Scaphoid fracture
Overview
The scaphoid bone is the most important bone among all the carpal bones, because it connects the two rows of carpal bone and thereby contributing much to the stability of the wrist joint.
However, its unique retrograde blood supply (the vessel delivers the blood from the distal pole to the proximal pole) makes the circulation more fragile and harder to heal when fractures occur.
The scaphoid fracture usually happens with a fall on an outstretched extended wrist. However, it is sometimes difficult to tell from the initial plain film X rays and certain special views may be needed to make the accurate diagnosis.
Features
Osteosynthesis of scaphoid bone was done to regain the strength and ROM of the wrist and decrease the pain of wrist. Additional bone graft might be indicated.
Procedures
The goal of osteosynthesis of scaphoid bone is to re-align the displaced fracture fragments to its anatomic location. The whole procedure is performed under C-arm fluoroscope. After the anatomic reduction of the fracture was achieved, a small incision is made at the distal scaphoid tubercle; the guide pin is inserted along the central line of the scaphoid to achieve the longest distance of bone purchase, and the drill bit is used to make the tunnel of the screw. Finally, the headless compression screw would be inserted into the tunnel along the guide pin, and the position of the screw is checked in multiplanar view under C-arm fluoroscope. In some cases with bone defect due to nonunion, bone graft would be used to fill the defect and the promote the bone healing.
After the surgery, volar thumb spica splint for at least 4 weeks immobilization is required. The doctor will arrange the rehabilitation protocol in the following months.
Notifications
Complications are not common but could occur.
- Nonunion/osteonecrosis of scaphoid bone: 5~!5% depends on fracture type
- Infection: 1%
- Allergic reactions to medications
- Excessive swelling & Bruising
- Damage to nerves or vessels: 1~2 %
Estimated Cost
For estimated medical costs, please contact International Medical Services Center.