# Scaphoid fracture



## Lobbydosser (Dec 24, 2004)

I fractured both my wrists back in July after landing badly off a jump. Unfortunately my left wrist has failed to heal after several months in a cast and I'm now waiting for surgery to repair this non-union scaphoid fracture.

Has anyone had a similar experience with this type of injury and if so what was the recovery like.

Thanks.


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## jminn0311 (Sep 18, 2006)

You should have had the surgery as soon as you broke it. You would be all healed by now. I broke mine in a motocross accident and had surgery about a week after. No cast afterwards and released in 4 weeks. It is really a simple surgery where they just screw the bone together. Another friend of mine broke his also and was in a cast for 3 months.

Good luck


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## Trigger (Mar 14, 2005)

I broke mine last year, they did a quick surgery to insert a screw. Quick healing time, small cast for 2 weeks, riding again in 3 weeks.


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## Lobbydosser (Dec 24, 2004)

Thanks for the replies.

Apparently my surgery is to involve a bone graft (taken from my pelvis) in addition to the screw.


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## bongpill (Nov 30, 2006)

I also recently broke my wrist (the scaphoid). The fracture was complete, 1mm separation. Iniatially a doctor told me I should have surgery. I personally prefer not too. So I have been in a cast and going to a proffesional fisiotherapist (very important for recovery). And in 4 weeks my scaphoid is getting back together (got Xray recently). I will be in a cast another four weeks. I migthntake longer, but i trust my body to heel itself. And I believe in the long term it will be best. A screw is fast, but all the people I have asked (motocross riders), they all lost wrist mobility, and with age lost wrist strenght. I want to avoid this by a natural recuperation, like the other bones i have broken. Of caurse everything has consequences. The worst one is I cant ride!!!!!!! Which is driving me crazy, I want to freeride!!!!!!!!! 
If you have a nonunion, of course its a different deal, good luck friend.


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## mtnkiwi (Mar 29, 2004)

I fractured my scaphoid about 14 years ago. I healed pretty quick, no surgery. For the past 4 years I have been getting arthritic-type pain in my wrist every winter. Not sure if that is the cause, but I remember a doctor telling me to expect it as the bone is very delicate and important to the functioning of the wrist. That said, it is also the same wrist I use with the computer mouse!

Hope you heal back as good as new, wrists are super important for mtn bikers.


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## icy (Apr 1, 2004)

I had my scaphiod fused with a graft taken from my hip it took quite a long time (about 3 or 4 months) for the strength to return and was tender to any jarring or twisting. Get yourself a good brace for when you get out of your cast.


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## Lobbydosser (Dec 24, 2004)

Once again thanks for the replies.

I am surprised at the difference in recovery for some people from several weeks to several months. Has the type of rehab anything to do with this?

Lobby.


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## wilks (Jan 15, 2004)

i fractured mine just over a year ago (car crash) and although the doctor says i am all healed the wrist is not like it used to be.....after a long technical downhill or an endurance ride my wrist hurts quite a bit...playing golf is a problem too....as is the extreme cold weather.i am not trying to be negative and i wish you all the best but you may not get it back to where it was......


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## spinnergirl (Sep 22, 2006)

BUMMER Best of luck with the surgery.... re recovery on implants I van vouch that the technology has gotten much better... my friend had his knee joint completely replaced and was back up dancing in competition in 6 weeks. He was in his 40s at the time! He is 50 now and says it is the best thing he ever did. If you're younger you should heal even better....

BTW does anyone know if it's possible to maybe get a small fracture without knowing it for sure? Had a bad fall onto rock a couple of weeks ago and have been having trouble with my ever since, still bad but not as, limited mobility... Also pretty sure I broke a toe (nothing to be done about that from what I hear...)


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## bbanker (May 21, 2006)

*scaphoid fx*

The scaphoid bone has very poor and tenuous blood supply; non-union fractures and instability are common. Hopefully surgery will be a helpful for you.


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## Becky Thatcher (May 18, 2004)

*A stitch in time saves nine*

I was told, on Friday of last week, that I broke my wrist few years back. I think I recall the incident but there have been a lot of crashes. End result was a years old scaphoid non-union that has advancing arthritis.

