Last week I was walking on some ice and fell. When I went down, I caught myself with my left hand, palm first (with my hand flexed). Since then I have had a pain in my wrist that won’t go away, but only when flexing my hand upward (like you would when doing a pushup). I have no swelling or range of motions issues except for pain when flexing that one direction, more pain when applying pressure and some tenderness when poking around it.
I read some stuff that indicates this could be a scaphoid fracture, but it just doesn’t hurt enough to be broken. Does anyone have experience with this?
I read some stuff that indicates this could be a scaphoid fracture, but it just doesn’t hurt enough to be broken. Does anyone have experience with this?
Enough to know that “it doesn’t hurt enough to be broken” is a classic statement from someone with a scaphoid fracture. Get it checked out by a hand specialist ASAP. This is not an injury to mess around with.
You have to be very careful with this sort of injury Vo2Matt… the primary concern is avascular necrosis (AVN) of the scaphoid. The development of AVN usually occurs if the fracture is at the distal pole of the scaphoid due to it’s lower blood supply and with that a slower healing time. Typically immobilization in a wrist splint is required AFTER imaging has confirmed the fracture and at the 6week mark of wearing the splint a follow-up imaging procedure to ensure adequate healing and then perhaps a few more weeks of wearing the splint is required. IF you do in fact have a fracture and do not allow it to heal and IF it develops into AVN, you are looking at the POTENTIAL of surgery and an even longer healing process. So… long story short, get some radiographs taken FIRST and have someone truly examine you. Do no mess around waiting for it to go away. I wish you the best.
Fractured mine back in August from a dirt biking crash. It wont show in a xray initially lots of times for up to 4 weeks. Mri will be better if your insurance allows it whcih mine didnt, so I had to waste about 4 weeks that could have been used for surgery and recovery. No joke injury not alot of blood flow to the bone and sometimes it will die, they tthen have to pull off your hip. All in all I just was able to do pushups with no pain about a month ago. Try and get a Mri to avoid wastin time.
Thanks for all of your input. I fell last sunday, so its been almost a week and I can’t make an appt with a physio until monday. Is this urgent enough that I should have it looked at today (ER), or can I wait until monday? Should I splint it now as a precaution?
I would splint it now… as a precaution. Better to be cautious now instead of placing too much stress on it. Whether or not to go to the ER… I would say that you could wait as this is not a life threatening issue for sure. Monday should be soon enough in my opinion. Ice it and keep it from moving or placing torque on it. Indoor trainer for now my friend :). Keep your attitude positive and when you have the experts take a look take what they say to heart and listen closely. Best of luck to you. ERIK
I don’t know where you are located, but as a PT here in the states I cannot (myself) order an xray. However, if your physio is involved in an ortho practice with MDs it should work. Otherwise, consider seeing someone who can get an image.
GO GET A FILM. If it shows nothing and still hurts even slightly - go get another one in a week or so. I have a fractured right scaphiod with avascular necrosis, there was a time where BOTH of mine were broken.
If it is broken you will be in a full thumb spika cast (over the elbow, past the thumb) for 12+ weeks. The scaphoid is one (maybe the only) bone in your body that gets its blood on the way back to your heart as opposed to on the way from your heart - this makes healing it slow. I would also start calcium and what not.
Your Orthopod may also suggest a Bone Growth Stimulator…I am not so sure I beleive in them but do have tricks to heal the scaphoid if infact you have a fracture…
Most of all go get an X-Ray before you get a handicapped wrist like I have that is VERY painful.
Oh, put on a splint - a rollerblade wrist guard would be perfect.
And as for the hip/coral option. It has a very low % of being any better off than a fuse. I know that I get to enjoy mine until such time I can no longer take the pain of my wrist. At that time they are going to fuse my wrist and I will have no motion of the wrist from my arm. As it sits, I do not have any issue with swim - bike -run. I do have issues on drop bars and anything that will put vibration directly into my wrist. Tennis, swinging a hammer, trowing a baseball, and the like are out. If I hit it I suffer for a few days with swelling and throbbing…and the more I go I get shards of arthritis in the other bones in my hand from it.
Also, if you can get it - get the MRI and be done with the diagnosis.
