Scaphoid Fracture

The scaphoid bone is part of the 7 carpal bones, being the one that fractures the most of this set of bones. 15% of acute wrist traumas occur in the scaphoid, being more frequent in young patients between 15 and 30 years old.

How the fracture of the scaphoid bone occurs?

It occurs when you fall with your hand outstretched, supporting all your weight on the palm of your hand, being frequent in traffic accidents or sporting activities.

What are the problems with a scaphoid fracture?

  • Upon arrival at the emergency room, the percentage of non-visualization of the fracture in the first X-ray can reach 40%, so the fracture can be mistakenly diagnosed as a simple wrist sprain.

 

  • In those patients who consult the emergency services due to trauma and wrist pain, tomography is a useful diagnostic tool, which helps us rule out and lower the percentage of failure of the X-ray. This exam has the advantage of providing three-dimensional images of the bone structures, thus increasing the probability of detecting the fracture.

 

  • Unlike other bones, the scaphoid has poor vascularization, this means that it has areas with less probability of consolidation, so depending on the area where the fracture is, the risks of appropriate fusing change.

Photo caption: As shown in the figures, the scaphoid bone, in its proximal part, does not have good vascularization (blood supply) as it does in its distal part, so this area may have a lesser consolidation of fracture.

Why operate on a scaphoid fracture?

Years ago, the management of a scaphoid fracture was carried out using a cast for 2 or 3 months, thus preventing the mobility of both the hand and the elbow, however, with the appearance of new tools (headless compression screws), nowadays the surgical procedure guarantees an adequate and rapid recovery of the fracture.

As doctors we seek to perform minimally invasive treatments or surgeries, which not only guarantee an adequate and rapid consolidation of any fracture, but also rule out associated ligament injuries, so the recommended surgical procedure for the correction of a scaphoid fracture is the technique of the wrist arthroscopy, together with the application of a screw through a minimal wound, this minimally invasive procedure has many advantages and benefits for the patient. 

What is the advantage of an arthroscopy in this type of fracture?

The wrist arthroscopy not only allows the user to evaluate the appropriate correction of the scaphoid fracture, but also the proper location and length of screw, as well as ruling out associated ligamentous injuries, thus guaranteeing an adequate result of the surgery and a prompt recovery and reintegration of the patient, not only in their work life but also in their daily life activities.

How soon can the hand or wrist be moved after a scaphoid fracture surgery?

If the scaphoid fracture is corrected using the wrist arthroscopy technique, the onset of mobility can be as rapid as the postoperative pain allows. The beginning of wrist movement can be started after the first check-up, a check-up that takes place three days after surgery, thus guaranteeing rapid rehabilitation and reintegration of the patient into their daily life activities, following certain recommendations. See the article What to do after hand surgery?

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