The surgeon stated, (and my research more or less confirms) that there is a point at which the attempt to repair is no longer advisable and it turns into a "salvage" operation. Since I am left-handed and we're talking about my left wrist I am worried at that prospect.

My MTB riding began tapering off about a year and a half ago because of the discomfort but I thought it was tendon related and thought I could rest it and it would recover. Truth is that was probably the beginning of the arthritis.

I have a question about all of this.

The worst case scenerio is a fusion of the wrist bones and limited motion of the wrist.

Has anyone had this procedure? Can you still ride with a fused limited motion wrist?

Any input would be appreciated. (My surgeon seems to be pretty good. Some of the wrist surgery articles I have read refer to a procedure that bears his name.)

Thanks.


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## Akaisoras (Sep 21, 2008)

I had my scaphoid fractured about 6 months ago, then I finally found out the bone was actually hurt, so lately I put a short cast on, its been almost 6 weeks already, would this thing actually heal?? 

and does non union happen to people at age 20 as well???

would working out on it possibly increase the blood flow and heal it up better??

want some serious experiences with successfully scaphoid healed up guys around here, I v been trippin mad about this


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## EpicProportions (Jul 8, 2008)

Non-union of a scaphoid fracture can happen at any age. The issue related to non-union is the fact that the scaphoid bone receives its blood supply from one side of the bone. When the bone breaks and there is sufficient separation of the bone halves, the end without the direct blood supply is at risk of osteonecrosis (bone death). If the fracture is not healed within a period of cast immobilization (up to 3 months) then surgery is typically required to join the bone halves. This can entail bone grafting (from the hip or wrist) and screw fixation. 

Not all scaphoid fractures require surgery. Those in this thread who suggest that early surgery is required for all scaphoid fractures are spreading misinformation. There are different grades of scaphoid fractures. Fortunately, the younger you are, the better the chances that the fracture will heal with cast immobilization. If you have non-union after 6 months, cast immobilization is unlikely to provide bone healing. Surgery in these situations is more likely.

The long term problems related to scaphoid non-union are mostly arthritic in nature. Arthritis pain and loss of range of motion (wrist) will result. Chronic problems can ensue necessitating joint fusion in worst case scenarios. 

Regardless, you should not be looking at this forum for your medical answers. Most of what you read is subjective in nature, coming from those that can only provide purely anecdotal experiences with a fairly common problem. Each of the contributors to this thread (that have had scaphoid fractures) only know their personal experience. 

That said, all scaphoid fractures are unique. Given the long-term disability associated with untreated or unhealed fractures, consulting with either a plastic or orthopedic hand surgeon is mandatory. If the recommendations of the expert isn't to your liking, then ask for a second or even third opinion. After that you should be able to make an educated decision about the treatment plan and the physician you feel comfortable with treating the problem. Leave the expert advice to the experts.


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## Akaisoras (Sep 21, 2008)

my scaphoid was not broken, it was just a slight crack between the bone, but its been annoying me every time I press down on my wrist, I v seen a doctor for it already, first the doctor told me I needed surgery, then she saw it healing a little bit so she decided the cast would do, its been 5 weeks since I had the cast on, sometimes when I move my hand to certain degrees it still hurts a bit, Im very worried if it is going to heal or not, at the 6 week mark they will check if its been healing and see whether we need another cast or not, I m just trippin, if it wasn't healing, then 6 weeks gone to waste,

I want to hear about dudes with similar experiences on this scaphoid thing, does short cast actually heal it completely?? and how much time required if you just have a fracture, not broken or chipped, this forum for some reason seem to have the most info and people that have scaphoid fracture compared to all the medical forums I v searched up


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## EpicProportions (Jul 8, 2008)

> my scaphoid was not broken, it was just a slight crack between the bone


By definition, a "slight crack" IS a fracture. It may not be a complete fracture, but it is a fracture all the same.

