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four-corner fusion of the wrist (avascular necrosis of the scaphoid)
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four-corner fusion of the wrist (avascular necrosis of the scaphoid)

Hello, I have developed somehow an avascular necrosis of the scaphoid. The condition happens when the the scaphoid is broken and one of the parts is not supplied with blood and dies. The only good news is that it was not on my right hand, since I'm right handed. The doc wants now to do a partial fusion of the wrist, with excision of the scaphoid and fusing the other 4 bones on the top of the wrist to provide stability. The excision of the scaphoid is said to be the only solution with partial fution of the wrist since I have alredy developed arthritis on the concerned wrist.  

My current situation is the following: almost no extention or flexion on the wrist; all other movements intact. If I keep the hand continuously in a splint i'll have no pain, but if i take it out i'll have pain in a very short time, doing even minor tasks.

Since I am quite young (29yrs) I am wondering what should I do. I dont want to live in pain, but I also know that this surgery will probably not be the end of this story. I know about this since the beginning of the year, and since then I've also done almost no sports. Before that I did sports almost every day.

My question is: has anyone here experience with partial fusion of the wrist? (four-corner fusion). Would you recommend it? What was the outcome?

Thanks a lot in advance,

Lerry  
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104 Comments Post a Comment
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Avatar_dr_m_tn
For avascular necrosis you cannot revive the bone so the movements at your wrist are restricted now.
So the solution as your orthopaedician has suggested in bone fusion to help you out with proper movements.

You would need physiotherapy after the fusion and you will slowly get some movements but the range of movements will never be similar to as before.

Discuss all the pros and cons and do's and dont's with your operating surgeon and we advice you to choose a person who is adept in this and has expirience. Take care!
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1000775_tn?1256918922
Hello Dr Vinod,

Thank you for your reply.

I am well aware of the fact that the wrist will never be as before, and I have at this point quite a lot of information about the 4-corner procedure. The thing that I fear the most are >> the complications from this surgery <<. Since I am 29 and I plan to live a long, healthy life, I'd like to avoid problems down the line.

Nowadays I have almost no extention or flexion movements. If I wear a wrist split and do no sports besides jogging (before did sports almost every day), I'll have no pain. But I also would not like to be wearing a wrist splint for the rest of my life. I also have to wear the splint while sleeping, so that I do not bend it accidentally.

I have read a lot of bad stuff on the internet about the spider plate too, so I wonder if it would be better to use K-Wires instead of the plate.

Given the X rays of my wrist I posted on my profile (one from Jan 2009, the other one from Aug 2009, so just from 15 days ago) and what I have described, what would you suggest, as a physician? Would you go for the surgery or continue wearing a splint? What is also your opinion about the spider plate? Is it reliable?

Thanks again in advance for your support,

- Lerry
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Avatar_dr_m_tn
We were trying to advice you that the procedure if done by experts is problem free and there is no need to wear a splint all your life.

It is your decision for going for the fusion surgery. If you go for it we can say that your quality of life will improve.

Some precautions should be taken, as you should not lift heavy weights, you cannot pull heavy weights but other activities are fine.

With Physiotherapy and over a period of time you will gain strength in your wrist but what we mentioned was it will never be same as before.

The plates and wires are all depending on case to case and surgery and leave it to the   expert. ( You can always suggest your operating surgeon about wires)

Take care!
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1027575_tn?1390964018
Hi lerry, first off i'm at a point of having my wrist fused. i'm in constant pain. the questions i have to ask myself is with a partical fusion will i have arthritis in a few years in the area not fused and will i have to go through this all again. i like you am extreemly active or at least was.  i am leaning to have a full wrist fusion.  i wouldn't listen to a thing that doctor responded to you.  look at his back ground he's a general practioner, he's not a orthpedic doctor. about a month has gone by since the post so i would be interested what you decided,  thanks   Phill
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Avatar_m_tn
I too am faced with inevitable four corner fusion or proximal row carpectomy.  I broke my schaphoid 40 years ago and never knew it.  it's been painful for 30 years, and now necrotic and collapsed it is time.

I'm very glad to see this string as I have searched the internet for years for information and support with this problem.  I am an avid surfer, gardner, and guitar player and treasure the use of my hands.  

I want to talk to others who have been through this and can provide support and advice on procedures, doctors, etc. (I had my hip replace 2 years ago and there were numeroous web-based bulletin boards with tons of information and support.)  I have not found that for SNAC wrist problems.

Any suggestions?  If there is no group we should create one....there are others out there who need it too.
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Avatar_m_tn
I too am faced with inevitable four corner fusion or proximal row carpectomy.  I broke my schaphoid 40 years ago and never knew it.  it's been painful for 30 years, and now necrotic and collapsed it is time.

I'm very glad to see this string as I have searched the internet for years for information and support with this problem.  I am an avid surfer, gardner, and guitar player and treasure the use of my hands.  

I want to talk to others who have been through this and can provide support and advice on procedures, doctors, etc. (I had my hip replace 2 years ago and there were numeroous web-based bulletin boards with tons of information and support.)  I have not found that for SNAC wrist problems.

Any suggestions?  If there is no group we should create one....there are others out there who need it too.
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1000775_tn?1256918922
I decided to have my four corner fusion; so lets see what will be the result. If I am mistaken; I will suffer with this decision the rest of my life. I got tired of listening to what people say; you will hear as many people saying you should do it as people saying you shouldnt. so it is about time to go by myself. will be 1 month in a cast, and hopefully all will be all right at the end
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1000775_tn?1256918922
Here is a video of a 4-corner fusion:

http://www.orthop.washington.edu/UserFiles/Media/faculty/Trumble/arthritissurgery/03/a/spider.mov

And here is some more information

http://www.orthop.washington.edu/UserFiles/Media/faculty/Trumble/arthritissurgery/03/a/spider.mov
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1000775_tn?1256918922
hi kriyamon, if you are leaving this long with a snac wrist you will probably need a total wrist fusion... a 4 corner fusion is called a partial arthrodesis of the wrist that can be performed given your other metacarpal bones did not go moved so that they occupy the space of the collapsed scaphoid... if this is the case (if the other bones already sunk on the space where the scaphoid was), only total wrist fusion can do it... this usually happens if you live a long time with this problem without doing much about it, and maybe this is your case.
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1000775_tn?1256918922
hi kriyamon, if you are living this long with a snac wrist you will probably need a total wrist fusion... a 4 corner fusion is called a partial arthrodesis of the wrist that can be performed given your other metacarpal bones did not go moved so that they occupy the space of the collapsed scaphoid... if this is the case (if the other bones already sunk on the space where the scaphoid was), only total wrist fusion can do it... this usually happens if you live a long time with this problem without doing much about it, and maybe this is your case.
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Avatar_n_tn
I also have avascular necrosis of the scaphoid and have been doing a lot of research on the internet.  I was curious if you finally got your partial fusion surgery and how it went.  I have been also reading about scaphoid replacement surgery, was that an option you considered?  I just found out a few days ago that the pain I have been experiencing for years may haunt me forever and I am really trying to find out the best options available to me.
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1000775_tn?1256918922
hi sozestail, i will get my surgery on monday, so in 3 days from today!!! f***, i am really nervous; cannot sleep and so on... thought about cancelling it, but that would be really bad for the docs, for the hospital and maybe for me, since i think the insurance would charge me for this last minute decision... anyways, now lets go for it. the thing that worries me the most is that i have not much pain, even though i have almost no flexion or extension on my hand now; my hand is at a point that it already does not move much up or down, so i have little pain. i cannot do any kinds of sports, though; only jogging is ok. so lets say, if you could imagine 3 stages: one where you are normal; one where your wrist if f*** up but you have no pain; and the last stage as the one with your wrist f*** up and you have pain; I am on the middle one. of course with this surgery i would like to improve as much as possible; but no doc would give me any guarantee; so at the end you are by yourself... it is a kind of a gamble with more chances of improvement than otherwise... will keep you posted...
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Avatar_n_tn
I hope your surgery went well :).  If you couldn't move your wrist well to begin with whats the harm in a little fusion surgery.  I think am in the third stage, constant pain, my scaphoid is almost completely collapsed.  I have been looking more into wrist replacement, but not too many doctor's do that.  I am trying electrotherapy now, we'll see how that goes, but it may be a little too late in the game.  I sure wish I would have taken care of this sooner, if only I had insurance when the injury occured.  Two years later and I have a permanently bum wrist at the ripe young age of 33.  :(
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Avatar_m_tn
Best wishes to all with broken wrists.

