C. Noel Henley, MD

Hand and Upper Extremity Specialist

  • About
  • For Patients
    • Deciding to Have Surgery
    • Nonsurgical Treatment
    • Living With One Hand
    • After Treatment
    • Instructions After Surgery
    • Make An Appointment
  • Disclaimer
  • Articles
  • What Patients are Saying
  • Appointments

Scaphoid Fracture Surgery – What Happens If A Scaphoid Fracture Never Heals?

October 19, 2012 by Dr. Henley Leave a Comment

An important part of deciding to have surgery for a scaphoid fracture is figuring out what can happen if you don’t have surgery. This article shows you a good example of what happens if a scaphoid fracture never heals.

What is a scaphoid fracture?

A scaphoid fracture is a break or crack through the scaphoid bone of the wrist. It’s on the thumb side of the wrist.

Scaphoid bones usually break when an athlete or young person falls on their hand and wrist, trying to break their fall. The impact hyperextends the wrist, snapping the scaphoid bone in half.

Why are scaphoid fractures bad?

The scaphoid bone has poor blood supply. The arteries that feed it blood enter the bone at strange locations. If the break is in a bad location (usually proximal, or further back away from the fingers), the bone can be very difficult to heal, even if surgery is done.

Most breaks happen in the middle of the bone. If the bone is held in a stable, solid position, it can heal, and does just fine most of the time.

However, sometimes when a scaphoid fracture isn’t recognized – it can be hard to tell the difference between a sprain and a wrist fracture – the wrist stops hurting as bad and the patient keeps using the wrist after a couple of weeks.

This keeps the broken pieces moving together, and the bone never heals.

What happens if the scaphoid never heals?

If the pieces aren’t lined up and held still with a cast or a screw in surgery, the pieces will keep grinding on each other and on the rest of the wrist joint, wearing it out over time.

This type of wear and tear after trauma (or fracture) is a form of arthritis called post-traumatic arthritis.

Here’s an example of an x-ray of a painful left wrist. This man injured his wrist about 40 years earlier and it was never treated surgically or with a cast.

The white areas between the bone edges are areas of bone-on-bone arthritis where the joint is wearing out.

This type of arthritis can only be treated with removal of the bones or fusion of bones together. This stops the pain of arthritis but limits the normal motion of the wrist.

How can this type of wrist arthritis be prevented?

Wrist arthritis after scaphoid non-union (failure to heal) can be prevented by an appropriate cast or surgery to line up the fragments and keep them still so they can heal together.  Most scaphoid waist fractures (in the middle of the bone) will heal in a cast if the pieces aren’t out of place.

Kendall Marshall, UNC’s star point guard, needed surgery for his scaphoid fracture.

Filed Under: fractures

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

EDUCATION PAGES

click on the links below to start learning:

  • arthritis: base of the thumb
  • arthritis: osteoarthritis
  • carpal tunnel syndrome
  • trigger finger
  • ganglion cysts
  • tennis elbow (epicondylitis)
  • wrist fractures
  • cubital tunnel syndrome
  • deQuervain's tendonitis
  • elbow fractures
  • olecranon bursitis
  • fingertip injuries
  • hand fractures

MAKE AN APPOINTMENT

Call our office today at 479-521-2752 to make an appointment with Dr. Henley

Featured Articles

Mallet Finger Injury

“my finger doesn’t work”“my finger is bent”“my finger won’t straighten”“my finger is drooped” These are several of the most common things I hear when patients come in with a mallet finger.  A mallet finger is the name for a ruptured (torn) tendon at the tip of the finger. A tendon rupture is where a tendon […]

Bad Thumb Arthritis – What Does It Look Like?

The video below shows a patient’s thumb moving back and forth. As you’ll see, most of the range of motion is at the MP (metacarpophalangeal) joint. This is abnormal – in a normal thumb, the majority of the motion is through the CMC (carpometacarpal joint, at the base of the thumb). When the CMC joint […]

Forearm Fractures In Kids – What Parents Need To Know

Bones in children are different from bones in adults. They break differently and they respond differently to injury. Some fractures occur both in adults and kids – some fractures occur only in children. Forearm fractures occur in both, with some important differences. This article will cover some of the basics of forearm fractures in kids. […]

Fingertip Ganglion Cysts – Mucous Cysts

The most common tumor in the finger is a ganglion cyst. A ganglion cyst is simply a fluid-filled sac. It can be visible from the outside or buried deep underneath the skin. Sometimes it causes symptoms like soreness and pain; other times patients have no idea it’s there. What is a mucous cyst? Ganglion cysts […]

Categories

  • anatomy
  • announcements
  • arthritis
  • bone health
  • carpal tunnel syndrome
  • common problems
  • current events
  • Famous Hands and Arms
  • FAQ
  • fractures
  • hand surgery
  • injections
  • media appearances
  • news
  • nonsurgical treatment
  • nutrition
  • philosophy of medicine
  • prevention
  • sports
  • surgery
  • tests
  • thumb
  • Uncategorized
  • video
  • wrist surgery

Copyright © 2023 · Dynamik-Gen on Genesis Framework · WordPress · Log in