Ryan Katz, MD, Hand Surgeon at the Curtis National Hand Center

Summer fun unfortunately brings an increase in hand and arm trauma due to seasonal outdoor activities. Aside from fractures and sprains due to sports accidents, trauma from the lawn mower and burns from firepits and fireworks are the most common summertime injuries. About 25% of hand and foot lawn mower injuries result in a severed body part. Contact with the spinning blade of the lawnmower can also cause complex fractures and touching the engine block can produce severe burns. There are about 80,000 lawn mower accidents each year in the U.S., and more than 6,000 children are injured annually.  In 2022 there were an estimated 10,200 injuries and 11 deaths related to fireworks. Hands and fingers are the body parts most often injured by fireworks, accounting for about 29% of all injuries. About 38% of all fireworks accidents that resulted in a trip to the emergency department were for burns, the most common type.  The best way to ensure your hands are safe this summer is to follow common-sense injury prevention tips. The Curtis National Hand Center is a regional referral center, so we see patients from throughout several mid-Atlantic states, including some who have suffered lawn mower and fireworks injuries that can’t be treated at their local health center. We’ve successfully helped many patients recover from summer injuries, but the best outcome is when a hand surgeon doesn’t have to get involved. An ounce of prevention is worth a pound of cure, so consider these tips to avoid an accident in the first place.  Most lawn mower injuries occur when someone makes contact with the spinning blade. When the sharp, fast metal contacts a hand, the result is often finger or fingertip amputation, open, complex fractures, and other traumatic injuries.  The most devastating injuries we see are those to children, often involved in the grass cutting chores by well-meaning parents. Please, keep in mind the high level of risk to your children as compared to the small benefit of their assistance with yardwork. Never allow children to play with, ride on, or operate lawn equipment.   Follow these other safety precautions to protect your family’s hands and arms this summer: Never disengage the safety mechanisms on your lawn mower. These components help stop the blades quickly if you leave the seat of a ride-on mower or release the handle of a walk-behind model. Always power down the lawn mower before attempting to examine it, remove debris, or adjust the cutting height. Don’t mow when the grass is wet and slippery. Dress safely in long pants, a long-sleeved shirt, eye and ear protection, gloves, and closed-toed shoes with slip-resistant soles. Remember a hat, sunblock, and fluids. Most fireworks injuries are preventable, so be sure to follow the manufacturer’s instructions whenever using these products, and ensure your fireworks are labeled for consumer use.  Even sparklers can cause burns – they reach temperatures of about 2,000 degrees Fahrenheit! In fact, sparklers caused 600 ER visits in 2022, and firecrackers resulted in 1,300 more injuries. Stay safe this summer with these tips for responsible use: Only responsible adults should handle fireworks.  Don’t use explosives if you have been drinking. Stay more than six feet away from the person lighting the fireworks. Almost half of injuries happen to bystanders. Light only one firework at a time. Have a bucket of water, hose, or fire extinguisher close at hand. Never point fireworks at a person Never light fireworks indoors Never relight fireworks that fail to ignite. Related reading: Hand and Wrist Injuries A properly preserved finger can be successfully reattached up to 12 hours after the accident. If a finger or your hand is fully or partially severed, preserve the tissue if possible by following these steps: Wrap the severed tissue in a damp towel. Place the tissue and towel inside a resealable plastic bag and close it. Fill a second plastic bag with a mixture of ice and water. Place the first bag inside the bag of ice water. The tissue should be kept cold but not saturated with water. There may be significant bleeding and pain associated with these injuries. It is usually not necessary to use a tourniquet to control bleeding in a hand or finger. Restricting blood flow to the limb with a tourniquet can cause long-term muscle and nerve damage, so tourniquets should only be used in an emergency. Instead, control bleeding by wrapping the limb in a towel and applying direct pressure. Go to the nearest emergency center right away so you can be checked for other injuries. Sometimes patients are distracted by the hand trauma and don’t realize another injury has occurred.  Complex fractures are sometimes called “open fractures” because they can involve multiple bones that may break through the skin. These types of injuries can be more serious than “simple” fractures since they can damage the surrounding muscles, tendons, and ligaments, increasing the risk of infection.  