Well, a good amount of traffic and potential for sharing here.  Lerrymoe how are you???????????   Sozestail, don't despair, you'll get by with a little help from your friends. So now for my story in short:

Note:  When I say "doc" below I'm eferring to several and many over the years.Orthopods mostly , but also rheumatologists, and alternative care practitioners.

I apparently cracke dmy scaphoid skateboarding when 18 but did not recieve medical treatment.  At 23 I went to the doc and he asked "when did you break your scaphoid?  At that point there was no procedure to repair (now there is grafting, replacement, etc), so I put up with pain.  About every 5 years I'd ask the doc what to do.  Surgery he said.I chose pills splints massage accupuncture and anything else that seemed to help.  At around 50 the pain started to become a problem (this is when it really inhibits your lifestyle) and I started getting carpal tunnel syndrome.  Now the doc said surgery or cortizone injections.  So I've had about 5 injections over the past 4 years.  They help each time for a good 6-8 weeks, but when they wear off I find I have used my wrist so much it is even worse.  I would ask the doc what would happen if I didn't get surgery.  He said it would just hurt more until surgery, but he wanted to keep an eye on one bone (can;t remember the name) to make sure it didn't get screwed up because that would make surgey not so good.  

Then 3 months ago out of the blue my thumb tendon broke while I was clipping my fingernails (yes, cliping fingernails).  I surf and and quite active an wish I had a better story, but I was cliping my nails.  It was painless, in fact, it reduced a little pain and carpal tunnel.  The doc said "you broke your thumb tendon"  I asked why and he said sometimes it happens with a collapsed scaphoid.  So he tranferred a tendon from my wring finger to my thumb and I'm still in recovery (although I'm doing very well).

I've found a PT who has helped several very active (surfing type) people through wrist fusion and that is a relief.  At least I have non-surgeon who knows surgey person on my side.  He is helping me a lot at this point and I intend to have some type of surgey in Jamuary.

If I create a wrist fusion bulletin board on another web site, how many takers are there out there????  When I had my hip replaced two years ago there were numerous sites I could go to for public information trade, right down to what doc and what hospital are the best.
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Avatar_f_tn
My ex husband, who was a roofer , installed wood cedar shake roofs with an electric nail gun. Not sure what it weighed, but not light. After many years doing this, he had a major amount of pain. Upon seeing an orthopedic dr, and having x-rays, it was found that the bones in his wrist died from the jarring impact of the nail gun. So, he had a partial wrist fusion. After 6 weeks in a plaster cast, then 2 months in the velcro dohickey cast, wrist brace, etc. he was back to square one. In extreme pain, and unable to use his wrist. So back to surgery for a total wrist fusion. He was very angry  for having the surgeon recommend the partial fusion first, then having to do a total fusion after all. We found out later most partial fusions don't work. Or didn't back then, in 1980. I hope the outcome have improved since then. It took him awhile to figure out how to use his right hand with it fused (he is right handed) but now does 99% of the things he wants to do.Even very fine art work. So even if you have a total fusion, just know that with time and working on it, you will be able to do almost anything you want. Good luck to all here.
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1000775_tn?1256918922
hi, just came back 2 hrs ago from the hospital... still kind of hard to type on the keyboard... had my for corner with scaphoid excision on monday.... after the op i had only one day with strong pain; thereafter only mild pain... they had to make a cut in my lower back to take red cells from my iliac creast to use on the wrist, and that is what hurted on the 1st day... now i have a cast on my hand and still it is quite swollen, but my fingers are moving just ok... i have to do as much exercise with my fingers now... will keep you guys posted on the progress.. cheers to all
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1000775_tn?1256918922
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Avatar_n_tn
Hope you are doing well post surgery.  Let us know how you progress.
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Avatar_n_tn
I have avascular necrosis of the scaphoid (of course on my dominant hand) and have a terrible doctor (stupid HMO).  Does anyone know if there are things I should or should not be doing?  I am in constant pain and I don't know if I should exercise the wrist and bear the pain or keep it as still as possible and avoid pain.  It just keeps getting worse and worse every day.  If I wear a wrist brace for too long I get a little sore, but if I don't wear one I end up bending or twisting it in a painful way.  Oh what to do.  I just called a specialist to see if I could just speak with him about my condition and with no insurance, it will cost me $230 for a conversation.  There has to be some other way to get advice.  
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Avatar_n_tn
Hello.  I am a new member... and luckily found your discussion, which I am hoping will help me.  I was recently diagnosed with advanced Preiser's disease.  

I am a single mother of 5, so the term "soccer mom" doesn't come close!  I work, chase kids, cook and drive kids all over the place. And, feeling very overwhelmed and scared right now, since I am right handed, and of course it is my right hand that is affected.  

With gardening being my only hobby, since my time is consumed in work and children, I have accepted the fact that I will probably have to give up the digging, planting and mulching.... but it is the active mom role that I am worried about. (and the fact I can't lift a cookie sheet.... nor a pot off the stove)

I am in Houston, and have a great doctor, who has treated several of these cases (which I now know are pretty rare alltogether).  So, that is somewhat of a relief.  However, I would really like to hear of a happy ending.  So, Lerrymoe (or anyone else that has been through this sort of surgery), please pass on your outcome.  I would really appreciate any input, as I am scheduled for surgery on December 21st, My surgical plan is that my doctor planning to perform bone grafts and revascularization.  However, after he starts the procedure, if he feel the odds are not good (based on what he sees, he will then perform a 4 corner fusion.  He says it is 50/50.... so, I will not know the outcome until I wake up.
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Avatar_n_tn
i have had ma scaphiod broken since 2008 in iraq i was told it was a sprain however in feb 2009 got it xrayed and it was broken i have had a bone graft which unfortuanatly did not work. i have spoke to my orthopedic and i have decided to go for fusion.reasons been its over a yr now i have been lifting doing pressups and weights on the bone and its nae good. with me being in the forces and having to go abroad all the time i have decided to get it done i have been told that some people get all movement and strngh back however some arnt i suppose it all depends on your body how well it heals.the way i look at it there is to options. leave it and live in pain and run the risk of losing all movment or get it done and lose 20 percent i chose 20 percent is better than none  as for the arthritis your going to get it at some point some quicker than others but at the end of the day it doesnt stiop you from getting on woth what you do im going to remain in the forces and progress regardless im nae having a dig at anyone ma heart goes out to you all honestly. But it doesnt matter what people say. if they aint had it done them selves they wont know so go with your instinct then it cant be the wrong decision thats my advice good luck to all
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1000775_tn?1256918922
hi joyster, you should definitely stop doing weight lifting and press ups... the more you f'' your wrist up, the worst will be for you, and i assume you need your wrist a lot since your are in the military. My case is that i have a "normal" day job, and therefore this is not such a great deal for me.

