# Fractured radius and Scaphoid. how long to heal without surgery/what's recovery like



## Mratomix (Oct 13, 2012)

Fractured my scaphoid and radius bones on May 9th this year mountain biking in Pacifica in the Bay Area on the lower section of Boy Scout's trail. Been in a fiberglass/plaster cast to reduce mobilization of my wrist and arm since then. I still will have shooting pains in the anatomical snuffbox area of the thumb and in the actual scaphoid itself. Is that common a month after injury? My MRI and x-rays done 1 week after the intial break (none taken since then, I'm on medi-cal so I get what I can get) suggest that I do not have a non-union situation going on and I'm not in immediate danger. When I pressed the surgeon though, he seemed noncommital to answer why I still am having pain and if there's a possible issue going on. I've got one more month to go, in theory, before I get the cast off on July 6th. My questions are: Is it normal to have some pain, if limited, a month after a scaphoid fracture and ligament hyperextension-causing fall on a MTB? What are my realistic chances of a non-union without having surgery there with a screw put in and how does someone know if they've got a nonunion situation going on and when do you absolutely KNOW you need surgery?

Thanks :O


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## Cleaner (Mar 23, 2004)

I am recovering from a fractured/displaced scaphoid in Feb of this year. I elected to have surgery and stabilize it with a screw which was completed 7 days after fracture. My surgeon advised me that with a fracture and 1 mm displacement the statistics were;
Cast for 12 weeks with a 65% odds for a successful outcome
Surgery(screw) and cast for 6 weeks with a 99% chance of successful outcome

This information coupled with research about correcting a non union scenario led me to elect to have the surgery.


I was in cast(s) from Feb 19-March 26 (then a protective brace) and in occupational therapy from the end of March until the first week of June. I did not experience much bone pain at all, most of my pain has been soft tissue at limits of ROM during therapy and exercise. 

OT released me when I recovered enough ROM not to fall in the disabled classification. I am still not 100% recovered with ROM or strength. I still can not comfortably get in a push up position. Therapists remarked that I recovered ahead of what is expected with this injury. It has been a much longer road to recovery than I expected as I initially thought I had just sprained my wrist. I only got back on my road bike at the end of May and it has been painful although less so each time I ride.

I went to OT 2x per week but I did exercises every day. I spent money to get some specialized equipment to replicate what is used in therapy at home. In my experience the OT regimen was key to coming back once cleared by the surgeon to start it. I am told I should get back 100% ROM or close to it. I also utilized instrument assisted soft tissue manipulation to deal with scarring/adhesions in the soft tissue. I got cleared from the surgeon to employ this method to help with recovery and believe it has accelerated progress. If you can find a hand therapist that is also trained in IASTM (i.e.Graston technique) that would be ideal. My therapist did not have IASTM training so I got guidance on my specific issues and treated myself using tools I purchased or fabricated.


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## Mratomix (Oct 13, 2012)

Cleaner said:


> I am recovering from a fractured/displaced scaphoid in Feb of this year. I elected to have surgery and stabilize it with a screw which was completed 7 days after fracture. My surgeon advised me that with a fracture and 1 mm displacement the statistics were;
> Cast for 12 weeks with a 65% odds for a successful outcome
> Surgery(screw) and cast for 6 weeks with a 99% chance of successful outcome
> 
> I went to OT 2x per week but I did exercises every day. I spent money to get some specialized equipment to replicate what is used in therapy at home. In my experience the OT regimen was key to coming back once cleared by the surgeon to start it. I am told I should get back 100% ROM or close to it. I also utilized instrument assisted soft tissue manipulation to deal with scarring/adhesions in the soft tissue. I got cleared from the surgeon to employ this method to help with recovery and believe it has accelerated progress. If you can find a hand therapist that is also trained in IASTM (i.e.Graston technique) that would be ideal. My therapist did not have IASTM training so I got guidance on my specific issues and treated myself using tools I purchased or fabricated.


Hiya, lots of good and helpful info here, thank you for taking the time to write this out and offer advice and support.

