12/13/2023 0 Comments Broken scaphoid![]() ![]() This article reviews current concepts regarding the treatment of scaphoid fractures and nonunions. Recently, vascularized bone grafts have gained popularity in the treatment of scaphoid nonunions, particularly in cases with avascular necrosis. Surgical treatment is directed at correcting the deformity with open reduction and internal fixation with bone grafting. If left untreated, scaphoid nonunions can progress to carpal collapse and degenerative arthritis. Scaphoid nonunions can present with or without avascular necrosis of the proximal pole, and may show a humpback deformity on the radiograph. Despite the advent of newly developed fixation techniques, including open and percutaneous fixation, the nonunion rate for scaphoid fractures remains as high as 10% after surgical treatment. Improvements in the diagnosis, surgical treatment and implant materials have encouraged a trend towards early internal fixation, even for nondisplaced scaphoid fractures that could potentially be treated nonoperatively. Delays in diagnosis and inadequate treatment for acute scaphoid fractures can lead to nonunions and subsequent degenerative wrist arthritis. Understanding more about injuries, gives people the power to prevent an injury from occurring in the first place.Scaphoid fractures are common, but present unique challenges because of the particular geometry of the fractures and the tenuous vascular pattern of the scaphoid. Please feel free to print out these news letters and put the in the staffroom and hand them out to your team. Physio Direct can also refer you directly for Cortisone injections, X-Rays and Ultra Sound Scans and on to Specialists if needed. Physio Direct is ACC accredited so you can come to us directly to get an injury registered with ACC without having to go to your GP first, followed by an assessment, treatment and follow up review, to ensure correct care and recovery. Always see a medical professional for advice on your injury. None of the information in this newsletter is a replacement for proper medical advice. Your physiotherapist can help you restore any deficits as well as resolve any shoulder pain or headaches that may have resulted from altered biomechanics. Following the removal of the cast or splint, there is often residual pain, stiffness or muscle weakness. Healing times will vary depending on which part of the bone has been broken. If you have a scaphoid fracture, your doctor will likely prescribe a splint or cast to ensure the wrist is kept still until healing is complete, usually for a minimum of six weeks. Though these fractures can often be treated without surgery, doctors may recommend surgical intervention for more severe cases. Occasionally scaphoid fractures will not show up on an X-ray, so if the findings are negative yet your medical team still suspect a fracture, they may wait a week then X-ray again or send you for an MRI or CT to double-check. If you suspect that you have a scaphoid fracture, you should consult your physiotherapist or GP who will refer you for an X-ray to confirm if the bone is broken. There may also be a deep, dull ache in the wrist that doesn’t settle easily. As the swelling subsides you might notice pain at the base of the thumb when opening jars or gripping objects. Symptoms of a broken scaphoid include wrist pain, swelling, bruising or discolouration of the skin over the injured area and difficulty moving the wrist or hand. It is more common in young adults than in children and the elderly. Scaphoid fractures are notorious for their high incidence of complications healing due to low blood supply to the area and how easily their diagnosis can be missed.Ī scaphoid fracture is often caused by a fall on an outstretched hand or a direct blow to the wrist. Scaphoid fractures are a relatively common wrist injury and are commonly misdiagnosed as the pain can be quite mild even when the bone has been broken. The scaphoid is a small bone in the wrist that connects the radius to the hand, and it is situated near the thumb. ![]()
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