Our Summary

This research paper is about an unusual wrist injury in a young, elite tennis player. The specific bone that was fractured, called the carpal scaphoid, is commonly broken when someone falls on an outstretched arm. However, it’s unusual for this bone to get a stress fracture, which is a small crack in the bone that often comes from overuse.

In this case, the tennis player, an 18-year-old Japanese man, was practicing a specific tennis move (the attacking backhand high volley) so much that he ended up with a stress fracture in his wrist. He came to the hospital because of pain, swelling, and limited movement in his wrist. Doctors treated him without surgery and he was able to return to competitive tennis five months after the injury.

The study concludes by saying that, even though this kind of injury is rare, doctors should consider the possibility of a scaphoid stress fracture if a tennis player has chronic wrist pain.

FAQs

  1. What caused the scaphoid stress fracture in the young tennis player?
  2. How was the scaphoid stress fracture in the tennis player treated without surgery?
  3. What should doctors consider if a tennis player has chronic wrist pain based on this research paper?

Doctor’s Tip

A doctor may advise a patient undergoing scaphoid fracture surgery to follow their post-operative care instructions carefully, including keeping the wrist immobilized as directed, attending physical therapy sessions, and avoiding activities that may put stress on the healing bone. It is important for the patient to follow up with their healthcare provider regularly to monitor their progress and ensure proper healing.

Suitable For

In general, patients who may be recommended scaphoid fracture surgery include:

  1. Patients with displaced fractures: If the fracture has caused the bone fragments to separate and become misaligned, surgery may be necessary to realign and stabilize the bone.

  2. Patients with nonunion fractures: In some cases, the fractured bone may not heal properly on its own, leading to a nonunion fracture. Surgery may be needed to promote bone healing and union.

  3. Patients with avascular necrosis: Avascular necrosis occurs when the blood supply to the bone is disrupted, leading to bone death. Surgery may be necessary to remove dead bone tissue and promote healing.

  4. Patients with delayed presentation of fracture: If the fracture is not diagnosed and treated promptly, it may lead to complications such as nonunion or avascular necrosis. In these cases, surgery may be recommended to address the delayed healing process.

  5. Patients with unstable fractures: If the fracture is deemed unstable, meaning there is a risk of further displacement or complications, surgery may be necessary to stabilize the bone and prevent future issues.

It is important for patients with scaphoid fractures to consult with a healthcare provider to determine the most appropriate treatment plan based on their individual case and circumstances.

Timeline

Before surgery:

  • Patient experiences pain, swelling, and limited movement in the wrist
  • Patient seeks medical attention and is diagnosed with a scaphoid stress fracture
  • Patient undergoes non-surgical treatment, such as immobilization in a cast or splint
  • Patient undergoes regular follow-up appointments to monitor healing progress and assess pain levels

After surgery:

  • If non-surgical treatment is unsuccessful, patient may undergo surgery to stabilize the fracture with screws or pins
  • Patient undergoes post-operative rehabilitation, including physical therapy to regain strength and range of motion in the wrist
  • Patient may experience pain and stiffness in the wrist initially after surgery
  • Patient gradually resumes normal activities and may be able to return to sports or activities after a period of recovery and rehabilitation
  • Patient continues to have regular follow-up appointments to monitor healing and ensure proper function of the wrist

What to Ask Your Doctor

  1. What is a scaphoid fracture and how is it different from a stress fracture?
  2. What are the symptoms of a scaphoid stress fracture and how is it diagnosed?
  3. What are the treatment options for a scaphoid stress fracture?
  4. What are the risks and benefits of surgery for a scaphoid stress fracture?
  5. What is the recovery process like after scaphoid fracture surgery?
  6. Are there any long-term consequences or complications associated with a scaphoid stress fracture?
  7. How soon can I return to normal activities, including sports, after scaphoid fracture surgery?
  8. Are there any specific rehabilitation exercises or physical therapy that I should do after surgery?
  9. Are there any measures I can take to prevent future scaphoid stress fractures?
  10. Are there any lifestyle changes or modifications I should make to prevent re-injury to my wrist?

Reference

Authors: Kohyama S, Kanamori A, Tanaka T, Hara Y, Yamazaki M. Journal: J Med Case Rep. 2016 Jan 18;10:8. doi: 10.1186/s13256-015-0785-3. PMID: 26781295