Our Summary

This research paper is a review of different studies that provide clear data about the success rates and functional outcomes of various treatments for a certain type of bone problem in the wrist. Specifically, it’s looking at conditions called “scaphoid nonunion” and “malunion”. These occur when a broken scaphoid bone (one of the small bones in the wrist) either doesn’t heal (nonunion) or heals incorrectly (malunion). The paper highlights that the methods of treating these conditions have significantly changed since a technique was modified in 1960.

FAQs

  1. What is the current method of treatment for scaphoid nonunion and malunion?
  2. How has the treatment of scaphoid nonunion and malunions changed since the 1960 modification of Matti’s technique by Russe?
  3. What kind of data on union rates and functional status is presented in the review of scaphoid fracture surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scaphoid fracture surgery is to follow a strict rehabilitation plan post-surgery to ensure optimal healing and regain full function of the wrist. This may include wearing a splint or cast, attending physical therapy sessions, and avoiding activities that put excessive strain on the wrist until fully healed. It is important to follow all post-operative instructions provided by your healthcare provider to achieve the best possible outcome.

Suitable For

Patients who are typically recommended scaphoid fracture surgery are those who have a scaphoid nonunion or malunion that is causing significant pain, limited range of motion, and functional impairment. Surgery may also be recommended for patients with a displaced or unstable scaphoid fracture that is at risk of nonunion. Additionally, surgery may be considered for patients who have failed conservative treatments such as immobilization and physical therapy. It is important to consult with a hand surgeon to determine the most appropriate treatment plan for each individual patient.

Timeline

Before scaphoid fracture surgery:

  1. Patient experiences a fall or other traumatic injury that results in a scaphoid fracture.
  2. Patient may experience pain, swelling, and limited range of motion in the wrist.
  3. Patient undergoes diagnostic imaging such as X-rays or MRI to confirm the fracture.
  4. Patient may be placed in a cast or splint to immobilize the wrist and allow the fracture to heal.
  5. If the fracture does not heal properly or if there are complications such as nonunion or malunion, surgery may be recommended.

After scaphoid fracture surgery:

  1. Patient undergoes surgery to realign the fracture, stabilize the bone with screws or pins, and promote proper healing.
  2. Patient may be required to wear a cast or splint for several weeks to protect the wrist and allow the bone to heal.
  3. Patient undergoes physical therapy to regain strength, flexibility, and range of motion in the wrist.
  4. Follow-up appointments with the surgeon are scheduled to monitor healing progress and remove any hardware used in the surgery.
  5. Patient gradually returns to normal activities and may experience improved function and reduced pain in the wrist.

What to Ask Your Doctor

  1. What is the specific type of scaphoid fracture I have and why do I need surgery for it?
  2. What are the risks and potential complications associated with scaphoid fracture surgery?
  3. What is the expected recovery time and rehabilitation process after surgery?
  4. What type of anesthesia will be used during the surgery?
  5. How long will I need to stay in the hospital after the surgery?
  6. Will I need to wear a cast or splint after the surgery, and for how long?
  7. What are the expected outcomes of the surgery in terms of pain relief and functional improvement?
  8. Will I need physical therapy after the surgery, and if so, for how long?
  9. Are there any restrictions or limitations I should be aware of after the surgery?
  10. What is the success rate of scaphoid fracture surgery in terms of achieving proper healing and functional restoration?

Reference

Authors: Janowski J, Coady C, Catalano LW 3rd. Journal: J Hand Surg Am. 2016 Nov;41(11):1087-1092. doi: 10.1016/j.jhsa.2016.08.019. Epub 2016 Sep 23. PMID: 27671767