here is my experience:

I had the surgery done. The docs convinced me at the end to use the spider plate... anyhow, after almost 1/2 year after the surgery, I must say that I am quite satisfied with the result... definitely I am much better now than before... I have no pain, and my hand is getting stronger by the day. Of course it is not as before, but surely enough to carry on with a normal life. The only things I had to change was mostly regarding sports... I dont do sports anylonger that require a lot of my wrist (eg climbing, rowing, etc), i also wear a splint while doing other kinds of sports... I dont do any sports that press my wrist; I have noticed that this is no good. But I allow myself to do, very carefully and in a very limited manner (only certain movements; very limited weight) some weight lifting. I decided to do that since my arm with my problem wrist was getting too thin, and I was getting a bit asymmetric... Anyhow, the summary is that things are good; hopefully they stay that way or get better...

cheers and I hope you get better!
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Avatar_f_tn
Hello Lerry. I have had 4 corner fusion surgery in 2007 following a mis-diagnosed displaced Scaphoid fracture as a 15yr old school boy in 1985, it was only brought to light after a mild accident on the same wrist when I was 20, the x-rays found I had 2 old fracture sites,  healed fusion lines on my Trapezium but my Scaphoid was basically in half still with a cist inbetween the 2 halves, the side seperated from the blood supply had died (necrosis). I had 3 attempts made to fix this using bone grafts from my hip and Herbert screw to compress the union site of the fracture .. they thought the 3rd attempt had worked .. but un-knowing to me it didnt, I thought the pain, stiffness I was suffering was a result of the surgery and my trade as a plasterer and hobby as a drummer. It was in 2004 when plastering a ceiling my wrist colapsed in, my Scaphiod basically crumbled, the pin was loose in my wrist cavity .. so on and so fourth. I had to have a 4 corner fusion done which is a Scaphoid removal and the fusion of bones in the wrist to compensate, also a lot of nerve work and ligament repair .... what basically happens is that they cause fractures across the 4 top bones in the wrist and fuse them together with pins and a spider wheel .. I'm not sure if you will need ligament and nerve work done but be prepared, I was in plaster for 10 weeks not six and my arm was black from my elbow down to my finger tips I kid you not!! Its one thing breaking a bone but its a totally different ball game when a surgeon has taken a drill, screw driver, screws and saw to them. The pain management was good though, a nerve block in your arm pit lasts for about 3 days but the paracetamol they give you is useless .. to be honest I would say put up with it how it is as mine is now weak and painful. I have lost about 40% of its movement, my right hand is noticabley smaller than my Ieft and the motor funtions of my fingers say during writing causes me severe pain ... I regulary have to take full strength C-codamol 500mg Paracetamol-30mg Codiene Phosphate to eleviate the pain.

I wish you the best of luck Lerry.
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Avatar_m_tn
At the end of this month I will be getting the 4 corner fusion and scaphoid excision due to an injury from Iraq back in 2005.  I'll be getting the k-wires instead of the spider plate though.  Now that it's been at least 6 months from your surgery, how is your wrist holding up?  Still happy?
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1000775_tn?1256918922
hi, pls take a look at my profile page.. i have descrived over there my experience. good luck!
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Avatar_m_tn
I just found this site and am glad I did. I had my left wrist scoped three weeks ago to remove the damaged cartilage and was told there is very little if any cartilage left in the joints due to psoriatic arthritis.  The surgeon has suggested removal of the scaf bone and a four corner fusion to stop the bone on bone grating that is causing the pain. I am a master carpenter and right-handed and I am quite concerned about the loss of mobility and after reading about the inability to lift or push any real weight, I am very worried. Does anyone have any experience as to what restrictions I will have?
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Avatar_m_tn
I hurt my wrist way back in the early 1970s. Fractured the scaphoid. Let it heal by itself. Re-injured it so many times I lost count. Went into the Army and excelled in Basic Training with a broken wrist (lol). Had manual labor jobs off and on for years. My wrist started to hurt more than ever when I started using a computer at night and lifting cinder blocks by day. Much pain for decades. Now I am going in for a 4 point fusion. I looked into a wrist replacement 5 years ago and passed on it. I hope I can post my xrays of before and after so others may be able to compare things.

I have a huge cyst occupying my lunate bone. A graft will be attempted if possible, otherwise it's a total fusion. I hope the graft works and I hope recovery goes well. Any stories on recovery after surgery?
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Avatar_m_tn
http://www.orthop.washington.edu/UserFiles/Media/faculty/Trumble/arthritissurgery/03/a/spider.mov

thanks to whoever posted this somewhere.
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Avatar_m_tn
I broke my in the early 70s to.  Similar re-injuries, etc, and just had a four corner fusion 3 months ago.  Recovery is going very slow for me.  I'm getting a bit pessimistic at this point but I believe patience is key.  I have no complications other than residual pain and stiffness.  Also, they advertise 30-50 degrees of wrist movement post-surgery and I'm more like 28 with pain.

I believe the recovery takes longer than the orthopods like to advertise, because all they see is bones.  They really don't see soft tissue recovery.  email me if you want to discuss
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Avatar_m_tn
I have very little motion in my right wrist. Holding my hand and wrist upright, palm facing out (like a straight stick)...I cannot bend my wrist inwards towards my left side...where the thumb is. No movement at all. Bend it to the right? Very little. Bend forward? very little. bend backwards? less than forward.

When the doc told me I might only have 50% of the use of my wrist I laughed. I have far less than that now. Any stories about recovery and movement of wrist with lessening of pain? I will post my ortho result from 5 years ago.
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Avatar_m_tn
Here are results from 5 years ago:

The right wrist is markedly abnormal, though the changes visible and are
likely all related to chronic abnormalities. There is an abnormal appearance
to the scaphoid, consistent with an old fracture, without definite union.

There is bony proliferation along the proximal-radial edge of the scaphoid
with moderately severe narrowing and spurring on both sides of the
radioscaphoid articulation. The scapholunate interval is slightly widened.

There is a large cyst replacing much of the lunate bone, probably with some
aneurysmal bowing of the cortex. There is a DISI configuration. There is
some spurring along the intercarpal row. There is suggestion of faint
chondrocalcinosis in the region of the TFC and probably also over the
scapholunate ligament.

No frank proximal migration of the capitate is
identified. Note is made of an atypcal facey of the lunate articulating with
the capitate.

Remote from the radiocarpal and intercarpal joints, there is mild first CMC
narrowing. Otherwise, the bones about the right wrist are within normal
limits.

