Clinical manifestations and treatment of scaphoid fractures

The scaphoid bone is a small bone in the wrist joint. It is named because of its boat-like shape. When a person falls with his palm facing down and supports himself, it is easy to cause a scaphoid fracture in the wrist. What are the clinical symptoms of a scaphoid fracture and how to treat it?

1. Clinical symptoms

After a scaphoid fracture, local swelling of the wrist joint may occur, especially in the area of ​​the snuffbox. Under normal circumstances, the snuffbox appears as a soft tissue depression. After trauma, the disappearance of the soft tissue depression indicates swelling.

In addition, wrist pain (especially radial pain) is also an important clinical manifestation, and some patients will have limited wrist movement. In clinical work, some patients' swelling, pain, and limited movement are not obvious, but the tenderness in the nasal cavity during physical examination has certain diagnostic significance. In addition, most patients have a positive Watson test.

2. Treatment Methods

1. Treatment of fresh scaphoid fractures

Fresh scaphoid fractures should be confirmed by imaging examination to determine whether they are stable, non-displaced fractures. If they are this type of fracture, plaster cast fixation can be considered, and the patient should be reviewed 2 weeks after the operation. If the plaster cast becomes loose due to swelling, the plaster cast should be replaced, and the patient should be reviewed and filmed 6 weeks after the operation. If the plaster cast has not healed, the patient should be reviewed every 3 to 4 weeks until the fracture is healed. If there is no sign of healing after more than 4 to 6 months of plaster fixation, surgical intervention may be considered.

2. Old fracture

For old scaphoid fractures, we must first distinguish whether there is osteoarthritis around the scaphoid. If there is no osteoarthritis, open reduction, bone grafting, and internal fixation can be performed. If there is osteoarthritis, different surgical options need to be selected based on the extent of osteoarthritis.