About your fracture, was it a non-union and how much was the non-union displacement? My scaphoid and radius are both *not* non-union according to the MRI and plastic surgeon (you get what you get at medi-cal...sucks not having a good job). Because they are not displaced, the doc said that my bones should heal OK and not form a Malunion or, worse, a non-union if I take it easy and don't mess too much with my hand. Did your doctor talk to you about options for people who have just normal hairline fractures and how many of thsoe people end up getting surgery and benefiting from it?


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## Cleaner (Mar 23, 2004)

I did not have a non-union as I got the fracture stabilized via surgery within 1 week of the injury. I elected surgery to avoid the occurrence of non-union and faster recovery. My fracture was displaced approximately 1mm, it was clear in the X-rays that the scaphoid bone was in two pieces and separated. 

My surgeon is an orthopedic hand specialist and had completed nearly 500 scaphoid surgeries to stabilize fractures prior to mine. I also got a second opinion from another ortho surgeon who also said surgery was the best option for my case to have a successful outcome. My understanding is that if the fracture is not displaced it is an option to use immobilization in a cast (no surgery) to treat it but I am not an expert in this area so you should get a diagnosis from a hand specialist to get relevant information to your specific injury. I gather that your insurance situation may make this difficult but it is worth asking for a consult with a specialist.

The scaphoid has a poor blood supply which is why it does not remodel (heal) quickly relative to other bones in the hand. This is why displaced fractures are at high risk for non union.


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## stripes (Sep 6, 2016)

I had a bad break in 3 places in 2007 (July 6 or 8 I think) on my dominant wrist (distal head of the radius, ulnar styloid, and scaphoid). Had surgery 3 days after the incident.

The doc put a bone screw in my scaphoid and put it back together with bone putty, and used a screw and bone putty to rebuild the distal head of the radius. Ulnar styloid was able to heal on its own.

Oh, and I got a "handlebar" in my arm, or an external fixator. 

4 months off the bike, 3 months out of work. PT was extraordinarily painful the first day because my shoulder was in a sling for most of that time.


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## alexbn921 (Mar 31, 2009)

The scaphoid is one of the slowest healing bones in the body. If you are not in a full case upp to your elbow you will be able to rotate your wrist and slow down the healing. I had to have surgery on mine with a full elbow cast and thumb isolation for 10 weeks, followed by a 1/2 arm cast for another 6 weeks. I used a soft cast for another 8 weeks. I was off the bike for 6 months and it took another 2 months of no risk riding before hitting any real trails. Basically it was a full year to recover. My break was displaced and I didn't take care of it right the first time which made it worse.
Take the time and do it right. Get PT and use a dynaflex ball to get your flexibility and strength back. Good luck.
https://www.amazon.com/Dynaflex-Pro-Gyro-Exerciser/dp/B004RZIBZU


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## stripes (Sep 6, 2016)

alexbn921 said:


> The scaphoid is one of the slowest healing bones in the body. If you are not in a full case upp to your elbow you will be able to rotate your wrist and slow down the healing. I had to have surgery on mine with a full elbow cast and thumb isolation for 10 weeks, followed by a 1/2 arm cast for another 6 weeks. I used a soft cast for another 8 weeks. I was off the bike for 6 months and it took another 2 months of no risk riding before hitting any real trails. Basically it was a full year to recover. My break was displaced and I didn't take care of it right the first time which made it worse.
> Take the time and do it right. Get PT and use a dynaflex ball to get your flexibility and strength back. Good luck.
> https://www.amazon.com/Dynaflex-Pro-Gyro-Exerciser/dp/B004RZIBZU


Because it's so slow healing, do whatever cardio you can, like walking. Yes it's not biking but it helps promote good blood flow.


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## Mratomix (Oct 13, 2012)

stripes said:


> Because it's so slow healing, do whatever cardio you can, like walking. Yes it's not biking but it helps promote good blood flow.


Hi there - I know this posts is years on at this point, but my hand never really fully healed and you had mentioned your healing was a very slow, arduous process. I feel arthritics in my entire wrist where the injury mostly happened and all of my joints make gross, popping sound. I had an EMG (sp?) done at the doc's office and he said there was some delay in the nerve response time.


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