Scaphoid fractures

When the fracture occurs, the symptoms usually manifest themselves as significant swelling, pain, and deformity in the fracture area. However, sometimes your bones can be broken without any complaints. This is a very typical problem especially for the scaphoid bone of the wrist bones. Many people think that when the scaphoid bone is broken, there is no sign other than very little swelling in the wrist, so it is a simple wrist injury.

The scaphoid bone is located on the thumb side of our wrist and between the thumb and forearm bones. The blood vessels of the bone start from the top of the bone and spread downwards. The fracture occurs in the middle or lower regions of the bone. Here, due to the difficulty of blood vessels in feeding a region below, the long duration of the union causes problems such as non-union.

Who are at risk?

Scaphoid fractures account for the majority of wrist carpal bone injuries. It is most common in men aged 20-40 years, but is less common in children and the very elderly. It is common after falling on the wrist. If the wrist is bent 90 degrees or more during the impact, the scaphoid bone will be broken if it is bent below 90 degrees, the forearm bones will be broken at the level of the wrist. This event is most common after sports injuries or motor accidents.

signs and symptoms

swelling around the wrist

Excessive pain with movement

Pain and tension on the thumb side of the wrist.

The pain may decrease over time and progress with repetitive and deeper attacks.

Pain in the triangular-shaped anatomical snuffbox between the two tendons that activate the thumb is a very characteristic finding.

Diagnosis

If you have fallen on your wrist and your pain feels like a minor wrist problem Contact your orthopedist immediately!
Your doctor will ask you for the details of the incident, question your fall style, identify sensitive areas with examination, and take your x-rays to examine the bone tissue. If the bone ends are not completely separated from each other, it may be very difficult to see the fracture on X-rays. Even if your doctor does not see any fractures on X-rays, they may apply a cast to you for the first week.

Treatment

Mostly, the treatment of scaphoid fractures is done with casts that include the upper or lower elbow and the big toe. The time to union of the fracture may be 6 weeks for the top of the bone and up to 6 months for the lower end. It should be checked whether the plaster loosens with weekly controls and it should be renewed if necessary. After the plaster is removed, physical therapy and rehabilitation to regulate wrist joint movement should be started.

Even scaphoid fractures, for which a cast is immediately seen and treated, sometimes does not heal properly. When nonunion is encountered surgical Bone grafting and internal fixation should be applied with treatment. In cases where the fracture is dissociated surgical treatment is preferred. During the surgery, the bone ends are brought together and attached with screws or wires. Bone graft may be used from time to time.

The scaphoid bones heal in a very long time. Delay in diagnosis reduces the chance of union and causes problems in the future. The most important complication is arthritis and joint freezing operations may have to be applied to relieve pain.

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