Just wondering if anyone has had the bad luck to end up with a fractured scaphoid and how they went about it.

Long story short I've ended up with the option of getting surgery; which involves a bone graft taken from the radius bone and inserted between the fracture and a screw inserted to compress the bone. This involves 1 month no work followed by 3 months light work (no kiting for at least 4 months). + a bill of about 4k, im not privately health insured, didnt have the foresight (I'm 21).

Surgeon believes this to be a 70/80% chance of being successful.

Or.

Arm/ wrist in a splint for 'several' months. No heavy lifting.

50/50 chance of bone healing.

Followed by a stiff wrist and some hand therapy.

Although this may not work at all and I'd have to get the surgery anyway.

For me, I'd prefer to get back on the water ASAP and surgery may be the best but I'm also a fan of the body doing it's thing.

Anyone have any ideas? Even other circumstances where you've chosen to avoid surgery I'd like to know about.

Cheers,

Max

Has the blood supply to the broken bit been compromised?

I cracked mine but blood supply was good so it healed naturally.
Took well over a year to be pain free though.

Badly broke mine years ago. Had a screw inserted and was in a cast for 3 months. I was a keen wake boarder back then and my doctor advised me to keep doing it one month after the operation as the blood flow in this area is poor which creates a lot of problems with the healing process. Gripping the bar with my four fingers helped pump blood through the area a lot better hence why he was keen for me to keep doing it. I got a cast made out of a special plastic and could remove it after getting it wet with some help of course.
After 3 months got the cast off and had the X-ray, went off to see the Doc and he stood back looking at the X-ray and admired his work. I asked him was it that bad and his reply was " Hell yeah, broken in six pieces and the tendons were a bloody mess". "If you went through public they would have just fused your wrist it was that bad".
20 years on and it is working fine just gets a bit sore in the cold weather. Screw was removed 1 year later.
Keep that blood flowing through that joint by gripping or squeezing exercises while your arm is in the cast.
sounds as though yours is a descent brake as well, especially getting a bone graft. Me personally you have better odds with the operation, 4K seems a lot but how much do you think your wrist is worth to work properly again.....don't think you can put a price on that. Good luck and do everything you can to get that little s&$t of a bone healed properly.

I'm pretty sure the blood supply is fine so could be the go just to leave it.

Think the bone graft makes it sounds worse than it is. I thought it was just sprained/sore for about 3 months before getting
scans. so the bone that was trying to heal is now old and they have to replace it with new stuff.

Surprises me to hear you say that he recommended that. The surgeon I saw is really not keen on me grasping this tightly,
carrying loads or punching stuff.

Cheers for the info

Falling over, landing with your hands out in front is how you do it -- motorbikes, snowboarding etc. Slow to heal due to, as all note, poor blood flow.

I woudlnt have have thought just a fracture would need surgery...? Pin, maybe, to stop it shifting if it's really broken.

I did my wrist big time in 2009, end of summer, when I was learning... "ooh overpowered... just one more run then I'll pack it in"
Had to have surgery, but still have the plate in. Pin was removed a few months after, was kiting and motor biking again in the spring. I'd say it took a year to be pain free at extremes of movement and now it's 100%.

Get the operation, as for rehab, wank mags

I did mine years ago playing football. After the given amount of time in a cast and an xray that showed it had healed I went to my Dr at the time and he went to cut the cast off. He didnt cut the cast all the way off my thumb and when he gave the cast a pull off he rebroke it. I yelled first at the pain and then at the thought of what he had done. He disagreed originally that he had rebroken but another xray proved it.

Obviously he was feeling pretty bad and pretty negligent. After several more weeks where it was obvious it was nt healing properly, he arranged an "express" appointment at the specialist hand clinic at a capital city Hospital.

I had a pin/bolt which looks a bit like a dumbell inserted. From memory I think it is called a Herbert screw after the Dr who invented it. It was quite new at the time. It healed up fine. If I punch with that hand I get a pain through the area but not too bad. Had a mate who did his roughly the same time. He also ended up having to have surgery and he only ended up with about 50% movement.

If you do need to have surgery make sure you get some good recommendations.

I'd go with surgery, it may cost you a bit upfront but in the long run you'll be glad. I demolished my wrist near on 18 months ago, broke a couple of bones but the worst was all the ligament injuries, i still have some screws in. The public system stuffed me around a big time initialy and i ended up just forking out for private.

Make sure when you start hand therapy you do every thing they say and keep going until you are happy with your range of motion and strength. Once i got to 50% at the hospital they let me go so i went to a physio for another couple months and finally got it to about 85% of what it was.

