2nd opinion on broken Scaphoid wrist bone

Triathlon Forum
1

Background.

50 yr old male. Right handed. Broken bone in left hand. Cycling accident. Generally I’m pretty healthy and active.

About 14 weeks ago I had a cycling accident. Broken Scaphoid bone in my left wrist. Fractured and displaced. Had surgery within a week to put a screw in it. Last time I was in the X-ray showed not good healing on the fracture. He said if it didn’t improve in the next 6 weeks he would recommend a 2nd surgery to do a bone graft. That appointment is a week from today.

My question is, ok I get the fact that it’s not healing, but won’t the screw hold the “dead” fragment in place. What is the harm in just letting it die?

Just trying to figure out what are the right questions to ask. What are my options. 2nd surgery and another 16 weeks seems like a really long time. I already can’t imagine how long the rehab is going to be after 16 weeks, 32 weeks gezzzzz

2

Scaphoid fractures are notoriously difficult healers and often go on to AVN. I’d certainly ask your surgeon about an external bone growth stimulator such as the Exogen (http://www.exogen.com/patients/) before another surgery.

3

Bump
.

4

Do whatever you can to get the bone to heal. You do not want a dead bone in your wrist if it can be helped. Dead bone = progressive arthritis. I have no experience or opinion on how to do this but bone grafting sounds reasonable. I’d be skeptical of bone stimulators just based on gut. A good hand surgeon should be able to give you sound advice; i’d listen.

Dave

5

I have a dangerously similar story.

I’m 53 tho.

About 5 years ago, I slipped getting into the pool and thougth I’d sprained my wrist. Strangely it was fine if I kept it straight but hurt if I flexed it. I treated it for a sprain, but after about 6 weeks, no improvement. X-ray was inconclusive so off to a specialist. He ordered an MRI. That showed a bruised lunate bone. He said he’d re MRI in 3 months. If it had improved, even a little, it would keep improving and no further action would be needed. If it hadn’t healed, it never would, and would need surgery (apparently the bones of the wrist have poor blood flow and in many people it’s barely enough to keep the bones alive, but not good enough to allow healing). IF you let teh bone die, it crumbles and you lose use ofyou wrist!!! They then have to seize it in place with plates and screws or your wrist just goes all floppy!

After 3 months, no healing so surgery was required. I had a chunk of bone, with artery attached, grafted from my (radius?) onto my lunate. Recovery was same as for a broken bone, meaning about 12 weeks before full strength.

While the surgeon says the operation was a complete success, I’m less happy. I get sharp pains like someone is slashing the back of my wrist, if I flex more than 45 degrees and apply any pressure. I can do chinup (well, not after Xmas :slight_smile: but for pushups, I have to have to do them with a fist, not with my palm on the ground. Alternatively, I use a pair of dumbells on the ground (the six sided ones, so they don’t roll). Not a biggie, but not 10/10 either :frowning:

The worst part is when I get conjugal visits with TriSpouse, which often include the pushup style missionary position, I need to use the fist in the pillow techniqe rather than a flat palm. While that might seem pretty minor, it takes a conscious decision to do that (I invariably forget until I do it wrong, ouch) and that interrupts the moment so to speak.

I’d say get the operation, as the option of the bone dying, and having to have your wrist locked into a rigid position, is not realistic to say the least. I hope you have more complete recovery than I’ve had. That said, I have the use of my wrist, and no longer do push ups. Pretty good solution if you ask me :slight_smile:

6

Background.

50 yr old male. Right handed. Broken bone in left hand. Cycling accident. Generally I’m pretty healthy and active.

About 14 weeks ago I had a cycling accident. Broken Scaphoid bone in my left wrist. Fractured and displaced. Had surgery within a week to put a screw in it. Last time I was in the X-ray showed not good healing on the fracture. He said if it didn’t improve in the next 6 weeks he would recommend a 2nd surgery to do a bone graft. That appointment is a week from today.

My question is, ok I get the fact that it’s not healing, but won’t the screw hold the “dead” fragment in place. What is the harm in just letting it die?

Just trying to figure out what are the right questions to ask. What are my options. 2nd surgery and another 16 weeks seems like a really long time. I already can’t imagine how long the rehab is going to be after 16 weeks, 32 weeks gezzzzz

I broke My right scaphoid by bike accident, was told 12 weeks, X-ray revealed fracture 2/3rds of the way through the bone,; 6 weeks later had an x-ray that showed healing, 12 weeks later cast came off. That bone will not heal properly if the fracture disturbs the artery feeding the wrist, sounds like this was the case with your injury. Go with the bone graft, it’s your best option for a normal wrist.
You’re prolly finding out by now even if you are right handed how usefull 2 good arms are.

7

Dude, you need your scaphoid. All of it. If you just let half die you will end up with terrible wrist arthritis for the rest of your life. If it hasn’t healed by now it probably won’t heal appropriately. Some people get lucky but I wouldn’t take that chance. 16 weeks or 32 weeks of rehab is way better than the alternative.

8

rroof is a doc so if he says the bone stimulator is legit, I’d go with that.
Make sure you’re getting enough calcium (3 x 500 mg a day) and vit D. Twin Labs Bone Support or Tri Boron are both really good.
Scaphoids are hard to heal; low to no blood supply