SCAPHOID FRACTURES

The wrist has 8 small bones (carpal bones).Wrist bones are aligned in two rows. Scaphoid, one of the said 8 bones, connects the two rows to one another therefore it is mostly exposed to trauma and fractures. Fractures often result from falling down on the wide open hand. It is often very painful during the first trauma. The pain goes away gradually in subsequent days. Cyanosis is very rare. No specific deformity or swelling is observed in some patients. For this reason one should be careful about the diagnosis and pay particular attention to the scaphoid during the radiological examination of the area. Some patients apply to a physician for a diagnosis months and even years after the fracture. The scaphoid fracture may not be visible on all graphies on the first day. In suspicious cases, the fracture should be put into a plaster and another graphy should be performed again on the 10th day. If there are still suspicions, an MRI or computerized tomography should be performed.

If the fracture is not dislocated, mobility is restricted with the help of a brace including the forearm, hand and finger. Recovery period may take 6 to 19 weeks especially in a brace. The reason for such a long-lasting recovery is that different parts of the scaphoid builds up blood and part of it builds up blood relatively less. Fracture interrupts with the functionality of vascular structures that enable blood build-up, reducing the build-up of some parts of the bone. To this effect, surgical intervention is more preferable for scaphoid fractures especially in parts close to the forearm. Surgery is the most suitable method for dislocated fractures. In surgical treatment, screws and pins are used for stabilizing the fracture. In some cases, bone grafts needs to be collected from other parts of the body and used in these areas. Stabilization with screws may be advised for non-dislocated fractures due to long period of bracing.

No-union due to bone-specific circulation problems, osteolysis due to malnutrition and articular deformity can be observed. In such cases, a surgical operation is advised to the patients

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