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broken Scaphoid

m 24 and i broke my scaphoid 4 years ago, but i never got it checked out in time and left it for 2 years before it was seen, ive since had 2 operations on it, the first one was a bone graft with a screw put in and that didn't work, i then had a second operation where they took out the screw and put lots more bone graft
in with pins and this hasn't worked either. I dont think they plan to do anymore at the moment but one doctor mentioned taking out the bone and fuseing the bone back together and putting it back in, but he said i was very young to have this operation. What id like to know is, if i did have this operation would it be better in the long run? and if i dont get it done and the bone falls away will it be too late to fix it? also i need my hand for my job ( taper and jointer ) if it doesn't get fixed will i be able to do my job? because my hand gets sore after work now, so im worried it will get a lot worse as the years go by. Any advise would be very helpfuf, Cheers!
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Avatar universal
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 universal
MEDICAL PROFESSIONAL
The healing of small bones is very difficult due to the position and all the tendon and ligament attachments. The Scaphoid is a small bone and is in the wrist and this problem of healing takes place with many cases. Your orthopaedician would try to fix it for better healing in the second operation, he would use wires and also with bone alignment your healing will get faster and your symptoms will decrease. Take care!
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Avatar universal
i broke my scaphoid bone last year in sept and i had my op 4 mnths ago and wot ive been reading sounds like im fooked lol and guna need another op went 4 a check up and xray 4 wk ago and its still not healing. did mine hitting a boxing machine wont b doing tht again in a hurry lol. dose any1 no how long ur in hos wen u ave the 2nd op???
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Avatar universal
Hi Jain, just wondering if you missed the last post?

Cheers, Alan Smith.
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Avatar universal
Hi,
I had a appointment with the surgeon yesterday but he was not there unfortunately and i had to talk to a different doctor, he told me that they were not going to do another operation, after 2 attempts its not worth it, ive read on another site, a person got theres fixed on the 4th attempt. Do you think i should get a second opinion? or should i just forget about it? because i still haven't got any of the answers i wanted about being able to use it for work because he said it varies from person to person and its too hard to tell,
because the job i do, i need good mobility in my hand and if theres still a chance it can be fixed i would like to try.
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Avatar universal
Hi,
I was also unaware about effects of smoking on bone healing. But during an interaction with patient about his chronic pain and non-union after surgery, we realized that he has been smoking 14-16/day. This was the real reason for his fracture not healing.
I suggest you to quit smoking in interest of your health.
There are several website which says about quit smoking, one of the name is quitsmoking.com (I am not sure) which is really helpful.
Keep me informed if you have any queries.
Bye.
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Avatar universal
Hi
I smoke 7 - 10 a day, and ive been smoking this amount for about 10 years now, i really dislike smoking and believe i can give it up and im going to make it a personal goal.
Again thanks for the help
Helpful - 0
Avatar universal
Hi Smithy,
How much do you smoke per day?
Are you been smoking before the injury too?
There are many reasons why bones fail to heal. These include smoking, osteoporosis, and malnutrition. Smoking is by far the greatest factor that can prevent healing of bones. Nicotine is a toxin that inhibits bone-growing cells. If you continue to smoke after your operation, you could undermine the fusion process.
Hope this helps you and motivates you to quit smoking.
There are studies shown in which people who were smoking post-surgery had delayed healing than patients who are non-smoker with similar lesion and similar surgeries.
Keep me informed if you have any other queries.
Bye.
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Avatar universal
Hi,
Unfortunately i am a smoker, ive never heard anything about the affect smoking has on bone healing, its something i have to give up.
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Avatar universal
Hi Smithy,
I think it is a great idea of getting back to work, as you would be engaged in your work most of the time and which take your mind of your ankle for a while.
It will also help release endorphins in your body which will help in healing faster.
Did we discuss about smoking and its effect on bone healing before?
Are you a smoker?
It's nice that you are getting back to work but make sure you don’t hurt your ankle again and land up in bigger trouble.
Keep me informed if you have any queries.
Bye.
Helpful - 0
Avatar universal
Hi Jain,
Im feeling alright health wise, i broke my ankle a few months back and had to get a metal plate and a few screws put in and ive been out of work since then, but im starting work again on monday, and i reckon i'll start feeling better and healthier when i get back into that routine. I'll let you know when i get more info, thanks for the help.  
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Avatar universal
Hi Smithy,
How are you feeling health wise?
It happens with all of us that it is difficult to talk about our colleague in same clinical field.
The doctor is partially right in sending you back to your surgeon for further explanation as he is the best person to let you know what his thoughts were while operating were.
Keep me informed about what your surgeon has to say.
Bye.
Helpful - 0
Avatar universal
Hi
Went to see a Orthopedic doctor today, he xray'd my hand again and went through my files and said the surgeon who did the surgery didn't plan to do another op on my scaphoid  because he felt it wasn't going to heal and it could cause more damage. I was asking him some of the questions i asked you but he said id be better off talking to the surgeon who done the op, so ive to meet the surgeon who did the op in the coming weeks and i'll know more then. I'll let you know how i get on.
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Avatar universal
Hope it goes well for you mate, let me know how you get on.
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Avatar universal
I'm having the same surgery this a.m. for the same reason. Hit me up down the road and I'll let you know how it went. Good luck
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Avatar universal
Ok thanks, i'll set up a meeting with the surgeon who done the last 2 operations and see if i can get something done, but they seemed reluctant to do another operation on my wrist, because after the first  
operation he said it would be only worth 1 more go at bone graft and fixation and that didn't work. Thanks for the advise i'll let you know what happens.
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Avatar universal
Hi,
Proximal scaphoid fracture means the bone closer to your wrist is fractures and distal one means away from it.
I think you should be seeing an orthopedist at earliest.
>90% of non-displaced fractures heal.
Treatment of scaphoid non-unions with vascularized bone grafting and internal fixation seems to have the highest rate of healing.
Good luck and let me know if you have any further queries.
Bye.
Helpful - 0
Avatar universal
Hi,
Thanks for the reply, Im not sure what a proximal or a distal one is. Is a distal one when its in a few pieces? Ive had many xrays and a CT scan on my wrist and the bone is split down the middle and on the xrays  it looks very far apart, and one surgeon told me it was the worst break he's seen, i really dont have enough info so i think the best thing to do is meet the surgeon and see whats best, Thanks for the help.
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Avatar universal
Hi,
I can understand how difficult it would be for you to work along with this injury.
Scaphoid fracture is fracture of the most radial (thumb side) of the carpal bones, usually as a result of a dorsi-flexion injury to the wrist.
Frequent problems include delayed diagnosis and nonunion.
What imaging was done?
Is it proximal fracture or a distal one?
Chronic fractures or non-unions should be treated with reduction and fixation plus bone grafting.
Salvage procedures for late-stage arthritis seen after untreated fractures include excision of the proximal row of carpal bones or partial wrist fusion.
Yes indeed it would be better in longer run. The healing would be faster if you operated now.
It would be difficult to say what actual outcome would be.
Keep me informed if you have any queries.
Bye.
Helpful - 0
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