Hunting & Cold Weather Hand Safety

If you’re one of the many who have found nature to be a source of respite during a uniquely intense year, there are tips for the sportsmen among us to mind so that hunting season turns out every bit as recreational as it’s intended to be.

Penn Highlands cosmetic, reconstructive and plastic surgeon Dr. Rice Rice, MD, says that perhaps unsurprisingly, this season presents one of the busiest periods for him to treat trauma injuries from accidents, specifically to patients’ hands. Fortunately he and his staff are well equipped, as Rice trained at Maine Medical Center in Portland, Maine for plastic and hand surgery, as well as Brigham & Women’s Hospital in Boston, an affiliate of Harvard Medical School.

In part because New England winters are often considered even more severe than ours, Rice says he’s seen a lot. Though unpleasant to think about, Rice says just for starters he’s dealt with hundreds of finger amputations with folks who have learned what can happen from using the hands to unclog the snowblower chute unclogged in heavy snow. “When I was in Boston, I had close to 19 in one day,” he says. (Some worthy advice? “Use the stick that comes with the snowblower.”) He observes how hand injuries come with their own set of concerns. “I feel bad because it’s pretty hard on some people,” Rice says. “Most of us rely on our hands for work.”

To try to help you avoid winter hand wounds altogether, the doc offers a few bullet points (no pun intended) for staying all hands-on this season.

• Step one: In any kind of emergency with injury, calling 911 or heading to the Emergency Department will usually be a good first move. From there, a clinician like Rice will evaluate the severity of the injury and lay out the plan for next steps.
• For archers: “With archery, I usually get crossbow injuries just because patients tell me they’re under a crazy amount of tension, much higher than a regular bow,” Rice says, explaining that the bowstring can come across the thumb and slice the tender area between the thumb and forefinger, as was the case with a patient he cared for recently. He adds that if the bowstring breaks, that can cause problems, as well.
• With guns: “I get a couple patients each year who get injured while cleaning their guns, or trying to clear the chamber and a misfire occurs. The bullet will go directly through their hand or finger, and result in a blast injury.”
• When cleaning a deer: “I’ve seen a couple patients recently who cut tendons while they were cleaning deer,” Rice says, advising that in these cases, it’s usually important to get on an antibiotic right away because the wound can be contaminated.
• For frostbite: “I’ve seen this when someone has been locked out of their house and spent a long time trying to get in.” Frostbite victims should warm up right away—“This is the most important thing at first,” he says—while simultaneously heading to the emergency department where a physician may administer medication to help open the blood vessels. Rice advises that once in a while, frostbite can be so severe that it requires amputation.

He also educates us by explaining that in medicine, the hand is seen as being divided into five zones, with the area around the fingertips composing zone one, and the wrist making up zone five. With lots of muscles, nerves, and tendons throughout the hand, Rice says that if surgery is required, a skilled hand surgeon will be able to appropriately address the injury depending on which zone or zones the injury occurs. If there’s a question of a nerve injury, “you have better outcomes if it’s repaired within a few days or a week,” says Rice, adding that nerves can take approximately a month to begin regrowing, and then grow at a pace of around a millimeter a day (“A cut to a nerve in the elbow area that affects the finger can take months,” he says, but in many cases it’s possible to heal). In the finger area, surgery might be ideal within a couple weeks—but overall, he says, “The sooner you do it, the better the outcome. “

For any cold-weather conundrum, from sledding injuries or car accidents to slips on ice and bike or motorcycle mishaps that occur due to slippery leaves, look to the professionals at Penn Highlands Healthcare. For a list of our emergency departments, visit www.phhealthcare.org/ED, and to learn more about the many services available at Dr. Rice’s practice, visit www.phhealthcare.org/plastic.