Houston Methodist. Leading Medicine

Wrist FAQ

Question:

Next week I'm heading in to surgery for a wrist fracture that didn't heal. There's a bone called the scaphoid that lost its blood supply and has started to die. The surgeon is going to take a tiny branch of a blood vessel in the wrist and divert it to the broken bone. What kind of results can I expect from this kind of surgery? Will I be able to use my wrist and hand again normally?

Answer:

Most of the studies of scaphoid wrist fractures that don't heal have been done on small numbers of patients. But there has been one study from the Department of Orthopaedics and Sports Medicine at the University of Washington in Seattle that included 30 patients. All had scaphoid fractures that didn't heal with immobilization. One surgeon performed a surgical procedure that included fixation of the bone fragments with a screw to hold them in place. A second step was taken to restore an adequate blood supply to the area using a branch of the radial artery to the wrist. Total wrist range-of-motion did not change but they did have improved grip strength from before surgery. Patients were very happy with the overall improvement they experienced after surgery and successful healing. Almost everyone returned to work or sports activity at a level equal to their preinjury level. Patients can expect a four to five month period of time before complete bone healing occurs. This can vary depending on the patient's general health, age, or other risk factors such as tobacco use (which is known to delay healing). Thanapong Waitayawinyu, MD, et al. Outcome After Vascularized Bone Grafting of Scaphoid Nonunions with Avascular Necrosis. In The Journal of Hand Surgery. March 2009. Vol. 34A. No. 3. Pp. 387-394.

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