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Suggest Treatment For Displaced Fracture Of Scaphoid Bone
Question: Scaphoid got fractured on 12th of XXXXXXX post which, underwent 3 weeks of plaster. Exercised as well but upon x-ray the results were a let down. It didn't get fixed. Revisited the doctor and he suggested a surgery to remove the fragmented bone. Another doctor asked to give another 45 days of plaster a shot. I am in a very cumbersome situation right now. What advice will you suggest?
Brief Answer:
Recommended plaster for 45 days and then repeat X ray
Detailed Answer:
Hi XXXX
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. Your X ray shows a minimally displaced fracture involving the distal pole of scaphoid bone near the tubercle. I have seen many patients having the type of injury you have and most of them heal after putting plaster and taking care to keep the scaphoid immobilized.
2. In my opinion 3 weeks is too early to decide on surgery. Putting plaster for another 45 days might cause required healing. Please keep in mind that the plaster should be properly placed and the scaphoid should be kept immobilized.
3. There is 20 percent chance that it might not heal with plaster and that will be known only after 45 days. At that time surgery might be thought if healing is unsatisfactory or does not take place.
Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Recommended plaster for 45 days and then repeat X ray
Detailed Answer:
Hi XXXX
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. Your X ray shows a minimally displaced fracture involving the distal pole of scaphoid bone near the tubercle. I have seen many patients having the type of injury you have and most of them heal after putting plaster and taking care to keep the scaphoid immobilized.
2. In my opinion 3 weeks is too early to decide on surgery. Putting plaster for another 45 days might cause required healing. Please keep in mind that the plaster should be properly placed and the scaphoid should be kept immobilized.
3. There is 20 percent chance that it might not heal with plaster and that will be known only after 45 days. At that time surgery might be thought if healing is unsatisfactory or does not take place.
Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your reply, but scaphoid got fractured now around 2 and a half months back, so what is the probability that it can be healed by plaster? and If I left this untreated, then what will happen?
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. If the fracture took place 2 and a half months back means that it is 10 weeks old. Scaphoid fractures might take a bit longer than usual. In your case the fracture is in the distal pole therefore there are still better chances of healing with plaster. This is because the distal part of scaphoid gets good blood supply.
2. The chances of healing however depend on many factors including proper immobilization and time since fracture. Your injury might still have more than 50 percent chances of healing by conservative means.
3. If it does not heal even with plaster then you might experience a dull pain when making movements involving the scaphoid bone due to movement at fracture site. If the pain gets significant then surgery might be recommended.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. If the fracture took place 2 and a half months back means that it is 10 weeks old. Scaphoid fractures might take a bit longer than usual. In your case the fracture is in the distal pole therefore there are still better chances of healing with plaster. This is because the distal part of scaphoid gets good blood supply.
2. The chances of healing however depend on many factors including proper immobilization and time since fracture. Your injury might still have more than 50 percent chances of healing by conservative means.
3. If it does not heal even with plaster then you might experience a dull pain when making movements involving the scaphoid bone due to movement at fracture site. If the pain gets significant then surgery might be recommended.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Okay got your point thanks, one last question, If I left this untreated, then what will happen?
Brief Answer:
In long term there might be pain but function of hand is normal
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. Research shows that 90 percent of fractures involving the scaphoid like the one you have will ultimately heal and the duration of time which it might take is 6 months.
2. Therefore your fracture is 2 and a half months old and it will be good to give it some more time to allow healing with plaster.
3. In the long run if there is non healing then the patient might have slight pain, about 1 in 5 patients, but there will be no deficiency in function of the affected hand.
4. Long term effects in patients including those with healed scaphoid fracture include early osteoarthritis. This might happen at a later time after many years.
5. In conclusion, your injury is not an emergency and most likely it will heal. Patients are watched for 6 months to observe healing in most cases. Please take care of the injured hand and allow it to heal slowly.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
In long term there might be pain but function of hand is normal
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. Research shows that 90 percent of fractures involving the scaphoid like the one you have will ultimately heal and the duration of time which it might take is 6 months.
2. Therefore your fracture is 2 and a half months old and it will be good to give it some more time to allow healing with plaster.
3. In the long run if there is non healing then the patient might have slight pain, about 1 in 5 patients, but there will be no deficiency in function of the affected hand.
4. Long term effects in patients including those with healed scaphoid fracture include early osteoarthritis. This might happen at a later time after many years.
5. In conclusion, your injury is not an emergency and most likely it will heal. Patients are watched for 6 months to observe healing in most cases. Please take care of the injured hand and allow it to heal slowly.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
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