scaphoid break

[slickricksta]

hi, i broke my scaphoid last may 2007 and previous to that in sept 2006, on both occasions i was put in a cast for 6-8 weeks ish... i still get severe pains, not constantly but frequently during most days and even every day activites cause problems. i find it is limiting what i can and cant do.. i feel i have lost strength in my hand. what would be the best course of action to take?//

[JainMD]

Hi,
If plain radiographs (x-ray) are negative but examination is suggestive of fracture, additional imaging is indicated, including:
Bone scan (in acute phase), CT scan with 3D reconstruction and MRI, which is becoming the standard test because results are obtained quickly.
X-ray's are also part of imaging study.
If you have non-union or mal-union then probably the surgeon would decide regarding further intervention like open surgery, bone graft etc.
Keep us posted if you have any queries.
Bye.

[JainMD]

Hi,
The major blood supply to the proximal pole enters the bone through the distal 1/3 of the bone.
Vessel disruption causes compromise of the blood supply to the proximal pole. There could still be compromise of blood supply to scaphoid bone hence there might be still pain.
Displaced fractures and proximal pole fractures would require surgery.
Keep us posted if you have any queries.
Bye.

[slickricksta]

i think the fracture was a non-displaced one. Due to the poor blood supply to the bone is this a possible factor in why i still have problems with the wrist. if so what steps would be taken?? Its a constant worry as i dont want to develop arthritis later on in life

[slickricksta]

i have booked to see an orthopaaedician but they cant see me until march 26 at the earliest. would an imaging study show more than an xray?? its so frustrating as im eager to be playing football but worry incase i take another blow to the wrist and cause a fracture (again). if the imaging study shows a non-union or a mal-union what would the likely course of action be???

[JainMD]

Hi,
If there is a non-union or mal-union of fracture then probably there would be symptoms of continuous pain and also pain often occurs after use of the limb which is true in your case.
I would strongly recommend seeing an orthopaedician at earliest. You need to get imaging study done of the affected limb.
We can take a call after examination and imaging is over.
Keep us posted with your queries and any assistance needed.
Bye.

[slickricksta]

is it common to be getting problems 8 months on after suffering the fracture?? would you recommend seeing someone?? if so what would the likely course of action be? i just want to be able to carry out normal activities without suffering. im not sure what fracture i suffered but i am sure it was two different fractures rather than a repeat fracture on the first one! even typing this hurts!

[JainMD]

Hi,
I have posted my thoughts on one of your post. You can review that post and keep us posted with your answers.
If you are having displaced fracture then displaced fractures should be treated with reduction and screw fixation.
Cannulated screws that are headless and have variable threads currently are used for fixation.
These screws can gain compression of the fracture site without protrusion of the screw from the edge of the bone.
The use of a cannulated screw with a guide wire aids in correct screw placement.
Cannulated screws may be placed percutaneously.
Chronic fractures or non-unions should be treated with reduction and fixation plus bone grafting.
Bye.