Our Summary

This research paper is about a type of wrist bone fracture called the scaphoid fracture, which is the most common and difficult to treat. These fractures can happen even with minor injuries and often present mild symptoms, which can lead to a delay in diagnosis. If the fracture is severe and the bone is displaced, surgery is typically needed. However, minor fractures that do not involve displacement of the bone can be treated without surgery, although this decision can be influenced by the patient’s needs. The paper suggests that in the case of athletes, opting for surgery even in non-displacement cases can help them return to their sport sooner.

FAQs

  1. What are scaphoid fractures and how common are they?
  2. What are the symptoms of scaphoid waist fractures?
  3. How are displaced and nondisplaced scaphoid fractures treated, especially in athletes?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scaphoid fracture surgery is to follow the post-operative rehabilitation plan carefully. This may include wearing a cast or splint, attending physical therapy sessions, and avoiding activities that could put stress on the healing bone. It is important to be patient and allow enough time for the bone to heal properly to prevent complications such as nonunion or malunion. Following the doctor’s instructions and staying committed to the rehabilitation plan can help ensure a successful outcome from the surgery.

Suitable For

Patients who are typically recommended scaphoid fracture surgery include those with displaced fractures, fractures that are not healing with nonoperative treatment, high-level athletes who require early return to sport, and patients with significant symptoms or functional impairment. Additionally, patients with delayed diagnosis or nonunion of the scaphoid may also require surgical intervention. It is important for healthcare providers to carefully evaluate each patient’s individual circumstances and goals in order to determine the most appropriate treatment plan.

Timeline

Before scaphoid fracture surgery:

  1. Patient experiences acute trauma to the wrist, often with mild symptoms.
  2. Patient may delay seeking medical attention due to minimal symptoms and low initial disability.
  3. Diagnosis of scaphoid fracture is made through physical examination, X-rays, and possibly MRI or CT scans.
  4. Treatment plan is established based on the severity of the fracture, with displaced fractures requiring surgical intervention and nondisplaced fractures potentially being treated nonoperatively.

After scaphoid fracture surgery:

  1. Patient undergoes surgical procedure to stabilize the fracture, typically with internal fixation using screws or pins.
  2. Patient is placed in a cast or splint to immobilize the wrist during the initial healing period.
  3. Physical therapy may be prescribed to help restore strength and range of motion in the wrist.
  4. Patient follows up with regular appointments to monitor healing progress and possibly undergo additional imaging studies.
  5. Patient gradually resumes normal activities, with full recovery typically taking several months to a year.
  6. In some cases, patients may experience complications such as nonunion or avascular necrosis, requiring further treatment.

What to Ask Your Doctor

  1. What type of scaphoid fracture do I have and what are the treatment options?
  2. How long will the surgery take and what is the recovery time?
  3. What are the risks and complications associated with scaphoid fracture surgery?
  4. Will I need physical therapy after the surgery and for how long?
  5. How soon can I return to normal activities or sports after the surgery?
  6. Will I need any additional imaging or follow-up appointments after the surgery?
  7. What can I do to prevent future scaphoid fractures or complications?
  8. Are there any lifestyle changes I should make to aid in the healing process?
  9. How successful is scaphoid fracture surgery in terms of long-term outcomes and preventing future issues?
  10. Are there any alternative treatments or therapies that I should consider?

Reference

Authors: Hughes TB. Journal: Clin Sports Med. 2020 Apr;39(2):339-351. doi: 10.1016/j.csm.2019.12.007. PMID: 32115088