I know I have an old scaphoid fracture, DISI, radioscaphoid narrowing as would be seen in early stages of SLAC wrist. I have a very large cyst in lunate, as described, and faint
chondrocalcinosis.
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Avatar_f_tn
I hope you r recovery is going well, and you get the results you are hoping for. 6 months after my husbands partial fusion, a complete fusion was done. He was a roofer, rancher, and cattle fitter. ( groom cattle for show, using heavy hair clippers, etc.)
And NOT  a person to be comfortable with any restrictions. He couldn't take wearing the splint with the partial, just gave up and got the total done. It took quite awhile for him to recover, and learn to compensate for the stiffness in his hand. Right handed, and right hand fusion. Today, over 20years later, if you met him you wouldn't notice any difference at all. He did have to change jobs since he couldn't use a nail gun any more, but went back into corrections, and has moved up from being just a corrections office, until he is now a Captain. A disability is what you make of it. If you make up your mind not to let it be a problem, you will be able to do (almost) anything you want. Good luck, I'll say a prayer for full recovery.

God Bless
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Avatar_m_tn
My surgery date was moved back a week. So this coming Wednesday of next week is my day in surgery.

LLWB: A splint? Why did your husband need to wear a splint after the partial fusion?
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Avatar_m_tn
Wednesday is the date of surgery. I will be going into surgery with hopes for a 4 corner partial fusion. I have a damaged lunate bone which has a huge cyst replacing most of the bone. If it is too damaged I will be getting a full fusion. I hope to add news about this as it all unfolds.

70sNU
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1000775_tn?1256918922
hello llwb, i had the partial wrist fusion done last october. as for how it looks now, well, it really depends. sometimes my hand is great, but sometimes it hurts and i have to wear a splint. even though the surgery was done and the problem kind of solved, i experience lots of limitations... now is summer and i would like to do some rowing, but i cant... i would like to do some weight lifting, but i cant... dance salsa with my partner or play basketball or tennis... unconceivable.. my problem is that i was quite active and i had to give up a lot; i did not to change jobs since i have a desk job and i really just need my brain and be able to type in the computer, so my hand is enough for that... usually my hand gets really worst when i just kind of forget about my limitations and try to do some sport or something that requires a bit more of my wrist... it is amazing how such a small bone can make such a huge difference, and unfortunatelly medicine is not advanced enough to heal it to 100%... also bad is that i'll be 30 this year, so maybe still a long way to go and this is sometimes scary (i try not to think too much about it, and couple with one day after the other)... also i help myself thinking that there are other people with much worse problems than mine and they manage to live their lives... so this may also help you...
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Avatar_m_tn
how much pt did you do?  i'm at 3 months now with a 4-corner fusion and am getting frustrated by continued pain. i now realize 6 months is more likely the turning point, but you sound defeated. what does the dr. say about it?  how about the pt?  are they just giving up?  

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1000775_tn?1256918922
i was to the doc last time on february, and may be back only on oct now 1 yr after surgery... pt i did for about 2 months... thats about it, there is not much more that can be done, my hand as well as yours will never be the same again. maybe in 10 or 20 yrs time medicine will be able to grow bones on lab and they may be able to fix it again, but til then you have to adapt your life according to the situation... think about a soldier that goes to iraq and loses both legs and stuff; not much that can be done now besides using prostetics; the same is true for us no matter how much we talk about it with other or with doctors...
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Avatar_m_tn
Hey, I suffered years (decades) of pretty serious pain while lifting cinder blocks and duty light to heavy construction jobs, all with my injuries. My other wrist was injured in a fall off a 2nd story window. I have almost NO movement in my prominent wrist, and have gotten by until about 5 years ago when my wrist started to act up so bad, some days I couldn't open a jar or pick up multiple pill bottles. Pain is all relative.  I hope to push the limits on what the docs say I can do. We'll see how badly they damage me with the knife.

I am optimistic while being realistic. At this time tomorrow I should be coming home from surgery. I will try and log on here within the first few days. We'll see.

70sNU
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Avatar_m_tn
" i would like to do some rowing, but i cant... i would like to do some weight lifting, but i cant... dance salsa with my partner or play basketball or tennis... unconceivable.. "

You cannot adapt your movements? I don't understand. Can you explain more why you can't do some of these things?
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Avatar_m_tn
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1000775_tn?1256918922
hi all, things are getting better, i am doing some sport and using my hand, and i think this was the trick... after the surgery i avoided moving my hand so to protect it... i think this was really dumb, so i advice anyone having the surgery to move your hand! make exercises, and it will be fine... now i am doing lots of exercises and no pain at all! good luck to you all!
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I am worried I might have necorisis of my lunate bone in my right wrist.  Can I ask what your MRI looked like?  My lunate has two large black spots on the bone, which takes up about half of the total area of the bone.  My ortho doctor told me he didn't know what that was.   I have been looking up thing online.  My MRI report said "mild heterogenity of the bone marrow of the lunate bone, with out associated edema".  My ortho doctor also told me he didn't know what that meant.  I would appreicate your thoughts on this.  Thanks and I am glad you're recovering and feeling better.
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Hey Lerry, I'm going to have to have the scaphoid excision and four corner wrist fusion also.  How is yours doing now.  Does it hurt still and how are the sports going.  My occupation is a personal trainer so I'm a little uncertain about how well I will be able to exercise and lift weights post op.  I'm also a competitive fighter, I was told that will be done when I have the surgery but my biggest concern is working out.  Any imput from anyone would be great.
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Lerrymoe:  Great to hear you are finally doing better.  Took over a year huh?

My stats:

Don't take this surgery lightly. Find a good surgeon and dont' expect too much.

I had my 4-corner fusion 6 months ago.

55 year old surfer/guitar player/engineer/gardner

Broke schaphoid as teenager but never diagnosed/treated until ....

Pain before surgery:  3-8
Pain afer surgery:  1-5 but new pain areas

Limitations before:  surfing/guitar playing/gardening all out  due to pain
Now:  All in with limited pain but new movement limitations now exist.  

It's not a panacea, but it has improved my quality of life significantly, and as with all bone surgery, I still have a couple of more years for improvement.




