Hi Guys.
I had a displaced fracture of the 5th metacarpal (little finger) and it got some metalwork put in.
I have a 4 stage MTB Race in 5 weeks time and I know it will be touch and go for the event but want to give it my best shot so as not to let my team mate down. The Op went well yesterday and i have a non waterproof cast that will be on for 2 weeks before it is changed to a fibreglass one for well hopefully 3 weeks unless I can ride/race with it.
I will ride TR Indoors for the next 2-4 weeks at least.
Has anyone had experience with a similar finger injury, how long did it take to get back to MTB with the rough surface and is there an alterative cast I can get so I can try riding after 3-4 weeks?
Did you break your finger or a bone in your hand? The fifth metacarpal is in your hand from the knuckle of the little finger to your wrist. Also, is the cast on just your finger or is your hand immobilized?
I asked because I broke my third and fourth metacarpals and needed four screws to put everything back together. Being in a full hand cast even for two weeks caused me to lose range of motion and strength. I wasn’t biking at the time but I could not have even closed my hand to grip a handle bar.
If it is your hand, talk to you doc about how to keep range of motion - ie exercises / movement a couple of times a day. The installed hardware will keep the bones together while they heal.
If it is actually your finger, hopefully the cast is much smaller and you can continue to keep your range of motion and strength up in the remaining fingers. Best of luck!!
Talk to your doctor and don’t let yourself get roped into doing an event that might not be beneficial to your health. If your doctor says no or even recommends against it, I’d cancel the race.
Hands are very sensitive, you have lots of small bones and muscles. Assuming this was a work accident, it seems you need your hand (with all fingers) to do your job. Just the vibrations from 4 (!) days of racing could lead to problems down the road. And there is the possibility of you crashing again.
I’m not a medical doctor, but my mom worked for several decades in an orthopedic clinic. One of their specialties were hand and feet. When I crashed on a mountain bike once, I had a big open wound on my palm (big as in I could see bones, muscles and tendons). My mom was super insistent that I really take care of the wound and told me to tell the doctor to take his time cleaning the wound (there were lots of small stones in it). Infections and such could lead to mobility issues later on. I realize the location was different and that the little finger is less crucial than a thumb. But still.
The xray was pre op, it will have a plate or wires in now and will be reduced.
I have this on for 2 weeks and then get a fibreglass one. I will ask for it to be on 2 weeks and then get a decent removable cast so i can get my ROM up and see how my hand fairs on the bike to get used to rough terrain.
Last summer, i had a small surgery done to remove a cyst on right thumb.
Doc cleared me to mtb ride (and it didn’t hurt at that point) but I found that downshifting was difficult as I had to still wear a gauze on it which I made even thicker to prevent dust from getting in and to add cushion in case of a hit - you know some random tree that doesn’t get out of the way.
I considered moving shifter to the left side but then my ingrained reflex is to do it on right side. So i just practiced downshifting with my palm for a couple of rides and 2h mtb race went ok.
Personally I’d say it’s not worth the risk. For one thing you might have a lot more pain after a couple of hours of hard riding, never mind a couple of days. The repeated small impacts and vibrations could do a lot of harm to the repair job, including loosening screws and breaking wires (leading to more surgery and complications). And if you fell and landed hard on that hand it’s good night Vienna. Is this race more important than having full function in your hand and wrist for the rest of your life?
Knowing this was a couple months ago but for possibly future reference:
This is an ulnar gutter circular cast. Next was, apparently, an ulnar gutter backslab (synthetic type) but that’s not a strict protocol. It could have been a backslab from the start, whatever material, as the purpose is to immobilize in the correct position in a fool-proof way and the material used is irrelevant.
After this, almost certainly, would be a removable splint - patient is allowed to remove it to shower, possibly sleep.
No way you were advised you could safely race. Were it a finger, sure, probably with a dorsal finger splint but on your own risk as any fall had the potential of catastrophe. This? Even handlebar vibration could F you up.
And pain isn’t a reliable indicator of anything relevant here. Surely your consultant surgeon would advise/advised you regarding this.
All good, raced the 4 days with no problem. 4 weeks in a cast total with a change after 2 weeks. Back on the bike at week 5 pain free just stiff fingers and a weaker grip. Had a protective brace over the # site just in case of a fall or some impact and also used protective loam lab bar ends.
I’m both a surgeon and an idiot dealing with a broken hand right now and wanting to get back on the bike… my advice is to find another race farther out. You’re putting a lot of weight on your 5th metacarpal on the mtb. At 5 weeks, you’re probably 60-ish% healed. A minor crash is going to put you back in the OR. The plate is super thin and you’ve only got like 2mm diameter screws holding that together. The plate construct is designed to hold it together with basic ROM, not bouncing around on the mtb or maintaining a crash. To put it bluntly, at best you’re gambling in your entire summer of riding, at worst, your hand functioning
Thanks for the advice, and all of what you were saying is very true. I also work in the field albeit just the Orthopaedic Rep.
I was surprised how well the hand felt and if I had any problems with any pain on the more technical stuff I wouldn’t have raced.
Yes if I had fallen again it may have been a different story but I did my mini risk assessment and decided my skills were good and the terrain not too technical. That doesn’t however compensate for accidents or stupidity but I do live to ride another day. The hand is still healing 9 weeks post op but I do wear a protective brace and thankfully yet to have another fall.
