Wrist Scaphoid Bone Fracture
What is the scaphoid bone?
Why does the scaphoid bone harden?
How does scaphoid fracture make complaints?
Which examinations are required?
How is the treatment done?
What is the scaphoid bone?
It is one of the 8 small bones in the wrist. It was called 'scaphoid', which means that it resembles a boat in Latin because its shape resembles a little boat.
This bone is one of the most commonly broken bones in the wrist after a fall. It breaks when you fall on it with the hand and elbow open.
Why does the scaphoid bone heal late?
It is a difficult and coy bone to boil.
• Since it is a bone that is completely in the joint, the network of blood vessels feeding this bone may not be strong enough to feed the whole bone after the fracture. When the end of the bone near the forearm is broken, it is more difficult to boil because this area is not well supplied with blood.
• A slipped scaphoid fracture can leak joint fluid into the space, affecting the union.
How does scaphoid fracture make complaints?
When the scaphoid breaks after falling, there is swelling and pain in the wrist. If the anatomical snuff box feels painful when pressed, a scaphoid fracture should be suspected.
Which examinations are required?
• X-ray: A non-slippery scaphoid fracture may not be visible on first x-rays. When this x-ray is taken after 2 weeks, the fracture edge becomes visible as the bone is absorbed. Scaphoid X-ray position is different from the standard position. The x-ray technician must know that an x-ray is taken for the scaphoid bone.
• MRI or CT: If there are complaints not seen in x-ray, MRI or CT is performed for diagnosis. After nonunion, whether the blood supply of the broken piece is impaired and whether there is decay (avascular necrosis) in this bone piece is followed by MRI.
How is the treatment done?
If the scaphoid fracture has not slipped, this lucky situation is treated with a plaster cast. Scaphoid plaster is made to cover the big toe. The period of plaster is not less than 6-8 weeks.
If there is slippage between the fracture parts or there is no finding in the direction of union in the follow-up, the broken parts are firmly attached to each other with screws and union is achieved.
Old nonunion scaphoid fractures should be treated surgically. Fresh bone tissue is brought into the fracture gap (taken from the pelvis suction or forearm) and the fracture is fixed with special scaphoid screws.