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Hi, I have been following  this thread for a while. Had four corner fusion in May. Broken scaphoid for at least 15 years or so, I never knew. Like Kriyamon 54 years of age surfer, carpenter , surfboard builder. After 5 months pain is minimal , though strength is way down probably 35% of before surgery. I have practically no extension though 60% of flexion compared to my other hand. I have been goin to P.T. 4 times a week since the cast came off I was in the cast for 3 full months. Rehab has been slow, while in the cast I developed numbness due to carpal tunnel, though that has subsided with therapy.  My doctor says to expect nine months to regain the strength I lost. And has prescribed a range of motion brace, though it seems to offer little improvement in the last two months. I am just now getting back yo work though very limited. I also have been surfing since mid July against the wishes of the doctor although with much caution.  When I started down this road  I did not know what to expect and the doctor never spelled out the length of the recovery. I would not change a thing only wish I had more info from the start. I was lucky to find this forum and have learned alot from it and would like to thank you all.
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Fractured the scaphoid in my left wrist in July 2009. After two failed operations it's still a non-union and I'm going to have my wrist fused next week.  I'm 63, retired and ride a dirt bike. I'm fully expecting to ride post-op.
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I had a 4 corner wrist fusion about 3 half years ago, i could not put any weight through the wrist before the op, and if i tried to use my wrist, i.e to write, then my wrist became very tight and sore, like some one had put a turnaque around it, it just got tighter and tighter, so i decided to have the op, i am still in alot of pain after the op, and am still in alot of pain, i really hate being like this, i hate pain killers as they don't work, to look at me you would not know what i am felling every day, i just wish i knew what to do next.
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I know exactly how you feel. I havnt had the fusion yet but I have had 2 bone graphs and my scaphoid fixated with a screw. I dont know what to do either. Im only 21yrs old but my wrist has already been broken for 26 months. I can't lift weights like I want to, I can't play football and bball with my friends, and so on. Im going to have to take a year off of school to get the surgery because the college courses Im taking now are only offered once a year. It totally *****. Its a heavy cross, and Im not sure what to do next either. So just know that you are definitely not alone.
Does anyone think I should have a 3rd go at the bone graft? Or has my window for proper healing passed?

Oh and thanks everyone for the info. I've learned ALOT. Its great to hear patient results first hand.
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i am 14 years old. In november around thanksgiving, i fell backpeddling in basketball practice and i hurt my wrist. I didn't go to the dr's office until around the middle of december. I realized that it never really got better. It hurt to shoot with my left hand and to carry things and just do things with it. I went in, and they said that it is a scaphoid fracture. I have to be in a cast until march or something. 3 months! They take it off every three weeks and before this, it hurt to push on where it was broken, but when they take it off it doesnt really. It just hurts to move it and bend it. I go in tomorrow for another xray. This is my 3rd one and its not getting any better yet. What do you guys think about the chances of me having surgery on it?
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Can an x-ray miss a scaphoid fracture?  Ive been having  wrist problems with my right wrist for a while and have had some cortisone injections.  Well then a fell about 3 weeks ago I had an x-ray which was negative for a fracture.  I am wearing a wrist brace and on a wait and see approach from the dr.  The problem is I continue to have a lot of swelling and pain.  My range of motion is really decreased.  The brace helps some but after a while my wrist becomes very sore with it on and i have to take it off for a while and just rest my wrist.  Most of my pain is on the ulnar side which is were it always has been. Sometimes when I try to write if I have th out of my hand or arm resting wdown my hand just shakes like crazy.  It just throbs at times and wakes me up.  Anyone have any suggestions as to what it could be.  

Any thoughts or input is greatly appreciated.  Thanks!
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CHECK A SECOND OPINION FROM A GOOD ORTHOPOD.  Hawk, do everything you can to get that bone to heal without having it removed.  It takes a long time, but be patient....this is stuff that will be with you the rest of your life.  Dar, yes I had mine missed on an xray as a teenager, but it was a long time ago and just a family doctor.  Get a nother opinion or push for a CAT scan.  Be patient but persistent.
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I WAS AT WORK CARRYING BOXES AND TRIPPED OVER A DRAWER THAT WAS SUPPOSE TO BE LOCKED. AFTER MY X-RAYS, MRI'S AND ARTHOGRAM, THEY STATED THAT I HAVE A COMPLETE TEAR OF THE DORSAL BAND OF THE SCAPHOLUNATE LIGAMENT. SMALL OSTEOCHONDRAL DEFECT ALONG THE DORSAL SURFACE OF THE LUNATE.  SO I AM STUCK WITH GETTING THE 4-CORNER FUSION, WHICH I DO NOT LIKE. JUST WANTED TO KNOW MORW ABOUT IT AND THE % OF (ROM) AFTER THE SURGERY IS COMPLETE AND IF THERE WOULD BE ANY FURTHER SURGERY AND HOW WELL IT SUSTAINS.
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I am now about 4 months out of 4 corner fusion. Broke my scaphoid 16 yrs ago. Had a cast, was told it was healed, NOT. I am going to therapy, and it is going slow. Barely any movement up, some down and very little side to side. Like some of the others I am tired of pain. Hoping time will make it better. Anyone else have trouble getting out of the bathtub? I am glad I did the surgery, and only time will tell if it worked. Please God no full fusion. Nice to hear others with the same problem. Thanks.
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How much does it cost to perform a four corner fusion?
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I've been battling a slac wrist for about a year now.  I had one surgery in september where the doctor tried to screw the scaphoid and lunate together.  It didn't work and removed the screw 5 weeks ago.  He is now suggesting a four corner fusion.  I'm a very active 36 year old.  I enjoy working out and playing sports, especially golf.  Has anyone returned to playing golf after this procedure?
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It's been awhile since my last post. I went through the schaphoidectomy and 4-corner fusion in may2010. Since then my pain is more constant and troubling than before the surgery. Now they want to trim off the tip that is at the top of the radius in the wrist. I was told it will either help or it won't. Next step after that would be a full fusion of the wrist, which I am not ready for yet.

Does anyone know the name of that surgery where they cut off the tip of the radius? It's been about two months since I talked to the surgeon about it and can no longer remember it.

Lerrymoe and everyone else, how are you all doing since your surgeries and how long has it been since the procedure?
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Hi Everyone!

Lerry, I bet you didn't think you would become so popular!  Thank you for starting this thread it has been more comforting to me reading honest posts rather than medical mumbo jumbo.

II don't want to bore you with all of the details, as it seems my story is very similar to everyone else's.  I have Stage III Preiser's and surgery is imminent, either the 4 corner fusion or complete fusion.  I have an appointment with my surgeon on Wednesday morning.

Where my story differs is that I work the majority of my time in Europe currently.  I am on a temporary assignment, which requires me to be traveling within Europe extensively for 6-7 weeks, then I come back to the US for 1 week.  Clearly with this schedule I am unable to commit to the months long recovery, which is why I have been putting off the procedure.

That being said, the pain has become almost unbearable, and I know I need to commit to this process.  I am just wondering if you guys could tell me more about the recovery?  Do you get a hard cast immediately or is there an air cast then a hard cast?  When did you go back for post op and then how often after that?  

I don't want to jeopardize my health or the recovery process but in order to maintain my health insurance, I need to keep my job.  I'd like to get a better idea of this process and start to put together a tentative timeline.