You quickly learn your limitations and how hard you can push it. The doc told me i would never be able to do a push up again, but i'm finally back into doing them. I can't box or have any sort of direct impact. I can wake and kite again, it just pulls up stiff the next day. Cold weather and water sucks!

All the best mate hope it all goes well.

Broke mine trying to be superman dirt bike riding.
What the others are saying is that blood flow in that area in naturally not good. So takes longer to heal.
I went with plastic moulded with Velcro brace. It offers great support and comes off easily for showering.
But each case is different so you have to do what you feel is right.

If the fracture is through the waist of the bone (the thinned middle area) it can disrupt the artery and you can get avascular necrosis of part of the bone and ongoing instability issues/problems/pain.

Go with the surgery, do the right thing, as for rehab its ROM exercises and I always adjust them once healed to eliminate stiffness and have correct biomechanics ;-)

Just a tip for the future for anyone with injuries. Someone i know stuffed up a kiteloop and popped his acl. First thing he did was get private health insurance and personal income protection when he got home. 2 days after went to physio and paid cash and used a mates name. Physio was **** and advised him swelling due to impact and jarring. Anyway soon after went to doctor after he slipped and fell while running that morning ;). Got referal for scan and specialised. Anyway long story short all covered and private med specialist and the whole lot. Understand if you break your leg this might not be practical!

Hey Peeps,

I recently did a Grade 3 rupture of my ACL (Shoulder) and also a soft fracture of my Radial Styloid. Doc suggested i'd get same percentage of success with natural healing as opposed to surgery.

7 days in a plaster cast for the wrist with a shoulder in an arm sling. After the week, plaster replaced with fibreglass cast. 5 more weeks in cast and sling. I gave up the sling after 3 weeks and only wore it when I got tired. I was concerned about the atrophy of the muscles so prefered the day to day movement to offer light physio rehab. Seemed to work well. I took the cast off myself after 5 weeks, a week prior to scheduled removal (it was driving me crazy).

Swelling was still obvious and the wrist was very tender, movement reduced. About a week after I had the cast off, I started getting insane nerve entrapment in my shoulder and wrist which caused Carpel Tunnel like symptoms which kept me awake most of the night after I went to bed. Still get it sometimes, but getting better. Swelling is dropping and movement is becoming almost normal. Still a bit tender.

I though the ACL would be heaps worse but doc said the wrist will be a greater problem and will lead to arthritis in due course. The ACL has healed quickly but with the obvious bump of my now sprung clavical.

Its now 12 weeks and I'm keen to get back on the water kiting and feel I'm up to it provide I take it easy. Paddling on the other hand is going to be a bit more slow in terms of recovery. I won't be back to full strength for some time in my opinion. Will miss the biggest summer ocean races this year.

This is my story andyhow.

Best of luck mate.

DM

Select to expand quote

mjp12 said..
Just wondering if anyone has had the bad luck to end up with a fractured scaphoid and how they went about it.

Long story short I've ended up with the option of getting surgery; which involves a bone graft taken from the radius bone and inserted between the fracture and a screw inserted to compress the bone. This involves 1 month no work followed by 3 months light work (no kiting for at least 4 months). + a bill of about 4k, im not privately health insured, didnt have the foresight (I'm 21).

Surgeon believes this to be a 70/80% chance of being successful.

Or.

Arm/ wrist in a splint for 'several' months. No heavy lifting.

50/50 chance of bone healing.

Followed by a stiff wrist and some hand therapy.

Although this may not work at all and I'd have to get the surgery anyway.

For me, I'd prefer to get back on the water ASAP and surgery may be the best but I'm also a fan of the body doing it's thing.

Anyone have any ideas? Even other circumstances where you've chosen to avoid surgery I'd like to know about.

Cheers,

Max

it all depends on if your a righty or a lefty

Haha a kite forum for medical advice??? Classic

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Nathe said...
Haha a kite forum for medical advice??? Classic

Private health insurance is expensive

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Nathe said...
Haha a kite forum for medical advice??? Classic

Not so much medical advice as life advice.
I've been presented with the options based on medical advice but given i have no experience with this stuff, just thought I'd ask. The surgeon has never fractured his scaphoid so doesn't know what it's like on the receiving end of a scalpel haha.

Thanks everyone,just the info i was after, thinking i might wait another month or 2 then get more scans to see if there's been any progress at all. If not I'll pull the trigger on an op.
Wishing my arm broke instead!

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PaulyOS said..

