Joe A Shaw PA-C - 2/7/2008

Question
Around 8 years ago I had an altercation with a very solid and inanimate object, receiving what is basically a boxers fracture. I had multiple fractures on the knuckle and finger area of my pinkie and ring finger on my leading hand that was hard casted.

Over time I did regain full mobility, but I highly doubt the years I have spent on the computer have done anything to help strengthen my hand.  Often times when shaking hands with anyone who has a firm grip the bone structure of my hand will compress causing mild pain.  

I've begun martial arts training over the last few months and the area continues to give me no short supply of grief.  My question is what can I do to start reconditioning the strength in my hands to limit the swelling and aching that occurs during contact.  I do properly wrap my hands and focus on correct technique with my punches.  There may also be some slight carpal-tunnel from my extended computer use over the years.

Answer
Jason,
Unfortunately your hand's fate was decided when the fractures occurred, especially what sounds like multiple fractures rather than a simple non-displaced boxers fracture. I have treated many "boxer's fractures" over the yrs. The only ones that seem to do really well..meaning little no problems yrs later are like the ones I mentioned above.
The problem with some of these fx's is it goes into the joints as well as the metacarpals (hand bones) so the joint surfaces are forever changed it seems,and over time the "unevenness" wears the joints down more so than not. You probably have arthritis setting up in these areas due to this wearing and rubbing over the yrs. I guess I would advise a evaluation with a ortho,xrays,PT referral etc..just to see where you are at.
I think you need to put ice on area after MA ( just like a pitcher after a game) You may could try different types of rubber balls tennis, racquet balls etc and squeeze these and build up reps...this is something like a PT would do. You may want to invest in a good padded fingerless glove for that hand,and explain to the Master why you need to wear it.
I doubt that if you have CTS it is from computer use. Harvard and others have pretty much disproven this as a "cause" of CTS. Certainly it (as well as other daily activities) may aggravate CTS, but thats different than actually causing it.