into another bone fragment
- Shear fractures when a bone splits
The fracture might not be displaced. There might only be a crack with no bone movement, or it can be displaced and broken into two pieces. If the fracture is comminuted, the bone has broken into three or more pieces. When a fracture is displaced or comminuted, you’re likely to be referred to a hand specialist who will determine the best way of treating the fracture in order to restore range of motion, function and strength.
Each hand has five metacarpal bones. The far end of each metacarpal bone form a knuckle. Most metacarpal fractures are treated with a cast. Surgery might be required if a finger has been significantly shortened by the fracture or if there’s a rotational deformity that causes the fractured finger to cross over another finger.
Bicycle riders suffer sprains when a ligament that holds one bone to another bone is partially or completely torn. In a bicycle accident, the hand ligaments that are most often torn are in the palm and where the fingers join the hand. Pain and swelling should subside in a few days. If it persists, the rider should see a doctor in order to rule out a fracture.
Other than maybe a routine sprain, there’s no guarantee that you’ll make a complete recovery from any hand injury suffered in a bicycle accident. You could end up with intermittent pain or arthritis with loss of range of motion of the affected fingers or hand. If your hand injury was caused by a negligent driver or negligent road maintenance, you might want to speak with an experienced bicycle accident lawyer.