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Scaphoid Fracture and Scaphoid Non-Union

Dr. Steven Rueda is one of the most sought after doctors for treatment of scaphoid fracture and scaphoid non-union in Palm Beach. The scaphoid bone assists in wrist movement and bending. Scaphoid fracture is considered a type of wrist fracture and usually leads to pain and swelling in the wrist after injury. Scaphoid “non-union” refers to a situation where there is no healing of the fractured bone ends after injury. Scaphoid fractures are sometimes difficult to identify on xrays and is common for them to be missed at the time of initial injury.

Scaphoid Fracture and Scaphoid Non-Union Symptoms and Diagnosis

The symptoms arise from movement at the raw bone ends in the broken scaphoid bone. Some of the most common symptoms include:

 

  • Pain in the wrist with bending
  • Pain in the wrist with twisting
  • Swollen and puffy wrist
  • Cracking and popping when moving the wrist
  • Decreased range of motion of the wrist

In some cases patients present with all of the symptoms, and in some cases only with some of them. Other conditions like a wrist sprain can cause similar findings.

The diagnosis of scaphoid fracture and scaphoid non-union is usually performed by clinical examination, history, and xray imaging. In some cases, advanced imaging like MRI or CT scan may be necessary to identify the fracture and decide on the ultimate form of treatment.

WHAT CAUSES Scaphoid Fracture and Scaphoid Non-Union?

It is not uncommon for an old scaphoid fracture to have been missed and for the patient to present months to years later with pain. Unfortunately, this bone has a very delicate blood supply that makes fractures very difficult to heal. Because of this limited blood supply, scaphoid fractures often need the help of surgery to enhance their chance of healing. However, there are some types of scaphoid fracture that can also heal on their own with prolonged immobilization.

Scaphoid Fracture and Scaphoid Non-Union Treatment Options

There are two main ways to treat scaphoid fractures: casts and surgery. Fractures are classified as “stable” or “unstable”. Stable fractures are those in which the broken bone is in a good position, or at low risk from moving from its good position. Unstable fractures are those in which the broken bone is in a bad position, or at high risk of moving to a bad position. Stable fractures are treated with casting and splinting, while unstable fractures are treated with surgery.
For the scaphoid bone the location is very important. Fractures are divided into those that are in the in the proximal pole (near the forearm side), waist (in the middle of the bone), or distal pole (near the finger side). Those near the fingers (distal pole) heal very readily with casting if stable. Those fractures at the middle of the bone and near the forearm usually do not heal well and usually need surgery. Scaphoid non-union treatment is typically surgical.

Scaphoid Fracture and Scaphoid Non-Union Procedure

Surgery usually involves placement of a screw that helps hold the fracture ends in place.

Incisions for scaphoid fractures are made in the back or the front of the wrist. It is more common to have incisions in the back of the wrist for the procedure, as the proximal pole of the scaphoid (the area closest to the forearm) is the one that frequently needs additional stability to heal. The length of the incision is highly variable with mini-open techniques being possible for simple fractures, and more extensive incisions for cases of scaphoid fractures with non-union or that have complicated patterns. Those with non-unions, comminuted fractures, or complicated patterns require an incision that is usually located in the area shown below:

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RECOVERY AND DOWNTIME

Very dependent on the type of fracture. Most fractures take 6-12 weeks to heal, however, this can vary widely depending on the site that the fracture occurred on the scaphoid. A cast is worn after surgery for at least 3 weeks.

The downtime is dependent on the type of fracture, treatment, but also on patient occupation. In some cases patients return to work after 1 week if they can work on a cast. In any case, any activity that may cause further injury to the extremity is avoided until it is fully healed.

Why Choose Precision Hand Center for your Scaphoid Fracture and Scaphoid Non-Union Procedure?

Dr. Rueda, a Hand Fellowship trained surgeon who has 7 years and 2,000 procedures of experience will be your safe and best choice for scaphoid fracture and scaphoid non-union treatment. Successful results in these procedures require a surgeon that is experienced and knowledgeable in hand surgery and hand anatomy. Dr. Rueda has published articles in expert peer reviewed journals and his work has been presented in several national conferences. Dr. Rueda’s passion for patient education and custom centered approach will guarantee you feel comfortable every step of the way. Dr. Rueda also believes in treating his patients as if he was treating his own family; you can trust you will enter a trusting and long-term relationship and have some of the best scaphoid fracture and scaphoid non-union treatment Palm Beach can offer.

FREQUENTLY ASKED QUESTIONS (FAQ)

It is important to optimize the bone’s healing ability in every way. Dr. Rueda starts by making sure the patient has an adequate Vitamin D level. Stable surgical fixation in form of a screw has been show to increase the rate of bone healing. In most cases, bone graft from other parts of the body is placed at the non-union site to enhance healing potential.