 Poster: A snowHead
|
My wife broke her radius down by her wrist on her first lesson at a dry ski slope 9 weeks ago (2nd Oct) , we are due to go skiing on 31st of Dec. So her arm will have had around 13 weeks to heal. Is this enough time to heal or will it break when she falls on it the first time? Is it advisable to wear one of the snowboarder type wrist supports?
Any advice greatly appreciated.
|
|
|
|
|
|
Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
|
Kramer is your man ! He'll be along shortly. 
|
|
|
|
|
|
Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
|
cmyers_uk, having taught hundreds of people to ski on plastic slopes without an incident like that my eyebrows are a little raised. A first lesson on plastic should be very gentle - half an hour walking around the flat on skis to get used to them, followed by a bit of side-stepping, ending with the most mellow of downhill runs - just a few feet of sliding.
A first hour on skis should present no risk of a nasty fall.
What was your wife being asked to do when she fell? Was she being taught by a qualified instructor?
Hope all gets better, and that she's confident to have another go!
|
|
|
|
|
|
You need to Login to know who's really who.
You need to Login to know who's really who.
|
|
David Goldsmith, My first and last dry slope lesson was exactly as you describe, followed by a fall. Gosh it hurt.
|
|
|
|
|
|
Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
|
| Quote: |
| A first hour on skis should present no risk of a nasty fall. |
You don't have to be skiing to break somthing. Someone I know broke their thumb on the second day of their first ski holiday. They weren't skiing as such though, they were just sliding over to where they were due to meet their instructor, and lost balance. 
|
|
|
|
|
|
You'll need to Register first of course.
You'll need to Register first of course.
|
|
mark_s, very true. A good friend of mine once broke her thumb by falling out of bed ...... not clever!
|
|
|
|
|
|
|
|
She was in her 1st lesson at churchill dry ski slope with what I hope was a qualified instructor, she was moving from a snow plough to normal skiing when she fell over, her arm went down behind her and broke the radius. It did look an innocent fall but unfortunately backwards with a straight arm into the lattice whilst still moving forward although slowly.
The instructor seemed to be teaching her in a manner that I have seen in Austria and at Tamworth, she was no more than 4 foot up the slope.
From what I can gather Upper limb injurys are very common on dry ski slopes particularly the thumb and wrists, at Churchill they have at least one break a week I was told. Picked the following from the web,
"Adult Hand Injuries on Artificial Ski Slopes.
Annals of Plastic Surgery. 55(4):357-358, October 2005.
Keramidas, Evangelos MD, EBOPRAS; Miller, Gavin FRCS (Plast)
Abstract:
Artificial ski slope skiing is a popular sport in Great Britain with significant risk of injury. We reviewed 36 patients who had been treated for hand injuries excluding the wrist in our plastic surgery department over a 14-month period after skiing on an artificial ski slope. Specifically, they were 15 fractures of the digits, 3 dislocations of the finger joints, 7 ulnar collateral ligament injuries of the metacarpophalangeal joint of the thumb, and 11 bruises and abrasions. The mean age of the patients was 28 years, and there were 20 men and 16 women. It is concluded that the hardness of the surface of the artificial ski slopes could be responsible for the types of injuries.
"
|
|
|
|
|
|
|
|
cmyers_uk, after thirteen weeks, the wrist will probably have healed enough to keep it in position, however it will be nowhere near to full structural strength, which will take somewhere between six months to a year, and two years before bone remodelling has completely finished. It sounds as if your wife has suffered a fairly typical skiing injury, and so her risk of doing it again is much increased, both because it's quite likely that she might repeat the mechanism of injury, and also because the bone will not have reached full strength.
Wrist supports probably offer some protection, but I wouldn't like to rely on them in this case.
Another issue that you should check is insurance, as if your wife was to refracture through her wrist, you would probably find that she isn't covered. As a fracture wrist could cost you somewhere in the order of £500 to £5000 this is significant.
Bottom line for me is that if I ever break something (touch wood!) I would probably leave it six months to a year before I skied on it again.
However as each case is different, I would get your wife to ask at her fracture clinic, to see what the surgeon says. Your GP is unlikely to have enough information to be able to give you any more detail than I have above.
I hope that this is helpful to you, although it may not be the answer that you were hoping for.
|
|
|
|
|
|
You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
|
It wasnt the answer I was hoping for but the facts I needed, Thank you for the information, I am phoning the insurance company tomorrow.
Regards
Chris
|
|
|
|
|
|
|
|
cmyers_uk, if your insurance company give you hassle, you may need a letter from her consultant stating that s/he feels that your wife would not be able to ski.
If that still doesn't work, then I would suggest that you get them to guarantee in writing that if she refractures through the site, then they will cover all expenses.
|
|
|
|
|
|
snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
|
Kramer, Thank you for all the excellent advise. Unfortunately I hadnt taken my insurance out when we went to the dry ski slope so I'll just have to put this one down to experience. Hopefully the insurance company will insure her to go but not ski and at least the rest of the family can enjoy the snow.