The treatment for a non-displaced fracture or an incomplete fracture would be the same. Conservative treatment by casting. Surgery would not be routinely recommended under those circumstances. Severely displaced fracture segments or evidence of osteonecrosis would lead a surgeon to operate.

I've been there. I was in a cast for 3 months before my fracture healed. No surgery. Unfortunately, the scaphoid is a bone that heals VERY slowly. As I stated previously, due to the bone's relatively poor blood supply, healing is not rapid. Other bones have abundant supply (blood) from both ends. Those bones heal rapidly.

Nothing is wasted by conservative treatment via casting. If the bone does not respond to conservative measures, then a discussion about surgery should occur.

The thing to keep in mind with all of this is that surgery is not always the best solution with scaphoid fractures. If it were, then all surgeons would recommend surgery early on. The literature does not support that treatment plan. Some fractues require early surgery, most do not require surgery at all.

I would suggest you give the given treatment plan a chance. If you try to elicit pain from the wrist while in a cast, you are obviously moving your wrist too much. That in effect can lengthen the healing process. I would suggest you minimize your movements within the cast. Chances are your fracture will heal like most do. Just give it time.


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## mojojojoaf (Sep 9, 2008)

EpicProportions said:


> Non-union of a scaphoid fracture can happen at any age. The issue related to non-union is the fact that the scaphoid bone receives its blood supply from one side of the bone. When the bone breaks and there is sufficient separation of the bone halves, the end without the direct blood supply is at risk of osteonecrosis (bone death). If the fracture is not healed within a period of cast immobilization (up to 3 months) then surgery is typically required to join the bone halves. This can entail bone grafting (from the hip or wrist) and screw fixation.
> 
> Not all scaphoid fractures require surgery. Those in this thread who suggest that early surgery is required for all scaphoid fractures are spreading misinformation. There are different grades of scaphoid fractures. Fortunately, the younger you are, the better the chances that the fracture will heal with cast immobilization. If you have non-union after 6 months, cast immobilization is unlikely to provide bone healing. Surgery in these situations is more likely.
> 
> ...


This is the reply you should be listening to. After working in the orthopedics industry and working with ortho's I have learned that the scaphoid is not to be ignored and should be looked at immediately by an expert who has seen hundreds if not thousands of these cases.


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## 93tankus (Jan 19, 2007)

Obviously, I can only give you information on my experience. I totally agree with EpicProportions. Each person has their own story, so take it for what it's worth.

I broke my scaphoid about 7 years ago. I ended up going the non-surgery route. Had a cast above my elbow (locked at 90 degrees) for quite a bit of time. If I recall, it was around 3 months or so. On top of that, I had a bone stimulator (insert joke here) that I would wear for X hours of the day. Don't know if it actually helped or not, but I do know that I never needed surgery. Yea, it took a long time, but I was happy - and continue to be - with the outcome. I'll have tinges of pain here and there, but overall, I can't complain.

Good luck!


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## yangpei (Apr 18, 2004)

*Well said*



EpicProportions said:


> Non-union of a scaphoid fracture can happen at any age. The issue related to non-union is the fact that the scaphoid bone receives its blood supply from one side of the bone. When the bone breaks and there is sufficient separation of the bone halves, the end without the direct blood supply is at risk of osteonecrosis (bone death). If the fracture is not healed within a period of cast immobilization (up to 3 months) then surgery is typically required to join the bone halves. This can entail bone grafting (from the hip or wrist) and screw fixation.
> 
> Not all scaphoid fractures require surgery. Those in this thread who suggest that early surgery is required for all scaphoid fractures are spreading misinformation. There are different grades of scaphoid fractures. Fortunately, the younger you are, the better the chances that the fracture will heal with cast immobilization. If you have non-union after 6 months, cast immobilization is unlikely to provide bone healing. Surgery in these situations is more likely.
> 
> ...


I agree with Epic Proportions' post. I am an orthopaedic trauma surgeon. Although, I'm not a hand surgeon, I treat many patients with scaphoid fractures. In my experience, the vast majority will heal with non-operative treatment (casting). As previously stated, the period of casting may be up to 12 weeks. Surgery is reserved for fractures that have not healed after non-operative treatment and for the comminuted / displaced fractures that may need early surgery.