Thanks in advance for your candid feedback!
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I just had the four corner wrist fusion on jan 28th of this year.  I was in your spot for about two years, didn't want the down time or to deal with the recovery but the pain was extreme.  I finally had to have it cause my wrist was just to bad and collapsing.  Here is my timeline- surgery jan 28th-splint for 1week till the swelling went down-then a hard cast till today, so 5 weeks-now I have a removable velcrow splint on, will begin therapy in a couple days.  I will wear the velcrow splint for 4 weeks while it gets stronger through therapy then I will be totally out of everything. I went to post op appointments only on the days I was getting the cast or splint changed, they did xray checkups then. I have read others say they where in casts for alot longer, then it was still painful and so on.  My experience has been pretty good and much better than I was expecting.  The pain is pretty much gone and my specialist told me my wrist should be as strong as a healthy one. It won't be quite as mobile but better than its been for the last two years.  I wouldn't expect you would have to take to much time off work.  Maybe a week while the swelling and pain go down if you need to use those fingures alot.  I am a personal trainer and I went back to work a couple days after surgery.  Noted though you will be on some very strong pain killers for about 2 weeks so you may not be as mentally sharp as you normally are but you may be able to get different ones from your doctor.  If it is as painful as mine I would tell you its worth getting done.  The recovery is not as bad as all the pain we delt with before.  The cast is not fun but its not that long.  Well wishes to you.
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I had four point fusion surgery Nov 5, 2010.  I am an avid golfer and am now back to playing.  I am also lifting weights.  I still have some swelling in my knuckles and fingers, but overall the wrist is getting stronger. My range of motion is 80 degrees so the impact to my swing has not been significant.  I am starting off slowly - working on short game and hitting some balls on the range.  Played 18 holes last weekend - wrist held up fine - iced it after playing and had no problems afterward.
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I had four point fusion surgery Nov 5, 2010.  I am an avid golfer and am now back to playing.  I am also lifting weights.  I still have some swelling in my knuckles and fingers, but overall the wrist is getting stronger. My range of motion is 80 degrees so the impact to my swing has not been significant.  I am starting off slowly - working on short game and hitting some balls on the range.  Played 18 holes last weekend - wrist held up fine - iced it after playing and had no problems afterward.
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You had a four corner fusion and have 80 degrees ROM? Flexion and Extension? That is amazing! I had my fusion with multiple carpectomies on 1 NOV  2010. I had a second surgery on 17 JAN 2011I also had complete rupture of ligaments and tendons. I am in therapy now and am about 35 flexion and 45 extension. How on earth did you get that much movement?
Congrats!!
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My total range of motion is approximately 80 degrees - 42 flexion, 38 extension.  

I still have a lot of fluid in my finger joints.  Is there any way to get rid of it or does it just take time?  If so how long before the fluid is totally gone?

Thanks
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I wish I could help. I have a great deal of edema myself. I have been using compression gloves and they do help with the swelling. They are limiting, but help with the pain associated with it as well. I am now also battling tendonitis. You go 2 steps forward and one step back. I am hoping to get more flexion, but the end point is solid. I still have hope, though because it would make life so much easier to be able to use my dominant hand for more ADL's.

If anyone has any suggestions on how to accomplish this, let me know!
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Hi, I am glad to hear that you are doing so well.  I've been struggling lately, you know the pain all day and night, and no time to dedicate to my health.  I have my pre-op this Thursday 5/5 (hey, Cinco de Mayo...how fitting) and I am nervous.

I have so much to do around the house before I become invalid and it is overwhelming.  Trash, laundry, lawn, etc etc and I have to get it done prior because if I'm in a cast for 7 weeks...!

I have been thinking about the fusion itself and the associated hardware.  I have really skinny arms, so will the hardware be sticking out? I know there will be a scar, but how long is it?  

I'm really not vain, but a little self conscious so your input would help thanks. :)

Again, glad to hear you're doing great and your help is invaluable!
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Hi - I hope your surgery went well.

The metal plate in my wrist is not visible so no need to worry there.  My scar is approx 3 inches long and not very noticeable with the exception of 1/2 inch that is a little wider and more red than the remainder of the scar.  Hopefully that small section of the scar will shrink a bit over time.  Good luck with your rehab.
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I too was living with pain for years because of a miss diagnosis, because they were too cheap to take an x-ray, so after complaining for a couple of years to several doctors i demanded an x-ray and for sure they found the scaphoid fractured, well i wasn't happy and decided to see about getting it repaired. I came to tolerate the pain though, it was manageable tolerable, i saw several doctors, 6 to be exact and received 3 different suggestions, 2 doctors said leave it alone if you can tolerate it, 2 doctors said to do a total scaphoid ectomy, where they remove 3 bones and the other bones would just drop down in its place and 2 doctors said to do the 4 corner fusion with removing the scaphoid, well after thinking about it and getting more info i went with the 4 corner, biggest mistake of my life, i should of left it alone, i could tolerate it before, and i could still work and play all the golf i wanted and throw a fribee and play baseball, now its been since December 13th 2010 and im in pain more then ever, i still have the same pain as before and developed others now more painful then the original pain, and one finger tip is still numb and and i get shooting cold feelings into some fingers when i use my hand, they say maybe a pinched nerve, i still have numbness from the cut nerves around the incision, now they have to do an EMG to see if i have problems with nerves and they want to go back in and fix the tendon, physio cut me loose because i was not getting better with the treatment, so now i cant work and i have tried a few times, but im in pain, and can not last more then 3 hours of work and i suffer for days after, every movement hurts, but i wont let it stop me from living, ill keep trying to go to work and i still go golfing because that's the one thing that's keeping me sane, and those who know golf understand this...I could go on all day and complain, but the bottom line is i should of left it alone, i was use to the pain before and was tolerable, the doctors just said that's because i can tolerate pain better then others, well that's true maybe, i can and they said if i left it alone i would develop arthritis in 5 to 10 years, well maybe but i would cross that bridge when i got there and whats not to say i wont get arthritis anyway, what do they think is going to happen anyway, i would be all better, no way, well my last comment is its was an unnecessary procedure in my case, all cases are different, if you can learn to live with the pain, then do it, don't go with the surgery, let life take its course, because the fusion is not reversible....
thank you...

Painfully
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I'm only 22 years old and I found out 3 years ago that I had avascular necrosis of the scaphoid bone as well. I have not done the fusing yet. Mainly bc it's my right hand and well I'm right handed. But also bc I'm not ready to lose it. My grandfather has had the partial fushion and he since has still been in a lot of pain. My doctor told me that the partial fushion will only last for like 10 years and after that they'll have to completely fuse it.
I know eventually I'll have to have the surgery. The pain is really hard to deal with. But hopefully my waitings paid off. I just heard of a surgeon who replaced the bone with a cadaver bone on someone who has the same injury. It worked perfectly. I'm hoping I can get the same precidure.

