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Wrist injury. Report shows displaced fracture through the mid scaphoid, avascular necrosis. Suggestions?

Hi, I stumbled upon this site looking for anwsers about my wrist injury. Any help would be much appricated :-) I injured my wrsit at work the 1st week of January. I work as a nursing assistant, and thought I had hurt myself providing personal care with a resident who is extremely contracted. I saw the Dr shortly afterwards, who perscribed a spica splint to be worn 24/7 for two weeks. I returned to her after a week as my pain was getting worse and I thought perhaps due to the splint. She said another 2 weeks in the splint and off of work. Soon after I was referred onto hand therapy through WCB who said that I had a scaphiod -lunate sprain . I saw the hand therapist 2 a week for 4 weeks. She did some ultrasound therapy and a few forced stretchs to try and improve mobility, but it wasnt getting much better so she sent me back to the dr for a referral for an xray. Turns out my wrist was broken, the following is my report - the date of injury at the point of this report is actually 9 weeks No prior studies . The patient has a displaced fracture through the mid scaphoid with radial displacement and ulnar angulation of the distal fragment. Significant articular step deformity at both the radial and carpal sides. There is sclerosis of the proximal pole of the scaphoid which indicates developing avascular necrosis . Cortication of the fracture margins in keeping with the clinical history of injury 4 weeks prior. Maintained scaphoid lunate interval. Now I have been referred to an orthapedic surgeon, as the amount of avacular necrosis will not support healing on its own. As well, the workmens compensation board is questioning how I could have broken my wrist at work doing my normal duties. The Dr thinks it looks like an old break, but the radiologist seems to state that it is consistant with the injuries. I have another 2 weeks till I see the specialist and this is really bothering me - any help would be much appricated! Sincerely, Melissa
Asked On : Fri, 8 Mar 2013
Answers:  2 Views:  147
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Orthopaedic Surgeon, Joint Replacement 's  Response
Jul 2013
Hi, thanks for writing to HCM.

Non-union and Avascular necrosis are frequent complications of scaphoid fractures.

The only effective way of treating an established scaphoid nonunion is by VASCULARIZED BONE GRAFTING which will yield optimum functional results. But this procedure is really cumbersome and needs sugical expertise.

So, I suggest you to consult an orthopedic surgeon with good experience in handling these sort of injuries.

Hope this information is helpful. Good day
Answered: Fri, 9 Aug 2013
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Physical Therapist or Physiotherapist Arun kumar's  Response
ur case of broken scaphoid bone unfortunately went missing and surprise no body could diagnosed.
and scaphoid is a bone and mostly proximal pole is relatively get this type of injury due to the damage to the artery supply blood over there ..
what u can to is have cont with hand movt howmuch ever possible to keep blood supply to the area to prevent further necrosis .
show it to orthopedic and get the surgery done if required .
u ll be alright
Answered: Fri, 9 Aug 2013
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