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Wrist Fracture


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Anyone have experience with fracturing their scaphoid? The x-rays taken a week after my accident to check my thumb subluxation showed a fracture. I go back next week to have my cast replaced and they'll take more x-rays, so I'm trying to educate myself on anything I should know or ask when I'm in there. Thanks!

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Scaphoid = little bone in your wrist at the base of the thumb. Usually breaks from high falls on outstretched palm. Often times not that painful, compared to other fractures. Hard to see in xrays. Easy to misdiagnose. Both for patient and Dr.

 

This bone can cause problems if not treated. Blood flows into the scaphoid only from one spot. If it is broken in two, part of the scaphoid will eventually lose all blood flow and die. This is called vascular necrosis (blood death). End result of vascular necrosis can often times be a fused wrist with limited use and range of motion. Not good.

 

I broke mine in April of 2000. Stupidity, dislike of doctors and life in general prevented me from seeing a Dr. until October 2000. Dr. gave me the scare story I listed above, which I confirmed w/some internet research, and talked me into surgery. A screw is inserted inside the bone to connect the two halves, then a bone graft is taken from either hip or radius to cover up the screw and promote healing. Pretty standard procedure. I did 3 months in full arm cast post surgery, then another month in short arm cast. My doctor told me cast alone would have probably been sufficient with immediate diagnosis.

 

Post cast my wrist was pretty sore for over a year, but I was skiing, climbing and biking almost right away. I DO NOT recommend this and my Dr. was very upset w/me, but I was able and so I did. See the stupidity comment above.

 

Now nine years later I find the only problems to be occasional soreness and lack of range of motion. Good wrist bends back 90 deg. bad wrist only bends about 35. The only thing this prevents me from doing are pushups. Wrist is as strong as ever in flexed position, like doing pullups, climbing or bike riding. I mostly do not think about it anymore.

 

Take home lessons as follows. Make sure it is healed. Probably want to work with an ortho specializing in wrist injuries to get proper diagnosis and confirm repair, even if you do not have surgery. Good idea, when falling, to not catch yourself with your hands. The outstretched arm makes a nice lever which can easily injure wrists and shoulders in falls. Take the blow on the body.

 

Hope some of this helps. Wish you the best of luck and a speedy recovery.

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Thanks 33M :) It does help.

 

I was in a splint the day of the accident due to my thumb and in a cast two days after that so I'm hoping to avoid the surgery. It's good to hear you're doing well. I can live without doing pushups as long as I can climb and ski :)

 

Appreciate the take home lessons, too. I actually hit my face with my thumb and ski pole as I was falling so I don't think my arm was outstretched especially with the huge bruise on my other arm where it looked like the pole may have also hit afterwards. I don't remember anything after hitting my face and thinking I broke my thumb, so who knows what actually happened. Just know I probably shouldn't have gotten up and kept skiing. But in defense of my stupidity, I had no idea I'd hit my head or hurt myself as much as I had.

 

Thanks again!

 

 

 

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I am an orthopedic surgeon. Do not ignore or mess with this fracture. Blood supply to this bone is tenuous. Depending on where the fracture is (middle or end, and which end) gives a better idea of the prognosis for healing - so ask the person treating you where it is on the bone and to tell you how well that particular fracture pattern heals. If you need surgery go to a hand specialist. Seattle Hand is a great group. Good luck.

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I write this just to give you a personal story because I know that early last year I was searching everywhere for peoples experiences with this. Just to give you a success story of a scaphoid Fx, thus far, I Fx'd by wrist back in '03 while driving around the country living out of my truck and stopped by a VA hospital who said it was fine and to just keep wearing the brace that I had been wearing. At that point it took about a year to regain 95% use of my L wrist.

 

Fast forward to Sept 07 and I crack my radius and they found the old Scaphoid with significant non union but vasculature intact. So after much review of countless studies on the future of my wrist with and without surgery, at this point my wrist was fine, I decided to have a screw and large bone graft placed in the gapping hole that was my middle portion of my scaphoid.

 

That was Feb 08. I would say the three months of cast time sucked but as of now I have probably 95% strength and 95% flexibility and am climbing harder than I have before, which still isn't that hard. : ) There are random pains daily but that is to be expected nothing debilitating.

 

What the studies show it that osteo arthritis is unavoidable but what the surgery should do is prolong the health of the wrist. Worst cause scenario with a non union is the scaphoid collapses and the other carpals all shift around and you end up getting a fused wrist.

 

It sounds like your doing the right things and just like others have said find a good hand team that do a lot of these and take the time to let it heal. It seems like forever but it's worth it to still be able to have the full use of you hands.

 

My Lessons learned:

-Don't "walk it off", get injuries checked out.

-Let yourself heal

-Don't go to the VA

-Lead with you face when falling : ), as per my hand surgeon.

 

 

 

 

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Thanks, base697. I actually found out today from my doctor my scaphoid isn't fractured. The first set of x-rays suggested a fracture in the middle portion as did the second set, but it still wasn't clear so they sent me for a CT scan yesterday. I'm very happy with the news. Unfortunately, the new x-rays showed my thumb isn't where it's supposed to be again so the cast didn't help there and now that's what needs to be figured out.

 

Anyway, I appreciate all the input. And all this will be here for the next person looking for info on a scaphoid fracture!

 

 

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Anyone have experience with fracturing their scaphoid? The x-rays taken a week after my accident to check my thumb subluxation showed a fracture. I go back next week to have my cast replaced and they'll take more x-rays, so I'm trying to educate myself on anything I should know or ask when I'm in there. Thanks!

 

 

I wish I could say that I have no experience with this bone, but it would be a lie......

 

 

I destroyed both of my wrists BMX dirt jumping, and the Scaphoid is seriously THE WORST bone to break. Well, maybe not as bad as a vertebral or skull fracture..... But as far as the extremities go, yeah.....

 

Essentially, it has a very limited blood supply and its healing time (if it heals at all) is very slow. The Scaphoid is built out of an extremely compact and strong type of bone, and is one of the body's densest structures. Because of its density and strength, it hasn't evolved a rich blood supply - it recieves nourishment from the distal and medial portions; and so proximal pole and waist fractures are the worst.

 

If you haven't yet, go look up a doctor named "Thomas Trumble" down at UW Medicine. He is the premier hand surgeon in the Northwest, and has a 97% success rate with Scaphoid healing. I suffered a very displaced Scaphoid waist fracture in 2005, and he basically saved my wrist from going necrotic and thus rendering me disabled for life. The trick with this injury is to act very quickly before the bone has a greater chance of non-union.

 

Again, go see Trumble. My family is full of OT's, PT's, and hand therapists, and they all refer people to him. Here is a link:

 

http://www.orthop.washington.edu/uw/tabID__3374/ItemID__2/mid__10294/Default.aspx

 

Good luck.

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