Nathe said...
Haha a kite forum for medical advice??? Classic

Private health insurance is expensive

Yes is but makes some sense as medical advice for a fractured scaphoid will very enormously - depending on who you see and what they specialise in.

Select to expand quote

Absolutbeginer said..
Has the blood supply to the broken bit been compromised?

I cracked mine but blood supply was good so it healed naturally.
Took well over a year to be pain free though.

Nathe said...
Haha a kite forum for medical advice??? Classic

That was also my experience. At times I thought it would never heal.

and

Yes is but makes some sense as medical advice for a fractured scaphoid will very enormously - depending on who you see and what they specialise in.

Scaphoid fracture is actually one of the more serious breaks you can have. As people have pointed out, it can be very hard to fix and often it will break again. It's a very common thing to happen to Skateboarders and a lot of them struggle with it for a long time. I'm no doctor, I would find a proper specialist or two and get their advice, every break is different.

All the best and hope you heal up soon!

Select to expand quote

polymer said...

Absolutbeginer said..
Has the blood supply to the broken bit been compromised?

I cracked mine but blood supply was good so it healed naturally.
Took well over a year to be pain free though.

Nathe said...
Haha a kite forum for medical advice??? Classic

That was also my experience. At times I thought it would never heal.

and

Yes is but makes some sense as medical advice for a fractured scaphoid will very enormously - depending on who you see and what they specialise in.

I've busted my scafoid on both wrist skateboarding and both times they have cast my hand like I'm holding a stubby. Had the doctors on both occasions say it could need surgery but after 6 weeks in a cast it had healed. Although it took a good 6 months for the strength to come back and pain subside. Listen to your body and good luck

go to a public hospital and hang to your money. the medical advice is just as good and sometimes better. see how long the wait would be before they can do whatever procedure is required and then decide whether to pay or wait.

I've found out today the waiting list for public is about 3 months. Which means i can give it a chance to heal itself and if it hasn't it should be my turn by then anyway.

Works out alright i guess haha

chipped mine and the bit was rough and sawed away at my tendon. has been a long road, that being said i kited gnarloo 6 weeks after surgery with a neoprene brace.
that being said was a good 12 months before i could do things like pushups and now just getting back into surfing.
cost me a bomb, but i got the best hand surgeon in WA. look around and make sure the guy knows his stuff.
after surgery was sore in more than scafoid and tendon. they have to move ligaments and bits n bobs to get in there, so both sides of wrist/hand end up sore and need rehab. but you are young and if you look after it should come good.
i almost thought my game was over, but has come good with a bit of pain occasionally.
good luck man.

Had a severe wrist and hand fracture dislocation where pretty much every thing was broken or crushed. The plates, screws and wires were removed by the 4th surgery about 7 months after the injury. However the surgeon left the screw in the scaphoid. He said he couldn't guarantee that it would have healed by then and there was no harm leaving it in.

For about $200 (you'll get about half back on Medicare) it might be worth getting another opinion? Dr Google and a forum like Seabreeze will give you some conflicting information though you can still learn more - and then google hand surgeons / sports to find a good specialist that could hopefully sort you out.

Like you said on your first post Max - letting your body heal itself might be the best way for your injury? You said a doctor gave you a 70/80% chance of good outcome with surgery or 50/50% without - personally I'd probably wait and see. But then again - don't take my advice - listen to the doctors, do the research and make a decision you are comfortable with!

There is a good wrist splint from an Icelandic company, that has aluminium, hard plastic and neoprene and velcro that works pretty well. I've tried a few different brands and this is the stiffest and the best IMO for this type of injury.

Hey,

Just thought I'd let ya know that after 6 weeks its fixed itself!

Doctor said it was unusual but I've avoided surgery. Just need a splint for high load activities for another month or two.

@Hausey can I please grab the name of that Icelandic splint company?

Cheers for all the advice yeww see you on the water.

^ Good to hear !

You might want to check with an expert (physic or doctor) which one is best for your injury. I need something that immobilises and supports the wrist and the aluminium in this model does this better than the others I've tried.

There are several brands and different models within some brands.

The brand from Iceland I was talking about is Ossur
Model: Exoform Wrist Brace

www.ossur.com.au/injury-solutions/products/upper-extremity/wrist-and-thumb-supports/exoform-wrist

I got mine in Tasy - though there should be links on the site on how to get one closer to where you live - so you can try which model / size fits you better - this one is best done up tight.

Sweet, thanks mate!

I'll check it out. I have an appointment with a hand therapist and wouldnt mind something that's waterproof so I can get out there.

I'll mention that brand to her