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

[lerrymoe]

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  

[hawk10boyce10]

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?

[Dar584]

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!

[kriyamon]

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.

[JMEZZY]

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.

[BIGCAVEMAN]

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.

[JMEZZY]

How much does it cost to perform a four corner fusion?