I fractured mine over a year ago, the pain is tolerable but not ideal, next step would be to put up and shut up or go for surgery, which involves skin graft and screw, anyone have any advice?
Why skin gaft? Just wondering? I think I'd prob go for the crew as its obviously not healed?
The scaphoid has a very poor blood supply so the bone dies, hence the need to graft healthy bone so a union can occur, usually grafted from the hip.
Yeh I know but you said skin graft - did you mean bone graft? 🙂
It's a bugger of a bone to break as the blood supply only comes in from one end (as I understand).
I bust mine as a teenager but luckily it mended in plaster.
A mate wasn't so lucky and he had to go through the operation/graft business which was very painful.
I'd guess you're gonna have to do the same?
Good luck.
So its a bone graft not a skin graft, just to clarify.
I can't advise you as I don't know how much pain you're in.
Shouldn't you be having this conversation with your orthopaedic surgeon?
Sorry foxyrider, yes of course bone graft.
docrobster - the pain is more of a niggle, feels weak when I lift heavy objects, such as my 3 year old. I'm seeing a consultant but doesn't seem that keen to the op.
having broken my femoral neck and 'got away with it' as far as bone healing and no need for a hip replacement I know how you feel.
I think you shoudl ask "How's it going to be in 15-20 years time?'
if the bone does/has died chances are it's only going to get worse and more dififcult to deal with over time.
If the ortho's are recommending surgery and you trust them then take their advice.
Hmm - I guess you have to base it on the likelyhood of success - If he/she says 9/10 are not successfull the? but if he/she says 9/10 are successful then? I think you know already they is annoying you and that the op will be uncomfortable (even with suitable analgesia).
high risk of avascular necrosis with scaphoid fractures due to blood supply. if your a year down the line and still having problems it's worth considering an op. If it was MY hand i'd be talking to an orthopaedic hand specialist about it? is you surgeon an upper limb specialist? If not get referred to one.
Al
doctornickriviera - thanks for the good advice, and yes I'm seeing a hand specialist.
The question is waht are the odds of surgery making it better and what odds it will be worse no better.
Its a probabilities thing and you have to weigh it up.
After a year and you still have pain - perhaps go for the op but consider it in terms of probabilities - especially as I assume there will be a rehab period post op
As a rule if you can't masturbate due to hand pain the you need to get it sorted!!!
The surgeon is probably being honest with you. No sensible surgeon is going to operate unless they are confident they can improve things in the long term. You may have to accept some long term pain if your hand function is otherwise good!
If you decide not to now, you can always change your mind at a later date, if you opt for surgery and it isn't a success, you haven't got a plan B.
The fact that the specialist isn't keen seems to indicate you might be better leaving it.
I was going to ask about "activities of daily living" but nickriviera beat me to it!
ADL's LOL! Never hear OT's discussing that one in patient reviews!
Thank you for the advice Docs, re: activities of daily living" fortunately I'm right handed and the fracture is on the left, saying that I've been in a sling with a fractured clavicle for six weeks.
Ambidextrous surely?
I am now 😆
I've read about non-union (bones) with this fracture due to patient not resting said digit long enough...
You're probably spot on Love Tubs, unfortunately it went undetected for several months, then I was in a splint for 3 plus months, then I thought what the heck and got back on the bike.
non union might explain the neeed for a screw and graft btw.
Well I have very direct experience of this one. Broke my scaphoid when I was 18, and thought it must just be a strain as it didn't hurt that badly, and I could just about still write with a bit of pain (though when I tried to go canoeing that evening it hurt a bit too much!) It also settled down fairly quickly to the point I could still do normal things with it, including canoeing. Roll on 18 months and I'd jolted it yet again, though worse than previously I decided to see the doctor. He said "I don't think it's broken, but go to A&E to check anyway". The doctor in A&E said "I don't think it's broken, but have an x-ray to check anyway". Cue much surprise that it was indeed broken (still) and 2 weeks in plaster which helped a lot to settle it down, but obviously didn't fix the problem as the bone was dead.
Anyway, I got myself booked in to hospital to have an op, including the bone graft as you describe. Even spent the night in hospital and had my wrist shaved in preparation. When the surgeon came round in the morning though, he wasn't very happy at the idea of the op (I'm guessing he'd only just seen the notes). It is apparently very tricky working on such a small bone and easy for it to go wrong, and he was concerned he could make it worse. Given I was managing OK, his advice was to leave it for now - apparently I've also got some cartilage grown around the bone which supports it.
Had lots of physio and also switched to doing lots of things left handed, including using left hand control for canoeing (I'd switched before I went into hospital on the theory my wrist was going to be immobilized for 3 months and the only way I would be able to paddle after that was left handed) - it helps that apart from very fine control I'm fairly ambidextrous. I did get told though that I'd likely get arthritis by the time I was 30.
I'm now 40, and I have so little problem with my wrist that it's only things like this which make me think of it. Occasionally I jar it, but that tends not to be a big problem now, and something I get over in a week or two. Have less flexibility in my right wrist, but that's not a big deal. Don't have arthritis. I definitely made the right choice - obviously your situation may be different, so I can't advise directly, but do get more advice and be aware that not having it done is a realistic option (until I saw the surgeon everybody was telling me I needed to have the surgery).
Edit: the sort of symptoms you describe sounds exactly like how I was finding it in the 18 months before I got diagnosed. It's got a lot better since.
aracer - thank you, that's very useful. I assume youth was on your side, I'm 40 pretending I'm 18, I'm going to talk this through with the surgeon. Can I ask what the physio consisted of?
I have had the reverse of aracer I broke mine playing rugby in 98 went to A&E on the monday after to be told it was a sprain and it should be ok in a week or 2 so I carried on as normal played rugby the following week still in pain but thats what you do when your 18. after this every now and again I would knock it doing something and it would hurt for a while then go away but the longer I left it the longer the pain would last so after a year I went back to the doctors and he sent me to have an Xray and they confirmed it was broken and dying away and the only thing they could do was graft some bone from my hip onto my Wrist with a screw since the op I have had no problems with my wrist and get no pain at all with full use so glad I have had it done.
only thing I will say is I had 1 week in hospital with my arm paralized for 2 days, a 6 inch scar on my hip, a 2 inch scar on my wrist and had 6 months in plaster.
hope this helps and good luck.
Thanks swarren27, a week in hospital - ouch!
Yeah they said it would only be over night but my hip wouldnt stop draining fluid.
My hip hurt more than the wrist after the op but I still managed to go snow boarding 2 weeks later and the plaster was the best wrist suport i could have had 🙂