I'm finding my whole situation hard to live with. I still have my whole life ahead of me. So I'm going to keep searching for an alternative solution. I hope y'all get the answer you want and everything works out for you. Best wishes!
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I am a 38 year old woman with two young children and a very active life style. I had a four corner fusion and scaphoidecotomy on June 1st 2011 and wanted to let anyone know that is interested how it went. First of all, don't let all the crap on the internet scare you. I suffered a scaphoid fracture when I was young, don't really remember it, and this "injury" came back to haunt me 30 something years later. The doctor called it a SNAC wrist. I have battled pain, loss of motion, swelling, and weakness for about a year and contributed it to carpel tunnel or something. With two young children, I just lived with it and went on. Finally in May, I went to see an orthopedic hand specialist and he was absolutely wonderful. You need to find a doctor that will sit down with you and explain to you why, what, when, how and where. You have a right to know what is wrong with you and what they will do to fix it. You have the right to discuss k wire vs screws, etc. I elected to have k wires. Surgery went well. I spent the night at the hospital so they could control my pain. They gave me a nerve block in my shoulder that kept my nerves bathed in numbing medicine so for the first three days, I felt nothing at all. I was in a splint for about 11 days, went in and got my stitches removed. I had an xray done to make sure that my bones were fusing correctly and they put me in a hard cast to below my elbow. I am going tomorrow to get my cast removed, another xray done and another cast put on. I will probably wear a cast for about 2 more weeks and then go in to have the k wires taken out. That is a procedure as well. I will be sedated but not put to sleep, they will numb my hand and take the wires out. I will immediately start physical therapy right after that and get fitted with my splint that I will wear for about 2 months. Its a long road but I was only down for about a week and I have managed to keep my house, take care of my kids and do what I need to do. I have pain sometimes but I keep it controlled with rest, cold packs and meds. I am off work right now due to the fact that I type most of the day on a computer. I hope to go back to work when the wires come out. I hope this helps. Its not bad and I am glad that I did it. I was scared slap to death but the key is to have a good doctor that will walk you through the steps. If you don't feel comfortable with your doctor, find another one. I did. My first doctor just told me to keep wearing my splint and come back if it doesn't get better. If you have any questions, just let me know. I will post how my doctors appointment went tomorrow.
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Hi, i've had a full fusion in my dominant wrist and a four corner fusion on the other. I have very few problems with either of them. I get a bit of pain in my partially fused wrist but nothing like it was pre-op. I still ride my motorcycle but use common sense to decide what i can and cannot manage; the biggest problem with a total fusion is wiping your bum.
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I am 50 and crushed my wrist 5 years ago. I had surgery to repair the wrist which worked fairly well. I went to physical therapy for 6 mos and was able to golf again. The the wrist started to fall apart 2 years later I had an additional surgery to remove the plate. Again was able to golf that summer. I have now not golfed in 2 years and have had 2 additional surgeries to do the partial fusioin. My doctor now tells me my only option is a full fusion. I have been getting cortozone shots for the past 9 months but still in  alot of pain. Full fusion here I come 4 surgeries later what a mistake!
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Did you have a full or partial wrist fusion...I too am facing a partial fusion of my left wrist and anxious to hear how yours is going.  Did you have a k wire or spider plate?  Not sure which my surgeon will do.  I have very small wrists which is a big concern.....Anxious to hear any input
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I am also facing a partial wrist fusion.....Ive been told by my surgeon that although the range of motion will be limited, the wrist will be strong and pain free and I should be able to resume sports like golf and tennis....am anxious to hear what your experience has been.....how much pain and swelling, and what is the projected recovery time?  I hear everything from 2 months to a year.  
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Hi - I'm in my 50s and very active, and also facing a partial wrist fusion....apparently an old injury which now has degenerative arthritis....I was encouraged by you post, and am anxious to hear how your recovery is going?  Can you tell me why they did a k wire?  I am small boned with very small wrists, and this is a big concern for me.  How much pain and swelling have you had?  Anxious to hear any news, and when they expect upi to start rehab.  Barb
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ive had wrist pain for the past 7 years. and 9 wrist surgeries. my doctor told me that my only chance is the four corner fusion. however i am 28 years old and not sure where to do it. wghat should i do?
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I.m also a golfer with AVN of the scaphoid and pain every day.  I have been putting off surgery given all the disparity in posts here post op.  How are you now after a summer of golfing?  did you have the wires or plate?
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I'm also a golfer with AVN of the scaphoid and pain every day.  I have been putting off surgery given all the disparity insuccess discussed in ther  posts here post op.  How are you now after a summer of golfing?  did you have the wires or plate?
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Howzit Blaine ,,after reading your post and an avid golfer too im in the same boat as you and going for full fusion next week. Im left handed but golf right handed and im getting the left wrist fused .I think im glad its the left getting fused  ,shouldnt hinder my swing as much ,what do you think ? how is your wrist doing now ?
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i had surgery #4 yesterday to debride the tfc in my left wrist. I'm 11 months post op from a partial fusion (plate & 8 screws) and my doc found the fusion was stable enough to remove the plate too. I work at a golf course during the summer and wasn't able to play until July when my doc shot the tfc with cortisone. After that, I was able to play 9 holes with minimal pain. I also bought a motocross brace from ****.com for about $25. Best $$$$ I ever spent. Good luck
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50 yrs young!!! I had partial wrist fusion Dec 2010. Next week Jan 2012 the plate and 8 screws to come out. Looking forward to that as its done the job. I have relatively thin wrists. Pain was considerate post op though I would go through it 10 times for the result I have. Active now as I was 15 yr ago. Yee hah. I work with my hands and find that having a stiff wrist hinders my ability very very little.  I certainly recommend the procedure when performed by a reputable competant surgeon.  I also recommend the external use of Comfrey (knitbone) ointment and the oral dose of symphytom (homeopathy) for the bones and Hypericum and calendula in sorbeline base for scar healing.
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My daughter is 18 and had the four corner fusion last week. She is a lot of pain right now but I will let you know how it goes. She is in college so this first week with pain and school have been tough. She developed Avascular Necrosis from steroids and chemo treatment for leukemia at the age of 15.
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Interesting reading here.  I am approximately 8 months out from my wreck and have a scaphoid nonunion after a bone graft was done.  I am now looking at having a scaphoid excision with a four corner fusion.  My motion is so little now that the doc says I may actually regain some motion after the surgery.  I'm just ready for all of this to be over as this will be my fifth surgery since the wreck.  
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I am exactly one year from having my schapoid excised and a four corner wrist fusion.  Has anyone experienced severe hand pain around the metacarpals post surgery. I have bad pain in my hand all the time, especially when I use it or try to grip hard or push of the ground, things like that.  Also my motor function is not all back.  Maybe 50 percent.  I am a 32 year old athlete.  Has anyone experienced similiar problems so far after surgery, it seems like to me?
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I have very good doctors here where I live but they were so pessimistic I started researching hard.  I went to the hospital for special surgery in New York to have Dr. Weiland do mine. He is an incredible surgeon.  I think the reason you see so many different results on this blog is the quality of the doctor! Weiland is the choice of professional athletes  that have wrist issues and they usually find the best. I am 2 months removed from my surgery and very optimistic. I hope to be golfing in 2 months pain free!
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I am in week 5 with the same procedure. Tell her first 2 weeks were the worst. I have a high pain tolerance but it was unbearable! Week 3 was a little better with 4 &5 improving a bunch. The key is to keep that thing elevated at all times and after swelling goes down gentle finger exercise helps tremendously. My fear is that I would somehow "hurt" the surgery but my doctor told me not to worry about that. Light pressure back and forth on fingers will help with recovery down the road. Good luck to her.
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Great post. I had the same procedure 2 months ago. I get my cast off today. How are you doing now? How long did it take to get back to normal? Pain gone?
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HI Lerry, I too have suffered for about 10 years with severe wrists pain, i did the splint thing too.  Now im to the point where my left wrist has almost fused itself, i cant bend my wrist anymore which is difficult as you know. My doc gave me the same options as you, he also mentioned wrists replacement, which is fairly new, but u may want to inquire about it. i have still yet to decide what to do. i wish i had a diagnosis...did you get one, they mentioned kiebocks disease but my ortho doc and hand surgeon disagree on it.
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I am a 21 year old athlete who broke my scaphoid 5 years ago, although I did not find out until this october when i got my surgery (bone graft and 3 pins). After 19 long weeks in a cast, I finally got my pins out today although the bones are only slightly healed. I do have some arthritis in the joint. Im wondering how long it will take to get back to lifting and playing sports again, and if lifting is even a good idea? Iv always been able to tolerate the pain from this, and even if my wrist went back to how it was before surgery i would be happy.  comments from anyone who has had this problem would be appreciated.
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hello all, its now more than 2 years i have done the surgery... i had a quite normal life until about 1 month ago when i started having some wrist pain again... i am waiting to see if it goes away alone, otherwise i'll have to check with the doc... its not pain, but a very uncomfortable feeling that my hand is very tired... i suppose this could be the beginning of an athrosis... cheers
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hey everyone, i'm a 40 year old male and i'm about to have my scaphoid fused with a bone graft. i was a carpenter, blacksmith and metal smith for 22 years and the impact has blown out the joint. the bone is arthritic and there are 5 bone fragments in the joint plus an avulsed a tendon coming off the scaphoid that took a piece of bone with it. i have limited motion due to all the "gravel" in the joint and if i use a screw gun or hammer for more than a couple minutes i am in extreme pain. i tried PT with lasers and ultrasound and the Ortho gave me cortisone. the PT helped some but since i stopped going the pain is coming back, the cortisone helped a little for about 3 days then i was right back at square 1. my surgery is scheduled for july 30th and i am still not sure if it's the best idea but i have tried everything over the past year with nil or limited results. i am also an Aikido instructor and this mess has kept me off the mat for a year, plus i haven't been able to kayak or golf either. the doc wasn't too excited about operating on me but when i told him all i had done he agreed it was the next logical step. i just hope i'm doing the right thing...
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Avatar_m_tn
4 months post fusion now.  My doctor actually removed the scaphoid and the triquetrum and did a 3 corner fusion using memory staples.  This method is supposed to result in better ulnar deviation.  My extension is ver low (something like 30 deg) and my flexion is doing pretty well.  My grip is back up to somewhere around 70lb.  I do still have pains daily if I move it to its extremes or put a lot of pressure on it.  Usually they are minor pains but they can be aggravating.  Just resting my head in my palm can cause it to start hurting after a short time.  Overall, I am satisfied and am optimistic that I will improve a little more but am not sure when or if it will ever quit hurting.  Either way, I'm better off than I was before.
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Avatar_m_tn
I am a 38 year old mother of 3. I broke my scaphoid 15 years ago in a car accident. At the time I had 3 surgeries. One to fix scaphoid with a Herbert screw. That didn't work so did a bone graft. After 15 years of relatively little pain or complications, I reinjured the wrist April 2011. After being told my only option with be a scaphoid excision and a 4 pt partial fusion. I had the surgery done february 2012. My ortho said I should be feeling great my may or June! Not the case, I am very active with my wrist and feel extreme pain. I have 3 kids , one being 20 months old. Doctor said I need to use it more. I went for a second opinion and doctore recommended casting for a month to see if full fusion will be needed for pain relief. I have only 3 degrees of flexion.