Complex fractures should be treated right away, so seek care at your nearest emergency center immediately. Do not attempt to straighten the bones or push them under the skin yourself. Moving broken bones can cause severe pain, increased bleeding, and can damage tissue around the wound, making repair more difficult. Cuts and burns are common summertime injuries and can vary greatly in severity. If you experience a severe burn or cut on your hands or fingers, go to your nearest emergency center for treatment. But not all burns are created equal. Superficial burns: If your skin turns pink like a sunburn, you probably don’t need emergency medical attention. A red, painful area with no blistering can be managed at home with good hygiene and a gentle topical salve like aloe. Second-degree burns: When you touch the engine block or tailpipe of the lawn mower, your skin will probably rapidly develop a blister. Burns of this severity should be evaluated by a medical provider right away, as they may require further treatment. Never break open a blister from a burn. Full-thickness or third-degree burns: These most severe burns from summer activities like fireworks or bonfires may not involve blistering. Instead, the skin may turn white and appear dry. These burns are best treated at a burn center or, if they’re isolated to the hand, a hand center like ours.  Seek medical attention in the case of a burn, especially if there is any chance of an inhalation injury. If your airway has been burned, it may take some time for symptoms to appear, but you could have difficulty breathing several hours after the accident so you should be evaluated thoroughly. If you cut your finger or hand while preparing for the barbecue, you may be able to follow simple steps to treat the wound at home. However, if blood is gushing, the cut is deeper than about ¼ of an inch, or bleeding doesn’t stop, head to the emergency center for cut treatment right away. Related reading: Researchers at Curtis National Hand Center Compare Effectiveness of New Surgical Approach to Treat Painful Neuromas. Accidents happen, so if you’re on the wrong end of summer fun, know that the experts at Curtis National Hand Center are here to help.  Our surgeons have exceptional depth of experience in treating these injuries and are talented in the kind of detailed microvascular reconstruction necessary for treatment, including transplanting skin or muscle tissue from another part of the body to return function to the hand. We are also making significant strides at the frontier of nerve transfers and reconstructions that can help restore function and mobility by replacing or rebuilding damaged nerves. The best way to keep enjoying your yard or barbecue this summer is to play it safe and avoid injuries that could result in significant trauma to your hands. Always follow safety instructions and remember to stay calm and get medical attention should things go wrong.

Do you have persistent pain in your hands or wrists? Is it difficult to complete daily tasks that require putting pressure on your fingertips or use of your thumb? Hand arthritis is a common condition that affects the joints of men and women alike. It can range in severity from mild to disabling, making it harder to carry out normal activities, such as opening doors or tying your shoes.  Fortunately, there are several treatment options that can relieve pain, from medication and physical therapy to surgery. The best treatment for you will depend on the location and severity of your symptoms. In addition, you may need to explore several different options before finding the best treatment for your unique case. Click to Tweet Within the hand and wrist, there are 27 tiny bones working together to perform day-to-day movement. Joints are where each bone connects to one another, cushioned bycartilage in between. Cartilage helps these joints to glide smoothly during motion, just as a watch with working gears displays the correct time. When something disrupts the cartilage in these joints, it can lead to pain, swelling, and inflammation.  Arthritis most frequently develops in three joints within the hand: Base of the thumb: Thumb arthritis can form at the carpometacarpal (CMC) joint, or the base of your thumb.  Fingertips: The joints of the fingertips closest to your fingernails are called the distal interphalangeal (DIP) joints. Mid-finger: The proximal interphalangeal (PIP) joints are the middle points of the finger, commonly known as the middle knuckles. Many times, hand arthritis is caused by normal wear-and-tear that occurs as we age. As a result, the condition typically begins in adults in their late 40s or early 50s. However, some people may be predisposed to developing early degenerative changes in the hands due to genetics. In other instances, arthritic hands develop as a result of trauma or a systemic inflammatory disorder, such as rheumatoid arthritis (RA).  