Thanks again
|
|
|
|
|
|
And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
|
I'd ask my orthopaedic /hand surgeon for advice. He's the only one of this lot to have seen the X-ray and therefore can determine the precise nature of the fracture. There are many different fracture types with subsequent implications for the strength of the fracture site/ wrist at varying times following injury. The strength of the repair is also dependant on the amount of physiotherapy / movement done in the weeks following injury. A good estimation of progress will be the "objective " evaluation of pain free grip strength done as part of follow up.
Its not a simple answer and it varies for each individual. 13 weeks may be OK.
Don't alter your (her) holiday plans on the strength of an internet reply.
|
|
|
|
|
|
|
|
cmyers_uk, do you know if it was an uncomplicated Colles' fracture or some other type, or if it was particularly bad in some way? Is it safe to assume she's going to have a reasonable amount of physiotherapy after she's allowed to move it?
mij, is pain free grip strength a good estimate of progress of healing, and if so, at which stages?
|
|
|
|
|
|
You know it makes sense.
|
slikedges
Immobilisation is dependant on the type of fracture and /or fixation type. If a plaster of paris is applied its usually removed at 6 or so weeks (if the x-ray shows signs of callus)( healing). Then mobilisation is commenced and grip strength is measured usually at 2-4 weekly intervals. Its done using a device called a Jaymar Dynamometer that registers the force applied to bring two metal bars together. its placed in the open palm and the bars come together when a fist is made. Initially, at around 6 weeks the grip strength is weak and sore, as the fractured bone(s) strengthen the pain diminishes and the strength increases. Force is measured in Kg of force. Normal is dependant on sex and occupation but is usually over 30 kg force (my grip strength is 60 kg).
Again each patient varies and normal grip strength doesn't mean the fracture site is as strong as a normal bone.
|
|
|
|
|
|
Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
|
|
I would definitely agree that the orthopaedic surgeon in charge is the best person to give you an accurate prognosis. However even if they give her the go ahead, I would also check with your insurance company, to see whether she would be covered or excluded due to preexisting injury.
|
|
|
|
|
|
Poster: A snowHead
|
Thank you all for your replies. The insurance company will not insure her arm until its healed for 6 months. It was a straight uncomplicated break of the radius and her arm was in plaster for 5 weeks , xrayed and showed it had started to heal but was not totally healed. She does have some pain when picking up heavy objects. As she is a total beginner it is very likely she will fall on it again without insurance it is a risk I dont think is worth taking. I am tempted to take her to do normal things like walking etc but again without insurance on that arm its a risk. The good thing is they will still insure her 3 remaining limbs!
Thanks again for all the replys very informative. I am speaking to the fracture clinic today and trying other insurances but expect the sensible choice is not to ski.
Regards
|
|
|
|
|
|
Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
|
cmyers_uk, best of luck - hope it works out for you!
Kramer/mij, just reading this got me interested. Daniel Carter the NZ flyhalf (rugby player) broke his leg fairly recently when playing rugby, he was back playing an absolute maximum of 3 months later - how on earth was that possible!?!?
|
|
|
|
|
|
Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
|
mij, all sounds very reasonable. I just wondered what the role of grip strength was in assessing bony union.
cmyers_uk, Assuming an uncomplicated fracture not involving the joint line treated by immobilisation ± manipulation only, I'd expect union at 6/52 in the upper limb and then, with the progressive reintroduction of appropriate stresses limited by pain (in our modern age, usually supervised to some extent by a physiotherapist), a gradual maturation and remodelling of bone and recovery of lost musculo-tendinous strength due to atrophy during the period of immobilisation. As Kramer said this goes on for years and full strength may never be regained though it's usually effectively back to full strength by 3-6 months.
Obviously the orthopaedic surgeon concerned is the best opinion, and whilst the insurance company has naturally been conservative, it may be that skiing at 3/12 is actually quite reasonable.
|
|
|
|
|
|
You need to Login to know who's really who.
You need to Login to know who's really who.
|
Adamski, it depends on the fracture and the person.
I think that this thread demonstrates quite nicely that if you ask three different doctors then you get three slightly different opinions. These things are never black and white.
|
|
|
|
|
|
Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
|
|
cmyers_uk, Given that your wife is still a begineer, it is safe to assume that she will fall lots of times during the holiday, therefore the risk of r-injury is high in an area that has seen recent trauma. It might be better to disuade her from sking until next year.
|
|
|
|
|
|
You'll need to Register first of course.
You'll need to Register first of course.
|
Thank you everyone. We are going back to the Fracture clinic to get their verdict. I have phoned the ski club of great britain insurance medical helpline and they said they would cover her at no extra cost. Even if she does not ski I would like her arm covered so we will take out this insurance and ask for it in writing (I dont trust insurance companys!). As with all things medical alot depends on the patient but this thread has really helped me get a sense of perspective and know the things to look out for,
Thanks
|
|
|
|
|
|
|
|
cmyers_uk, I seem to remember a professional footballer or two playing very soon after similar fractures and they had to wear a removeable plastic brace.
I believe that these were individually molded and very similar to a split plaster cast in their length (i.e. from base of fingers to just-below elbow) and shape.
This would probably not be obtainable on the NHS however.
