Our Summary

This research paper is about the best way to treat a specific type of wrist bone break (scaphoid fractures) that happens often in high-level athletes. The researchers recommend fixing these breaks quickly, especially if the bones have moved out of place, to help the athletes get back to their sport as soon as possible.

They suggest using computed tomographic (CT) scans for all scaphoid fractures. This is a type of X-ray that can create detailed pictures of the bones, which can help doctors understand exactly how the bone has broken and where to best place screws to hold the bones together while they heal.

The position of the screws is crucial to how well the fracture heals and when the athlete can return to their sport. The researchers also suggest using CT scans after the operation to check how well the fracture is healing. This could potentially allow athletes to start playing their sport again sooner.

FAQs

  1. Why are CT scans recommended for all scaphoid fractures?
  2. How does screw placement aid in the healing of a scaphoid fracture?
  3. Can postoperative CT scans influence the timeline for an athlete to return to play?

Doctor’s Tip

One helpful tip a doctor might give a patient about scaphoid fracture surgery is to follow postoperative care instructions closely, including wearing a splint or cast as directed, attending physical therapy appointments, and avoiding activities that may put excess strain on the healing bone. Compliance with these guidelines can significantly impact the success of the surgery and the speed of recovery.

Suitable For

Patients who are typically recommended scaphoid fracture surgery include:

  1. Elite athletes with displaced scaphoid fractures: Surgery is often recommended to expedite the healing process and allow for a quicker return to full function.

  2. Patients with minimally displaced scaphoid fractures: In some cases, surgery may be recommended to ensure proper healing and prevent complications such as nonunion or avascular necrosis.

  3. Patients with scaphoid fractures that have not healed with conservative treatment: Surgery may be recommended to promote healing and restore wrist function.

  4. Patients with complex scaphoid fractures: Surgery may be necessary to address more severe fractures that cannot be effectively treated with conservative measures.

  5. Patients with scaphoid fractures that are at risk for complications: Surgery may be recommended for fractures that have a higher risk of nonunion or avascular necrosis, such as fractures with poor blood supply.

Overall, the decision to recommend scaphoid fracture surgery is based on the individual patient’s specific circumstances, including the severity of the fracture, the patient’s activity level, and the potential risks and benefits of surgery. It is important for patients to discuss their treatment options with a qualified orthopedic surgeon to determine the most appropriate course of action.

Timeline

Before scaphoid fracture surgery:

  1. Patient experiences wrist pain and swelling after a fall or injury.
  2. Patient may have difficulty gripping or moving their wrist.
  3. X-rays are taken to confirm the scaphoid fracture and determine the extent of displacement.
  4. Patient may undergo a CT scan to further evaluate the fracture anatomy and plan for surgical fixation.

After scaphoid fracture surgery:

  1. Patient undergoes surgery to fixate the fracture with screws or pins, typically within a few days to a week after the injury.
  2. Patient is placed in a splint or cast to immobilize the wrist and promote healing.
  3. Physical therapy may be recommended to regain strength and range of motion in the wrist.
  4. Follow-up appointments are scheduled to monitor healing progress and possibly undergo postoperative CT scans.
  5. Patient gradually resumes normal activities and may be able to return to sports or other physical activities within a few months, depending on the extent of the fracture and individual healing process.

What to Ask Your Doctor

  1. What are the risks and potential complications of scaphoid fracture surgery?
  2. How long is the recovery time after scaphoid fracture surgery?
  3. Will I need physical therapy after surgery, and if so, for how long?
  4. What restrictions or limitations will I have during the healing process?
  5. How soon can I return to normal activities, including sports or physical activities?
  6. Will I need any follow-up appointments or imaging tests to monitor the healing of the fracture?
  7. What type of anesthesia will be used during the surgery?
  8. How many scaphoid fracture surgeries have you performed, and what is your success rate?
  9. Are there any alternative treatments or non-surgical options for my scaphoid fracture?
  10. What can I do to help promote healing and prevent future wrist injuries after the surgery?

Reference

Authors: Jernigan EW, Morse KW, Carlson MG. Journal: Hand Clin. 2019 Aug;35(3):365-371. doi: 10.1016/j.hcl.2019.03.011. PMID: 31178093