I'm very frustrated since the doctors are conflicting with treatment plans! Anyone had a similar situation that went from partial fusion to full fusion?
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Avatar_m_tn
Hello just wondering if any one has created a public bulletin as of yet for broken/fractured schaphoids??
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Avatar_f_tn
Hell-o everyone. I had my four corner fusion in February 2012. I don't know if anyone had to have therapy or not, but I do. I have therapy twice a week. They were trying to get 35 degree range forward, but can only get about 20 degrees. Currently they are trying to get the stiffness out of my fingers. As long as my fingers are warmed up first before therapy, you can bend them. After they cool off I can't bend them. I can't make a fist. The back of my wrist is very stiff. Whenever it rains, there are times I am extremely stiff. Like right now.
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Avatar_m_tn
I bet you moved your fingers very little post-surgery.  That will make them stiffen up.  I bent mine back and forth several times a day from the day after surgery onward and never had any stiffness in my fingers at all.  It should loosen back up though from what I have heard but it might take a bit.
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Avatar_m_tn
Hi ,august 9 th had my 4-corner fusion and scaphoid excision plus work on nerves as well.
Had a car accident in the past.
My dearest hobby is icehockey and I work as an airline captain.
I hope I Can return my profession but I am worried about icehockey- Any hockey players here?
Cheers JA
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Avatar_m_tn
Hi ,august 9 th had my 4-corner fusion and scaphoid excision plus work on nerves as well.
Had a car accident in the past.
My dearest hobby is icehockey and I work as an airline captain.
I hope I Can return my profession but I am worried about icehockey- Any hockey players here?
Cheers JA
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Avatar_m_tn
Can you still surf with your scapnoid injury? Have you after surgery from the four corner fusion?

I am an avid surfer, and broke my scapnoid. It didn't reheal after the complete fracture, and was split in half. After being pinned, it didn't heal. I  got hit by a car on my bicycle.
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I surf all the time since four corner fusion surgery. My hand hurts at times but not too bad. Its a little tougher popping up but you learn to adapt. Had the procedure three years ago come end of May. At 57 years old I am still riding a short board 6' 2". Would probably be easier if you ride a fun shape or longboard. Bottom line is if you want to do something bad enough you find a way. Good luck with your situation.

      
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Avatar_m_tn
anyone heard of 'Pyrocarbon Adaptive Proximal Scaphoid Implant (APSI).' for treatment of SNAC?
i just read a  study article about it dated jun of 2013. there were positive results for all the patients in the study, without need for fusion of the joint. i knew that it had been explored in the past with mixed results, but this is recent, and sounded very positive. ive been holding off on surgery, because i dont want to lose what range of motion i have left.
i look forward to any new developements on this front.....
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Avatar_m_tn
any chance of an update mike. what was the pain you are have been experiencing?  Also, have you been able to carry on with your sports and martial arts?

regards
Lee
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Avatar_m_tn
Just had my 4 corner fusion 2 weeks ago. I already have full movement of my fingers. However, my index finger and thumb are numb. I still have a bit if swelling in my hand. My doctor says for me to wait until cast comes off in 3 weeks. If numbness is still present, he will perform carpal tunnel surgery. Has anyone else had this issue? Over all I am very pleased with the results, just want the feeling back in my finger and thumb back
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Avatar_m_tn
I am an active 53 yr old female who is scheduled to have a four corner fusion in a few weeksl. It is my dominant wrist and I am in constant pain. I have almost no flexion or extension in my wrist. At times, my whole right arm throbs and aches b/c the limited wrist movement has caused severe tendonitis in my elbow. Does anyone else have a problem with elbow tendonitis because of their limited wrist movement? I have my pre-op in a few days. Does anyone have some good questions I should ask my doctor?
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Avatar_m_tn
Hey guys. Im glad to know I am not the only one who is dealing with this. I'm learning more and more about this process. I'm a big sports person. Have been playing flag football for years. I just had the 4 corner fusion 2 weeks ago. Its been a pain. Knowing what I know now, I may have waited longer, but then again my wrist was hurting so I had to do it. So its been two weeks and the splint on my wrist bothers my incision area, wrist is sore at times, and my doc said I should be making a fist...... no where close. I'm worried about them having to go back in to clear up scar tissue to get more movement with my fingers. Anybody else with this issue? Also can anybody suggest another splint to use?
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Avatar_m_tn
How did you fusion surgery go?? I just had mine 2 weeks ago...
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