After Care and Therapy
Fixation of Scaphoid
Fractures of scaphoid bone are a common injury of the wrist. For most fractures plaster treatment is sufficient and healing occurs in 90% of cases. Sometimes despite adequate treatment or when no treatment was sought, fracture fails to heal (non-union). This can continue to be a source of pain and could lead to arthritis later in life. It is therefore necessary to sometimes fix these fractures early but usually when healing has not taken place. Fixation is achieved by a screw and bone graft is also used to help the healing process.
The operation is performed under general anaesthesia (being asleep) as a day case procedure. You will be discharged home in a plaster cast extending from below the elbow up to the knuckles of fingers and a sling to keep the arm elevated. You will need some pain killers for a few days.
0 – 6 Weeks
At your first clinic visit (2 weeks), the plaster will be removed and skin stitches taken out. X-rays are carried out to check the position of fixation. A new plaster is applied. You will be encouraged to exercise your fingers and thumb and also move your elbow.
6 – 12 Weeks
You next clinic appointment will be at 6 weeks when plaster will be removed. Fresh x-rays are performed to check for signs of healing. You may be asked to wear a removable splint for a further 4 weeks. The splint can be removed frequently to carry out exercises as instructed. You will be referred to a Therapist for exercises of wrist and fingers and for care of the scar. The therapist will take you through gradually increasing amount of exercises and strengthening of the wrist joint and fingers.
After 12 Weeks
You will next be seen in the clinic at 12 weeks from operation for new x-rays to check for signs of healing of scaphoid. If all is well you will be discharged. With regular exercise and use, your wrist will continue to improve in the next 6–12 months. It is sometimes necessary to repeat x-rays at 6 months to confirm healing if x-rays at this stage show that complete healing has not yet taken place. Once healing is confirmed you will be discharged.