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Interview with Orthopedic Surgeon Richard S. Gilbert, M.D. of
Mount Sinai School of Medicine Department of Orthopaedics

 

Dr. Gilbert specializes in hand and upper extremity surgery.

 

Q. Dr. Gilbert, what kind of snowboard and ski injuries are you seeing lately?

 

A. The most common snowboard injury is a wrist injury. [Editor's note - up to 100,000 snowboard wrist injuries occur each year worldwide.] 62% of all fractures in snowboarders are wrist fractures. Snowboard injuries to the upper extremities (hand, arm shoulder) vary from fractures that requires a cast, to injuries requiring surgeries.

 

For snowboarders, fractures of the distal radius (main bone toward wrist) are the most common due to falling forward onto outstretched hands.

 

There are different kinds of injuries besides fractures. There is also the ligamentous injury or sprain. This can be a small stretch of the ligament, or a complete rupture.

 

Q. How is the sprain repaired?

 

A. Sprains are usually sutured back into place. Sometimes with an incision (cut) or sometimes orthoscopically (tiny incision with camera and tools inserted.)

 

Studies show that the most common ski injury is to the thumb ligament. Skiers have more knee injuries than upper body injuries.

 

Q. How are fractures repaired?

 

A. Fractures can be treated surgically or non-surgically depending on the injury. If the bone is really out of position, it needs to be placed back into position with metal pins or plates and screws. These devices may stay in, or may be taken out. Sometimes we drive a pin through the skin and just cut off the part that sticks out past the skin.

 

Q. What kind of recovery can patients expect?

 

A. It depends on the injury. If it's a cast injury it needs about 6 weeks of immobilization, and 6 weeks of rehab. For injuries that need surgery, it depends on the type. Fractures generally fare better than ligament wounds. Bone heals better. Patients may be at risk of arthritis in the future, or stiffness.

 

Q. What about growth plate fractures?

 

A. Growth plate fractures happen in the young (skeletally immature) because the growth plate is the weakest point. It is less common to have to operate on those. Usually growth plate injuries require just pushing them back into place. With children's fractures, the biggest risk is that you can have an injury that impairs future growth.

It is important to push the growth plate displacement back into place within 24 hours to avoid permanent injury. With an older person, the timing is not as critical.

 

Q. What do you think about snowboard wrist guards?

 

A. I have never seen a patient with a wrist fracture who was wearing a wrist guard. Though I have seen many patients who say "I wish I was wearing a wrist guard." Certainly wrist guards have been shown by studies to reduce injury.

 

Q. What about the "hard core" snowboarders who want to ride before their injuries are healed?

 

A. I would not recommend a person who has a fracture to snowboard. Before it's healed you can convert a non-displaced fracture to a displaced fracture.

 

Thanks Dr. Gilbert!

 

 

Richard S. Gilbert, M.D. is a Board Certified Orthopedic Surgeon specializing in surgery of the hand and upper extremity. He has a Certificate of Added Qualification (CAQ) in hand surgery. After receiving a Bachelors degree from the John Hopkins University, he went on to obtain his medical degree from the Mount Sinai School of Medicine. He completed his residency in Orthopedic Surgery at the Mount Sinai Hospital. He further sub-specialized as a hand and upper extremity fellow at the Yale University School of Medicine.  

Dr. Gilbert is a clinical assistant at the Mount Sinai School of Medicine and a vital member of the hand surgery service. He is actively involved in the education of residents and medical students on the orthopedic surgery and hand surgery services. In addition to general orthopedics, his specialty interest is in the reconstruction and treatment of fractures, soft tissue injuries, and neuropathies involving the hand and upper extremity. Outside of medicine, his interests include reading, music, sports and photography.

 

"Let's Ride!"

 

 

 

 

 

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