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Publication: Combat Edge
Date published:
Language: English
PMID: 32896
ISSN: 10638970
Journal code: FCBT

One Wednesday morning my wife called me at work angry at our 16-year-old son (again). He'd stayed home from school that day because he was "sick." We knew his sickness was related to being up late the night before texting and talking to his girlfriend. Being the dutiful husband and father, I headed home to resolve the conflict. It was after 1100 before my son finally dragged himself out of bed. I waited until he was out of the shower and eating lunch to have a fatherly chat with him.

This wasn't the first time in recent weeks we'd had to sit together to talk about aspects of his behavior. The relevant point to this story was that we discussed the consequences of the choices we make. I mentioned that one of the foibles of youth was not realizing that all actions have a consequence. Kids (and most adults) don't consider what those consequences will be before performing an act - it's all about the moment to them. Of course, since I was his father (and by definition an idiot), nothing I said seemed to have any effect on him.

A couple of days later he had baseball conditioning. On this particular night he popped into the house after the conditioning with one of his friends and they went straight up to his bedroom. It was very unusual for this particular friend to be over so late and piqued my curiosity. About an hour later my son came down holding his right hand and told me he thought it was broken. As testament to that, it was black and blue and swollen with dried blood on the knuckles. I had him put ice on his hand then asked what had happened. He told me they'd been split into teams and were doing relays when one of his team members fell out because he was tired. My son was the team captain so he had to run double stints in the other boy's place. His team was losing and he was getting frustrated so he decided to take his frustration out on the bleachers. Well, as it turned out, the bleachers weren't the pushover my son thought they'd be.

We went to the Urgent Care Center and after x-rays the Doctor informed us he'd broken the fifth metacarpal (the bone of the hand right below the little finger). They splinted his hand and gave us a follow-up appointment with the Orthopedics Clinic for a couple of days later. At the Orthopedics appointment, we got a CT scan and found out it wasn't just a simple break (a boxer's break) as we'd assumed. My son had compressed the base of the metacarpal into the joint and mushroomed the end. Not only that, it had displaced, meaning the bones weren't lined up anymore. After some vacillating, the Orthopedic Surgeon finally decided he could probably yank the bone back into the correct position by hand but decided his best course of action was to take my son into the operating room, cut open the hand to get a good look at the break, and then visually align it. He said he'd probably end up putting a plate with a couple of pins to ensure everything stayed In place and healed right. My son turned to me and said he thought he'd only have to get a cast. His eyes told me he'd just learned a valuable lesson.

The day of the surgery came as anticipated. My son got the prep about 1000 hrs and they kicked me out about 1030 to take him into the operating room. My wife and I expected it to take about an hour but the minutes kept ticking by. Passing 2 hours we were getting more than a little worried.

It was well after 1300 when the surgeon finally came out to tell us how the procedure had gone. He told us he'd initially tried to put everything back into position by yanking and pulling as hard as he dared but just couldn't get it to go where he wanted it or where it needed to be. He ended up cutting open the hand and then had to remove some tissue (muscle) that was keeping the bones out of position. With the hand opened up he was able to manipulate the bones to where they needed to be then finished it off with four pins to hold his handiwork all together, one of them going more than halfway through the hand. He showed us a series of before, during, and after pictures so we could see he'd gotten everything lined up the way they were supposed to be. He told us the pins would get pulled out in his office after about a month of healing.

A week later we went back to the Orthopedic Clinic to have the splint removed and a cast put on. Coincidently, there was a 20-yearold Navy Seaman there getting his right hand cast. He'd broken it punching a file cabinet at work. Luckily for him, however, his was a simple break without the extra pins/surgery/etc. Evidently filing cabinets are a little more forgiving than bleachers.

My son got his cast cut off and pins pulled about 3 weeks later. The doctor had to yank on the pins pretty good to get them out. It looked painful to me but my son said it just felt weird. Of course he wanted to keep the pins as souvenirs but the doctor didn't let him. Overall, the hand looked good and was healing as expected but they put him into another cast for a couple of more weeks to finish up the process. Time will tell if there are any adverse effects from the repair. For now, he's working on getting the strength and movement back so it doesn't affect the Spring baseball season.

Actions have consequences! All too often we pay the price because of hasty or ill thought out decisions. Even when proper risk management is performed, adverse consequences result. At least in those cases the act was performed after careful consideration of the consequences (hopefully). Punching bleachers (or file cabinets for that matter) is a no-win situation. They don't feel a thing, but your hand surely will. Like I told my wife the day it happened, my son wasn't the first to break his hand punching an immovable object and he won't be the last. Did my son learn a lesson that day? Only time will tell, but he's already down 1-0.

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