Our Summary

This research paper looks at the relationship between the shape of a specific wrist bone (the lunate) and how well a broken wrist bone (the scaphoid) heals, either with or without surgery. The study looked back at patients who had a broken scaphoid bone between 2014 and 2017. They examined medical records and x-rays to figure out the shape of the lunate bone, where the scaphoid bone was broken, what treatment was used, and how long it took for the bone to heal.

The researchers found two main shapes of the lunate bone in the patients they looked at. They found that patients with one type of lunate bone shape (type II) were more likely to have their broken scaphoid bone not heal properly, regardless of whether they had surgery or not. The size of the lunate bone did not seem to make a difference. In other words, if you break your scaphoid bone and have a type II lunate, you might have a higher chance of your broken bone not healing properly.

FAQs

  1. What is the relationship between the shape of the lunate bone and the healing of a broken scaphoid bone?
  2. Does the size of the lunate bone affect the healing of a broken scaphoid bone?
  3. Does having a type II lunate increase the risk of a broken scaphoid bone not healing properly after surgery?

Doctor’s Tip

Based on this research, a doctor might tell a patient with a scaphoid fracture that if they have a type II lunate bone shape, they may have a higher risk of their fracture not healing properly. In such cases, the doctor may recommend surgery to ensure proper healing and reduce the risk of complications. It is important for the patient to discuss their individual case with their doctor to determine the best course of treatment for their specific situation.

Suitable For

Based on these findings, patients with a type II lunate bone shape may be more likely to be recommended for scaphoid fracture surgery. Additionally, patients with other risk factors for poor healing, such as a large gap between the broken ends of the scaphoid bone or a significant displacement of the fracture, may also be recommended for surgery. Overall, the decision to undergo scaphoid fracture surgery is typically made on a case-by-case basis by a healthcare provider, taking into account factors such as the specific characteristics of the fracture and the patient’s overall health and lifestyle.

Timeline

Before scaphoid fracture surgery:

  1. Patient experiences a fall or trauma to the wrist, resulting in pain, swelling, and limited range of motion.
  2. Patient seeks medical attention and undergoes a physical examination and imaging tests (such as x-rays or MRI) to diagnose the scaphoid fracture.
  3. Patient may be placed in a cast or splint to immobilize the wrist and allow the bone to heal naturally.
  4. Patient may undergo conservative treatment, such as physical therapy, to help with pain and improve wrist function.

After scaphoid fracture surgery:

  1. Patient undergoes surgery to stabilize the broken scaphoid bone using internal fixation (such as screws or pins) or bone grafting.
  2. Patient is placed in a cast or splint post-surgery to protect the wrist and promote healing.
  3. Patient undergoes physical therapy to regain strength, range of motion, and function in the wrist.
  4. Patient follows up with their surgeon for regular check-ups and imaging tests to monitor the healing process.
  5. Patient may experience pain, stiffness, and swelling in the wrist post-surgery, which gradually improves with time and rehabilitation.
  6. Patient gradually returns to normal activities and sports, with full recovery typically taking several months to a year.

What to Ask Your Doctor

  1. What type of scaphoid fracture do I have, and how severe is it?
  2. What are the potential risks and benefits of scaphoid fracture surgery in my case?
  3. How long will the recovery process be after scaphoid fracture surgery?
  4. What are the alternative treatment options available for my scaphoid fracture?
  5. Will the shape of my lunate bone affect the success of the surgery?
  6. How many scaphoid fracture surgeries have you performed, and what is your success rate?
  7. What kind of rehabilitation or physical therapy will I need after scaphoid fracture surgery?
  8. What are the potential complications or long-term effects of not having surgery for my scaphoid fracture?
  9. How soon should I expect to see improvement in my symptoms after surgery?
  10. How can I prevent future injuries to my wrist, especially in relation to the shape of my lunate bone?

Reference

Authors: Hein RE, Fletcher AN, Tillis RT, Pang EQ, Ruch DS, Richard MJ. Journal: Hand (N Y). 2022 May;17(3):452-458. doi: 10.1177/1558944720937368. Epub 2020 Jul 22. PMID: 32697111