Most patients with hand arthritis experience pain during motion, such as pinching, grasping, or gripping an object. For example, patients will describe their pain by saying, “It hurts everytime I do [fill-in-the-blank].”  However, it’s possible to have arthritis in the fingers or hand without pain. Other arthritic signs may include: Stiffness, swelling, or tenderness in the finger joints or wrist General weakness in the hand Decreased range of hand motion  Enlarged knuckles or other finger deformities At your first appointment, your doctor will conduct a physical examination and ask comprehensive questions about your symptoms to understand how they’re affecting your everyday life. Hand arthritis is generally confirmed using X-ray imaging, which reveals what’s going on under the surface of your skin. The best treatment for one individual may not be the best treatment for the other, which is why it’s important to meet with a doctor specializing exclusively in treating hand conditions. A hand specialist will be able to recommend the right method for managing your symptoms, including nonsurgical options that may include one or more of the following: Medications: There are several options available for managing pain, including topical medications, over-the-counter or prescription pain relievers, and corticosteroid injections. Splinting: A supportive brace or splint can stabilize arthritic joints, which may alleviate some pain. Physical or occupational therapy: Certain hand exercises may help you regain strength in the fingers and wrist, which might prevent worsening arthritis. In addition, your doctor or therapist may recommend lifestyle or activity modifications that can help limit the strain on your finger joints and minimize pain. Depending on the severity of your arthritis, conservative treatment options may be enough for managing pain and other symptoms. However, if these treatments don’t provide satisfactory long-term relief, there are several surgical treatments that can help manage symptoms and slow down additional wear-and-tear. If pain or limited mobility remains after trying nonsurgical options, your doctor may recommend surgery to manage your condition. The procedure your surgeon will recommend will consider the type of surgery that will be most appropriate given the location and impact of your arthritis. They’ll also thoroughly explain the pros and cons of your surgical options, so you can make the best decision for your goals.  If thumb base arthritis prevents you from using your thumb, your surgeon may recommend a trapeziectomy. During this procedure, your surgical team will remove one of the joints at the base of the thumb (trapezium), which should eliminate your pain. In certain instances, your surgeon may also replace the joint with a tendon graft, but this is not always necessary. In either case, it’s a safe and effective outpatient procedure that typically involves a two-to-three month recovery.  If you have debilitating arthritis in the DIP joints (near the fingertips), your surgeon may recommend joint fusion surgery. This involves removing the arthritic joint and permanently fusing the remaining bones, which means they will no longer have flexibility to move. Because it eliminates the joint altogether, it’s generally a successful option that gets rid of pain.  For individuals with arthritic pain and mobility limitations in the PIP joint (the middle of the finger), there are different options, each with their own benefits and disadvantages. These may include joint replacement surgery, which involves replacing part or all of the affected joint with an artificial joint. Advantages of this procedure include correcting any deformity and alleviating pain. However, it will not completely restore your range of motion and the replacement will likely not last for your lifetime.  A different variation of joint replacement may replace the worn out joint with joint material from somewhere else in your body, such as the toe joint. This is a more involved procedure, but it has the potential to be effective for the rest of your life. The best treatment for your hand arthritis is the one that alleviates your pain and restores your quality of life. And for the most effective results, it’s important to seek care from a hand specialist who focuses exclusively on diagnosing and treating arthritis and other conditions that affect the fingers and wrist. This level of expertise involves additional training and education, giving hand experts the experience necessary to minimize the risk of any potential complications.  Even if you don’t need surgery, a hand specialist will be most well-versed in the full range of treatment options that will best meet your individual needs and goals. While there’s no cure for arthritis, our doctor and surgeons are experts in helping you manage symptoms so you can get back to daily life, work, and recreation without pain.