Our Summary

This study took place at Queen Mary Hospital in Hong Kong between 2007 and 2011. It involved four patients who had a specific type of wrist bone fracture that was not healing properly. The researchers treated these patients with a surgical procedure that involved repositioning the bones and securing them with screws or plates. Additionally, a bone graft from the hip bone and a special substance from the patient’s own blood known as Platelet Rich Plasma (PRP) were used to promote healing. The aim of this treatment was to help the bone fuse together properly while also relieving pain and restoring normal movement. The study found that all four patients experienced successful bone healing, pain relief, and regained normal wrist and thumb movement following this treatment. As a result, the researchers recommend this procedure for similar cases where the wrist bone fracture is not healing as it should.

FAQs

  1. What is the purpose of using Open Reduction and Internal Fixation (ORIF) supplemented with Bone Graft (BG) from iliac crest and Platelet Rich Plasma (PRP) in treating scaphoid fracture non-union?
  2. What was the average age and follow-up period of the patients included in the scaphoid fracture study at Queen Mary Hospital, Hong Kong?
  3. What were the outcomes for patients treated with ORIF, BG, and PRP for non-union scaphoid fractures?

Doctor’s Tip

A doctor might tell a patient undergoing scaphoid fracture surgery to follow post-operative instructions carefully, including keeping the wrist immobilized and participating in physical therapy as recommended to aid in the healing process and regain strength and range of motion. It is important to attend follow-up appointments to monitor healing progress and address any concerns promptly. Additionally, maintaining a healthy lifestyle, including proper nutrition and avoiding smoking, can help support the healing process and reduce the risk of complications.

Suitable For

Patients who are typically recommended scaphoid fracture surgery are those who have non-union of the fracture, meaning the fractured bone has not healed properly on its own. These patients may experience persistent pain, limited range of motion in the wrist or thumb, or other symptoms that affect their daily activities. The surgery, known as open reduction and internal fixation (ORIF), is often supplemented with bone graft from the iliac crest and platelet-rich plasma (PRP) to promote healing and achieve union of the fractured bone. This treatment approach has been shown to be effective in achieving pain-free range of motion in the wrist and thumb in patients with scaphoid fracture non-union.

Timeline

Before scaphoid fracture surgery:

  1. Patient experiences pain, swelling, and limited range of motion in the wrist.
  2. Patient undergoes X-rays and possibly MRI to diagnose scaphoid fracture.
  3. Patient may undergo a period of immobilization with a cast or splint.

After scaphoid fracture surgery:

  1. Patient undergoes open reduction and internal fixation (ORIF) surgery to stabilize the fracture.
  2. Bone graft from iliac crest and Platelet Rich Plasma (PRP) may be used to promote healing.
  3. Patient undergoes post-operative rehabilitation, including physical therapy to regain strength and range of motion.
  4. Follow-up appointments and X-rays are scheduled to monitor healing progress.
  5. Patient achieves union with pain-free range of motion in the wrist and thumb.

What to Ask Your Doctor

  1. What is the success rate of scaphoid fracture non-union surgery with open reduction and internal fixation (ORIF) supplemented with bone graft and platelet rich plasma (PRP)?

  2. What are the potential risks and complications of the surgery?

  3. How long is the recovery period after the surgery?

  4. Will I need physical therapy or rehabilitation after the surgery?

  5. What is the expected outcome in terms of pain relief and range of motion after the surgery?

  6. How long will I need to wear a cast or splint after the surgery?

  7. Will I need any additional follow-up appointments or imaging studies after the surgery?

  8. Are there any restrictions on activities or movements after the surgery?

  9. Will I need to take any medications after the surgery for pain or to prevent infection?

  10. What are the alternatives to surgery for treating scaphoid fracture non-union?

Reference

Authors: Aslam MZ, Ip J, Ahmed SK, Fung B. Journal: J Pak Med Assoc. 2021 Aug;71(Suppl 5)(8):S103-S106. PMID: 34634028