Scaphoid Bone Fracture Surgery

The scaphoid bone is one of the bones in the wrist. It is between the hand and forearm on the thumb side of your hand, it is a small bone that is connected to several other bones in the wrist. The scaphoid bone can take a long time to heal because it has a limited blood supply. It’s important to treat early to ensure it heals correctly.

Scaphoid fractures present a special problem because they are difficult to diagnose initially, and the poor blood supply hampers healing. It may be necessary to place the injured wrist inside a cast for an extended period of time, up to 3 months, in order to allow the fracture to heal. If the wrist does not heal, then surgical treatment may be necessary.

What are the symptoms of a fracture?

The scaphoid fracture usually results in soreness in the “snuff box” (which is where people used to inhale snuff from, at the base of the thumb on the top side towards the wrist). The pain can be quite mild or severe, and might only present itself when moved in a particular motion.

Bruising and swelling may also be prominent. It’s very important to see your doctor if you have any pain in the snuffbox after a fall.

How do I treat the pain before seeing the doctor?

Rest, it’s important you rest your wrist until you can get to the doctors, it should not be used. You can apply ice which may help reduce the pain and take anti-inflammatory medication as long as you take with or after food. You could apply a compression bandage also which may assist.

What happens when I go to the doctor?

Your doctor may instruct you to have an X-Ray, however, not all fractures can be seen on an X-Ray. You may require a CT scan or MRI to diagnose the problem.

Your doctor may prescribe some pain management for you and may put it in a cast. Once the issue is diagnosed your doctor will begin treatment.

How will it be treated?

Generally, it will be immobilized with a cast to start with. Speaking from personal experience, I was immobilized with a cast first, and once the CT scan showed that it was indeed fractured I was put in a thermoplastic splint and referred to a hand specialist. Treatment time can be 6 weeks to 3 months or more. If the bone is broken, you may require surgery.

Scaphoid Surgery

Your wrist has a bunch of bones all jumbled together at its base which allows the wrist to operate and move the way it does. While they are the reason for their versatility, they can also be the wrists downfall.  Imagine wrists as a brave Othello being slowly torn down and destroyed by the evil… uh… I’m sorry, I can’t think of what Iago would be in this situation.

A wrist hammer?  It was a weak metaphor, to begin with. That’s what you get when you mess with Shakespeare.

Anyway, the bone lying at the base of the thumb and is adjacent to the radius, the main bone in your forearm. It has a few features that make it the easiest bone to break in the wrist bone complex.

Part of that is its shape, which is kind of bent like a boat. Also, it’s a little bit larger than most of the other bones in the wrist. Also, it’s located in a spot that can be particularly prone to injury because of its proximity to the thumb.

Then there’s the fact that it doesn’t heal well on its own because there is kind of a low amount of blood getting to it most of the time. It’s generally a pain to treat, and a lot of the time, an injury of the scaphoid requires surgery, while other major bones would only require a cast.

Because it doesn’t heal well on its own, casting doesn’t work as well as one would like, though there are plenty of situations in which a cast would work on a mild fracture.

The good news is that it’s not as painful as other breaks, but because it doesn’t heal quickly, treatment is usually more heavy-handed (bam!) because it’s relatively easy for arthritis to form as a result of the scaphoid surgery.

It’s also possible that it just won’t heal, or it will heal wrong, which is generally not what one wants. So basically, scaphoid surgery is relatively common.

The way it works is fairly simple, and it’s not super invasive, because this particular bone lies right near the exterior of the hand. Usually, what they will have to do is connect the two parts together and bind them there to make sure they can heal properly and don’t cause further problems.

 A lot of the time, the problem is simply that casting a scaphoid wound won’t actually bring the two separated parts back together, because the pressure from both sides is limited.

I should note here that I looked this up on WebMD, and under “causes,” they wrote “punching incident,” among other things, which I find amusing. Really, if you break your bones punching someone, it’s your fault for not having good form.

As it is, you generally want the form of a punch to deliver most of the weight of the blowdown to your elbow, and you do that by having your fist lined up with the rest of your arm. I mean, I can see trying to punch someone and having the fist glance off and maybe hit something else, which could bend your wrist and hurt you that way.

But really, I think it would be smarter to just not punch anyone or to not get into a situation where you might have to fight someone, and that will save you the trouble of getting this surgery.

If it’s not totally apparent by now, I feel I should probably mention that I am not in any way a doctor or have any medical qualifications. I’ve written a decent number of medical articles, but as you can see, I usually get hung up on Othello or punching, which I think shows my amateurism not only at medical issues but also at writing in general.

With surgery, a wire or a screw may be necessary in order to keep the bone stable while it continues to heal. Usually, the surgeon will have the incision on the back of the front portion of the wrist.

Using a very small incision is preferable for you so you do not have a scar, and if this is possible, wire or screw may be put into the fragments of the bone. After the scaphoid surgery is completed, the wrist will still need to be placed into a cast.

It will still be necessary for you to keep the wrist stabilized and not use it so that it has enough time to heal properly.

In some cases, the scaphoid bone may not heal correctly, even after surgery. This may be due to there not being enough blood supply to the bone. In this situation, your surgeon may discuss utilizing a bone graft in order to assist the bone with healing.

A CT scan or an MRI may be ordered to assist the surgeon with being able to visualize what is happening with the bone and how to fix it. If a bone graft is necessary, the surgeon may need to take a bone graft from your pelvis, your forearm, or the surgeon may opt to use a manufactured bone graft.

It is very important that the scaphoid bone heals properly. When it does not, it may lead to arthritis located in the wrist. Arthritis of the wrist can lead to a number of problems, such as general aching in the area, trouble gripping items and holding them, and not being able to move the wrist as effectively.

It is important to remember that if you just need a cast to stabilize the wrist or if you are wearing a cast following surgery, you need to give your wrist the rest it needs in order to heal properly. This means that you will need to take it easy for a while.

This may mean that you will have to limit your activities for about six months. This length of time will vary based on the severity of your fracture, but be sure to speak to your doctor about your rehabilitation so that you do not cause further injury to your wrist and you allow it to heal.

Anyway, you shouldn’t use this article as medical advice – really, you shouldn’t use anything online as medical advice – what you should really do is see a doctor about any problems you might be having.

That said, you should get checked out for a scaphoid fracture if you recently hurt your wrist in some way, and if you feel soreness in your wrist or have bruises right around the base of your thumb on your wrist. Also, if you have trouble using your wrist, that’s bad too.

Scaphoid surgery is usually avoidable if you make sure you get it taken care of early on in the injury.  Otherwise, it’s only going to get worse, as it has a lot of trouble healing on its own.  So if you feel the symptoms of a scaphoid fracture, try and get it taken care of pronto, or you’re putting the future of your wrist at risk!  Wrist at risk.  That could be made into a tongue twister.  I should go.

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