Seen at Zoom: The #1 Bike Injury (It's Not a Broken Wrist)

August 11, 2020

Seen at Zoom

In June and July, bike crashes send people to Zoom twice as often as any other month. Which isn’t that surprising. Here’s what is: The most common injury isn’t a broken wrist. Nor is it a broken collarbone.

What happened

Our clinic data shows that when Portland cyclists kiss the pavement, the most frequently fractured bone is the unsuspecting elbow. Or, more specifically, the radial head and radial neck — two parts of the radius bone in your forearm closest to your elbow joint.

An x-ray of a radial head fracture

"I’m seeing 5 to 10 radial head fractures from bike crashes, every week — and that’s just at our clinic in the Pearl," says ZOOM+Care Orthopedic Surgeon Carolyn Yang, MD.

Why it happens

“The bone density in different parts of your skeleton changes throughout your lifespan,” explains Dr. Yang. “In your 20s and 30s, your wrists are strong — they can sustain quite a bit of high-energy trauma.”Your radial head and neck aren’t so tough.“The impact of your hand hitting the ground travels up your forearm, where it hits a fixed point at the elbow,” says Dr. Yang. “And that’s where the damage happens.” The head or neck of the radius bone fractures and sometimes fragments.”

What to do if it happens to you

Pay close attention to arm pain after a bike crash instead of blowing it off and hoping it goes away. “One sign of a radial head fracture is pain when you attempt to extend your arm,” says Yang. “But an Orthopedic doctor will have to give you an exam and x-ray to determine the severity of the fracture.”Treatment for fractures usually involves a splint or sling for a few days or weeks, followed by a slow, steady increase in movement — often supervised by a physical therapist. “Too much moving or lifting can cause the bones to separate again,” says Yang. In the worst cases, bones will have to be held together with screws or a plate, bone fractures will have to be removed surgically, or the radial head may have to be replaced.

Wait… can’t you prevent it from happening?

Sure: Don’t crash your bike. Otherwise, probably not. “Extending one or both arms to break a fall is something we do instinctively to protect our heads, which is good,” says Yang. “If you can think to do one thing as you go down, bend your elbows, which will reduce the impact on the joint.”Got broken bones or banged up joints? Schedule a same-day, no-wait visit for Orthopedics.[Feature photo by Neal Fagan, via Unsplash. Inset photo by James Heilman, MD]

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