I am also surprised that several posters that had surgery state that they were riding within a short period after surgery. Putting a screw and bone graft into a bone doesn't heal it. The body still has to undergo the process of fracture healing. So, even with surgery, there is usually at least 6-8 weeks of down time before sports / activity.


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## Akaisoras (Sep 21, 2008)

should i get a brace for my hand? i want to know if getting a brace is as good as getting a cast. i need it for my fractured scaphoid


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## EpicProportions (Jul 8, 2008)

Short answer: NO!

Scaphoid fractures need to be immobilized (i.e. casted). Splints will allow small movements of the wrist that will prevent the healing of the fracture. Splinting has no long term role in the treatment of true scaphoid fractures.


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## Akaisoras (Sep 21, 2008)

what about those CTI braces some of you guys have


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## EpicProportions (Jul 8, 2008)

The scaphoid articulates with the thumb metacarpal. Any type of carpal tunnel brace is going to leave the thumb free to articulate (move). Therefore, you will not properly immobilize the fracture.

Don't be a fool. Get the fracture immobilized in a cast. This is the only means of avoiding surgery and/or chronic arthritic changes in the wrist. Trust me, I know. I fix these fractures for a living!


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## Akaisoras (Sep 21, 2008)

I just got the cast off after being in one for about 10 weeks, the doctor says it looks like it healed completely, they are still waiting on next week's cat scan to make sure if my scaphoid is healed or not, I highly doubt my ****ing fracture can actually heal, when I relax my hand and bend my wrist down or upward it still hurts like it hurt b4 I don't know why the **** is it still hurting!! damnit I m so frustrated at this fracture, anyone have exp on a fractured scaphoid hurting like this?? how long is it supposed to hurt after you get your cast off, or did it just never heal at all? I am also wondering if the pain I m feeling right now due to not movin inside the cast for too long, or is it the original pain that never healed, I don't get why the bone looks good on the xray why isn't it good yet!! Im freakin here! I don't mind it hurting, I m just wondering if I push too far would I just crack a bone and break my hand off


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## gibson00 (Nov 26, 2008)

I too broke my scaphoid...just recently, on Nov. 15th. I had surgery on the 21st to put a screw in, as well as a plate to fix some other bones. After the surgery, I was placed in a splint of sorts, with a piece of plaster on both top and bottom, all wrapped together (to allow for swelling I assume).
I go on Dec 4th for follow up and to have stitches removed. What would I expect at that visit? Will I be allowed to continue on with a splint since I have a screw in there?

Accident was due to a bike crash of course...


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## SHIVER ME TIMBERS (Jan 12, 2004)

If your scafoid is bad enough that you need a bone graft, then I wouldn't do it....I would ask your doctor about stem cells.....what they do is grab some bone marrow and mix it with some protiens....they take the scafoid and hollow it out like a coconut...they put the stem cells in and it is like magic.

I had the bone graft and it didn't take after 8 months....I wish I went to a more up to date doctor who would have done stem cells


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## gibson00 (Nov 26, 2008)

I didn't have a bone graft, at least not yet! I had a screw put in the scaphoid, and a plate put under the radius. My wrist was stapled shut, so those came out at my Dec. 4th appt., which was about 3 weeks after the accident, 2 weeks after surgery. 
The surgeon did in fact let me go with a tight splint, and said I could start running and indoor biking, just not to put any direct pressure on that hand/wrist yet. Getting next xrays in 2 more weeks. Here is the current:


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## gibson00 (Nov 26, 2008)

stripes said:


> I broke my scaphoid last year (along with shattering a few other wrist bones). Scaphoid was surgically repaired along with my distal head of the radius (pretty much crushed, requiring bone putty instead of a graft, and an external fixator to stabilizie it).
> 
> I've been biking again for over a year. Get it fixed, then go ride


I'm riding indoors, but can't work the shifter with my right hand. I think it'll be a while before I'm on the road. Wrist has to heal before I can try to do the sort of movement needed for an STI lever (road bike), and also to gain the strength back in the wrist...


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