Our Summary

The scaphoid is the most frequently broken bone in the wrist, but it’s often hard to spot on X-rays, with up to 40% of these fractures not showing up. This can lead to complications if the fracture is not discovered and treated promptly, including the bone not healing properly or developing a serious condition where the bone tissue dies due to lack of blood supply. If initial X-rays don’t reveal a fracture, more advanced imaging techniques like CT scans or MRI scans can help with more accurate and quicker diagnosis. The best imaging method to use depends on the specific circumstances. New technologies are also being developed to improve the diagnosis and treatment of scaphoid fractures.

FAQs

  1. What is a scaphoid fracture and how common is it?
  2. What are the potential complications of delayed or misdiagnosed scaphoid fractures?
  3. What imaging techniques are used for the diagnosis and treatment of scaphoid fractures?

Doctor’s Tip

A doctor might advise a patient undergoing scaphoid fracture surgery to follow postoperative instructions carefully, including keeping the wrist immobilized and attending regular follow-up appointments to monitor healing progress. It is important to follow a physical therapy regimen to regain strength and range of motion in the wrist. It is also important to avoid putting excessive weight or strain on the wrist during the recovery period to prevent complications.

Suitable For

Patients who are typically recommended scaphoid fracture surgery include those with:

  • Displaced fractures that cannot be effectively treated with casting or splinting
  • Fractures that have not healed properly (nonunion)
  • Fractures that are at risk for developing complications such as avascular necrosis
  • Patients with high physical demands or those who require full use of their wrist for work or daily activities

It is important for patients to undergo thorough imaging studies, such as CT and MRI, to accurately diagnose the extent of the fracture and determine the best course of treatment, which may include surgical intervention. Early diagnosis and appropriate treatment can help prevent long-term complications and improve outcomes for patients with scaphoid fractures.

Timeline

Before scaphoid fracture surgery:

  1. Patient experiences wrist pain, swelling, and limited range of motion after a fall or injury.
  2. Patient seeks medical attention and undergoes physical examination and X-rays to diagnose the fracture.
  3. If the fracture is not visible on initial X-rays, advanced imaging such as CT or MRI may be required to confirm the diagnosis.
  4. Once the fracture is confirmed, the patient may be placed in a cast or splint to immobilize the wrist and allow the bone to heal.

After scaphoid fracture surgery:

  1. Patient undergoes surgery to stabilize the fracture, typically with screws or pins.
  2. Post-operative recovery includes pain management, physical therapy, and follow-up appointments to monitor healing.
  3. Depending on the type of surgery and individual healing process, the patient may require several weeks to months of rehabilitation before returning to normal activities.
  4. Complications such as nonunion or avascular necrosis may occur and require further treatment or surgery.

What to Ask Your Doctor

  1. What is the likelihood of my scaphoid fracture healing on its own without surgery?
  2. What are the risks and benefits of scaphoid fracture surgery?
  3. What type of surgery do you recommend for my scaphoid fracture?
  4. How long will it take to recover from scaphoid fracture surgery?
  5. What are the potential complications of scaphoid fracture surgery?
  6. Will I need physical therapy after scaphoid fracture surgery?
  7. How will you monitor the healing of my scaphoid fracture post-surgery?
  8. Are there any restrictions or limitations I should follow after scaphoid fracture surgery?
  9. What is the success rate of scaphoid fracture surgery in terms of full recovery and return to normal activities?
  10. Are there any alternative treatments or therapies for my scaphoid fracture that I should consider?

Reference

Authors: Amrami KK, Frick MA, Matsumoto JM. Journal: Hand Clin. 2019 Aug;35(3):241-257. doi: 10.1016/j.hcl.2019.03.001. Epub 2019 May 11. PMID: 31178083