mtomaino
10-02-2011, 12:22 PM
In the September issue of the American Journal of Hand Surgery, yet again, the necessity for careful treatment of scaphoid bone fracures was emphasized. You may read the article at this link:
http://www.rearmyourself.com/assets/lib/files/Risk%20Factors%20contributing%20to%20scaphoid%20no nunion.pdf
Here's the summary. The charts of 96 patients who went onto develop 99 scaphoid unhealed fractures (nonunions) were reviewed to look for risk factors. 85 patients with 88 nonunions were contacted, and were the basis for an analysis of pattern of presentation and treatment details.
78 were men, 46 were from sports injuries, and 7 had no recollection of any injury.
First key point:if you have an injury to your wrist and it still hurts after a few days, get an x-ray AND have your wrist examined by a Hand Specialist
You may ask, why? Well--in this study, the authors found that for 57 patients who sought care, only 42 were diagnosed with a fracture and received appropriate treatment.
15 patients either never had an x-ray, or if the initial x-ray was negative, never had a repeat---so their injury was never diagnosed. Had it been identified in a timely fashion, a cast might have been placed, and the fracture might have healed, thus preventing the development of a nonunion.
20 of the nonunions were proximal pole fractures---like the one I have attached.
Second key point: proximal pole fractures, and fractures that do not show progression of healing on serial x-rays, should be fixed
The postoperative x-ray attached shows the type of cannulated screw that can be used---and you can watch a video at this link:
http://www.rearmyourself.com/article/treatment-of-acute-scaphoid-fracture
The bottom line is that a "wrist sprain" may actually be a "scaphoid fracture". And, a scaphoid fracture may not show up on an initial x-ray. So it behooves you to have an examination by an expert so that your wrist problem can be accurately diagnosed and treated.
http://www.rearmyourself.com/assets/lib/files/Risk%20Factors%20contributing%20to%20scaphoid%20no nunion.pdf
Here's the summary. The charts of 96 patients who went onto develop 99 scaphoid unhealed fractures (nonunions) were reviewed to look for risk factors. 85 patients with 88 nonunions were contacted, and were the basis for an analysis of pattern of presentation and treatment details.
78 were men, 46 were from sports injuries, and 7 had no recollection of any injury.
First key point:if you have an injury to your wrist and it still hurts after a few days, get an x-ray AND have your wrist examined by a Hand Specialist
You may ask, why? Well--in this study, the authors found that for 57 patients who sought care, only 42 were diagnosed with a fracture and received appropriate treatment.
15 patients either never had an x-ray, or if the initial x-ray was negative, never had a repeat---so their injury was never diagnosed. Had it been identified in a timely fashion, a cast might have been placed, and the fracture might have healed, thus preventing the development of a nonunion.
20 of the nonunions were proximal pole fractures---like the one I have attached.
Second key point: proximal pole fractures, and fractures that do not show progression of healing on serial x-rays, should be fixed
The postoperative x-ray attached shows the type of cannulated screw that can be used---and you can watch a video at this link:
http://www.rearmyourself.com/article/treatment-of-acute-scaphoid-fracture
The bottom line is that a "wrist sprain" may actually be a "scaphoid fracture". And, a scaphoid fracture may not show up on an initial x-ray. So it behooves you to have an examination by an expert so that your wrist problem can be accurately diagnosed and treated.