I think that my best tip is to have a quiet word with the fracture clinic receptionist and try to see an orthopod who is a skier (and therefore likely to be more sympathetic regarding any custom-made splintage.)
|
|
|
|
|
|
|
|
I'd agree with Kramer about the 3 slightly differing opinions amongst 3 docs. I think we've all come at this from slightly different angles. I think the lady in question's fracture would probably be strong enough to withstand probably a bad fall at 13 weeks post injury IF she was confident enough to use the hand/arm normally as quickly as possible. This would probably strengthen up the associated structures mentioned by slikedges. However, thats probably asking too much from a beginner and I'd be concerned if I was her loved one and she fell on the 1st turn. I'd postulate that if she were a confident skier then she'd have no problems because she'd have more control over her circumstances.
I use grip strength merely as a semi objective assessment of progress by comparing an individuals results over time. It's similar to decreasing pain in a lower limb fracture site when walking /running etc. Bony union assessment is almost impossible in the normal fracture site healing process - it is interesting when malunion occurs - I'd argue that when function is "normal" and pain free then bony union has reached its zenith. Remodelling will subsequently take place but it may not add much to the overall strength of the fracture site.
Phew - more info exchanged here than at a boozy ortho conference!!!
|
|
|
|
|
|
You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
|
|
Well this thread has rapidly outpaced my knowledge.
|
|
|
|
|
|
|
|
This thread and all the people who have responded have been a great help. As a direct result we have arrange additional insurance from Ski Club of Great Britain to suppliment our dogtag insurance and make sure her arm is covered whether she skis or not. We have arranged a consultation at the fracture clinic to re -xray and get some advice from a doctor who can see the xrays and test movement. We have not booked her ski lessons so will not loose any money if she cant ski.
Thanks again the info has been very interesting.
|
|
|
|
|
|
snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
|
|
This is very interesting stuff. On an associated point I'd like to know if I should be skiing at all having suffered a 'non-displaced' fracture to T3 and herniating discs L3 and L4 5 years ago?
|
|
|
|
|
|
And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
|
|
cmyers_uk, Good work. If we have a problem at work I shall give you a ring. You seam to have that ability to investigate a issue. ask the right questions, and come up with all the right answers. Obviously not involved with Government.
|
|
|
|
|
|
|
|
kevin mcclean, again specific advice is difficult to give without knowing a full and detailed medical history, but essentially as long as the fracture had healed with no problems, there would be no problem with you skiing.
The herniated discs are more troublesome. Some patients have very severely herniated discs on MRI scan, and very little problems with them, others have very mild looking MRIs and severe problems. It would depend on the persons specific history. If every time you skied it caused you unbearable back pain, then the answer would perhaps be to avoid it, however if you've previously skied with no difficulty, then there should be no reason to avoid skiing. General advice these days for back pain is to keep active, and not let it limit your lifestyle too much. Skiing would tend to fit with this, but as ever meaningful advice would need to be given on a patient by patient basis.
|
|
|
|
|
|
You know it makes sense.
|
Yes, thanks very much Kramer and you're precise with your points about the herniated discs being more troublesome than the fractured T3. Basically, I was out with a guide in Italy and we were on the Monta Rosa doing some interesting stuff when I basically missed an edge and tumbled for what seemed like an eternity. Unspeakable and unbearable agonies were the obvious result, naturally, and it would seem the compression of the landing forced my lower lumbar discs to herniate. Pretty scary stuff. Anyhow, I actually received first class medical care both over there and in the UK but I was quite understandably laid off for quite a while. Of course, I accept that when one sustains an injury of this sort you're really never going to be the same again and I do have my daily battles but I ski technically as well as I used to though I am somewhat reticent about the crazier aspects of the sport!
People have asked me why I continue to ski after sustaining such dreadful injuries. My simple answer to them is that I continue to ski because I can.
You up for some big jumps then?
|
|
|
|
|
|
Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
|
|
Final update for anybody who is interested. My wife went to the fracture clinic and had another xray, the Doctor has cleared her to ski. Apparently the bone has healed and she should be no more likely to fracture it now than before. He also wrote a letter to that effect for insurance purposes. All in all a good result.
|
|
|
|
|
|
Poster: A snowHead
|
|
cmyers_uk, Top Banana, what a great result, welld done!
|
|
|
|
|
|
Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
|
|
|
|
Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
|
cmyers_uk, excellent news! Have a good holiday. 
|
|
|
|
|
|
You need to Login to know who's really who.
You need to Login to know who's really who.
|
Adamski re: Daniel Carter the NZ flyhalf - yeah, but it's also a testament to the insane value NZ places on the All Blacks and hence a) the wads of money spent by the NZRA on rehabilitation of Carter's injury and b) the (paid) time available to him to focus on all day on rehab.
Mere mortals with 9-5 jobs don't have that kind of money/time luxury and so our rate of rehab is often noticably slower....
|
|
|
|
|
|
Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
|
|
|
|
You'll need to Register first of course.
You'll need to Register first of course.
|
|
slikedges, Shouldn't that be on the Kate Moss thread?
|
|
|
|
|
|
|
|
|
|
|
|
|
FAQ