And - dont waste your time with a physio, PT, Chiro or even a PCP. What you want is an expert diagnosis from a Radiologist and Orthopod. My initial ED and follow up visits to PCP showed nothing. Weeks later a buddy who is a Radiologist saw a “shadow” and then MRI confirmed the fracture…but it was too late.
The deal with scaphoid fractures is that they might not show up on xray until they start to heal. The healing fracture will show up in a week to 10 days. So, when people come to the ER complaining of wrist pain in that area after a fall we put them in a splint even if we can’t see a fracture on Xray. You need an xray, though, to make sure that part of the scaphoid isn’t grossly displaced, which would lead you at higher risk for avascular necrosis, and that you didn’t actually fracture something else in that area.
You don’t need a hand specialist. You can go to an ER or call your primary care doc and get them to shoot you an xray and put you in the correct splint.
I would do what your doc suggests depending on if you have the pole seperated or what…that is their call not mine.
I was able to heal my left one in <5 weeks and got the cast off…this stunned my hand guy who is an expert in this field (http://www.rockfordortho.com/physicians/bear.html). Knowing that this bone has very poor blood flow I got an idea…and I think that it worked.
What I would do is spin my arm in circles so that blood would fill my hand until it throbbed - I would then put my hand over my head and let it drain and do it over - and over - and over - and over. I would get my cast changed every tuesday and have it moulded to my CarbonX aerobar so that I could ride the trainer (if you sweat in a cast a ton you will want it changed).
After just under five weeks we shot a film to see what was up and it did not show any fracture at all and the healing looked very good. We took off the spika cast and just went with a small brace after that and it has been perfect since then. This was not a scientific study at all and I may be nuts - but we know that blood flow heals wounds, we know this bone has low blood flow and we know I forced the issue and gave it way more blood flow that it would ever get had I not played the gyroscope game with my hand. Wish I had done it with the right hand…
Matt - It’s nice that we can give you a variety of courses of action, splinting, casting, pinning, screw fixation, etc. but for now what you need is a diagnosis…and someone responsible for your care. In many areas, access to specialized care can be pretty difficult. If that’s true where you are, then maybe working with the system and getting your xrays at the ER is in order. But, if you were my patient, even if the xrays were negative you’d be splinted until a follow up exam and probable re-xray in 7-10 days. And that would include bike stays in the house and you watch old TdF dvds on the indoor trainer, too! It’s so easy to do the right thing early in the case of scaphoid injuries.
My only fracture so far (knock on wood), was a scaphoid fracture. It took a while for the doctors to find it… because it was so thin. So once you get the xrays make sure they take a very close look.
Other than that, I think (not remember much), it took about 6-8 weeks to heal and then my wrist was very stiff and weak. And then for the next 2 years it hurt while road riding. Its been about 5 years now and its ok. So you’ll have to be patient on the healing.
Good luck!
Thanks John,
I do live in a fairly remote area, and I’m not sure if there are any hand specialists in town. I’m definately going to treat this as the worst-case scenario. Since it’s been a full week, I’m hoping that any fracture will show up in x-rays, but if it doesn’t I’m still going to push for imobilization and try to find a specialist within reasonable driving distance. And I’ve been trainer bound for a while with all the snow, but I’m betting this pretty much kills any hope of me getting in any ski time this winter.
Chip, your idea does intreague me and made me start thinking. Do you think there would be a benefit to using a heating pad or even contrast baths to try and improve circulation?
You don’t need a hand specialist. You can go to an ER or call your primary care doc and get them to shoot you an xray and put you in the correct splint.
As a hand surgeon, I’ve seen many improperly, or under treated scaphoid fractures from ER and Primary care docs. The diagnosis and treatment of scaphoid fractures is best taken care of by a specialist. I understand that many primary care and ER docs feel qualified to make the diagnosis, but they rarely get an opportunity to f/u with their frequent improper care. The risk of improper treatment, and delay are enormous. Many scaphoid fractures go undiagnosed for years, and only present when AVN and SLAC/SNAC wrist occur. Classic history is fall with a diagnosis of a wrist sprain. This is not the correct forum to dispense that kind of advice.