Wrist and Hand Injuries After a Collision

The wrist is not one joint. It is a cluster of eight small bones arranged in two rows, bound by a dense web of short ligaments, with the forearm bones above and the hand below. This arrangement gives the wrist remarkable range of motion. It also gives it a lot of individual parts that can be injured separately.

The braced hand

Gripping the wheel puts the wrist in extension. Loading a wrist in extension is the classic mechanism for scaphoid injury. The scaphoid is a small bone at the thumb side of the wrist with an unusual and somewhat precarious blood supply, which is why scaphoid injuries are treated with more caution than their size suggests.

The distinguishing sign is tenderness in the small hollow at the base of the thumb when the thumb is pulled back. Scaphoid fractures are also known for being invisible on initial X-rays, so persistent pain in that specific spot deserves follow-up imaging rather than reassurance.

The little finger side

On the opposite side of the wrist sits a small cartilage and ligament complex that cushions the joint and stabilizes the two forearm bones against each other. Loading combined with rotation, which is what happens when the wheel turns against a gripping hand, can tear it. The result is pain on the little finger side of the wrist with twisting motions, opening jars, or pushing up out of a chair, often with a click.

Airbag injuries

A driver's airbag deploys from the center of the steering wheel at very high speed. Hands positioned over the top of the wheel are directly in its path, and the deployment drives them upward and backward violently. Thumb injuries, wrist sprains, and forearm abrasions from this mechanism are well recognized. The airbag still protects your head and chest, which is the trade it exists to make.

Numbness deserves attention

Swelling in a compartment as tight as the wrist can compress the median nerve where it passes through the carpal tunnel, producing numbness in the thumb, index, and middle fingers that is often worse at night. As with the elbow, symptoms in the hand can also originate at the neck, so the pattern of which fingers are involved is genuinely informative.

Why wrists get overlooked

A sore wrist competes for attention with a neck you cannot turn. People assume they jammed it and that it will settle. Most sprains do. The ones that do not are usually the ones where a specific structure was injured and never identified, and by the time it is clear something is wrong the easy window has closed.

If your wrist or hand has been bothering you since your accident, have it examined. Call (725) 255-7333. Henderson, southwest Las Vegas, and North Las Vegas.