Scaphoid Fracture
Did I fracture the scaphoid on my wrist?
It is not uncommon for patients who after a fall have wrist pain that do not go away after several weeksor sometimes even increases, on some occasions theyhave consulted with a doctor who assured that everything was fineand that there were no fractures or dislocationsdespite having taken a plane X-ray from the wrist,however after the new assessment with the hand surgeon, a fracturedscaphoid is found, so it is recommended to immobilizedthe hand, forearm and elbow with a cast for several weeks or perform surgery.Why did thishappen?
The “scaphoid” is a wrist bone that connects the radius, a forearm bone, with the rest of the carpus, is irregularly shapedand can fracture after a high-impact fall on the hand, for example when falling froma bicycle, a motorbikeor during a race. As pain is the patient’s main complaint, it’s often difficult for some doctors to see the fracture so they neglectit,since they are looking for some others more frequents injuries such as radius fractures.
Plain X-ray is a flat image of bodies with three dimensions that allow you to see somefeatures but that can hide others, especially when it isextremely irregular such as the scaphoid, when taking special projections that an experienced specialist requests after suspicion.In several cases it is possible to highlight the fracture but, in some others, it is not,even with moresophisticated studies such as tomography or MRI. That is why in these cases, it issuggestedto immobilize the wrist for a coupleofweeks and repeat the study to avoid overlooking the fracturesof the scaphoid and other wrist injuries, which aftertime pass by tend to get complicated;I personally postpone MRI for patients who persist with pain afteracouple of weeks andspecial X ray projections doesn’t show the cause.
Treatment of scaphoid fracture can be done with or without surgery, this decision depends on several factors that during anappointment the hand surgeon can explain clearly.