Question:I'm 18-years old and need some advice. I have a broken bone in my wrist (scaphoid) that isn't healing. On the advice of a surgeon, my parents want me to have an operation to repair the bone. I'm young and active. I think I should be able to just wear a cast and it will heal on its own. What should I do?
Answer:The location, size, and shape of the scaphoid bone in the wrist make it a prime area of problems. Depending on which end of the bone is broken, problems can occur with loss of blood supply.
Most experts advise surgery to correct the problem. Without treatment, the bone can collapse causing deformity and later, joint damage. If the blood supply is disrupted, the bone can also die.
Casting the wrist and arm is not recommended based on other research in this area. A long arm cast is needed to stabilize the bone for healing. Healing can take up to six months or more. During that time, you can lose wrist and elbow motion, which can affect your overall function and quality of life.
Even patients who are symptom-free are advised to have this operation. This is because there is plenty of evidence to show a link between nonunion fractures and osteoarthritis later on.
There are a few reasons why this operation is not recommended. If the patient is an older adult and/or smokes, surgery may be too risky for the benefit it would provide. Surgery to correct the problem may not be a good idea if the wrist has already collapsed. In such cases, the bone may be removed instead of repaired.Thanapong Waitayawinyu, MD, et al. Scaphoid Nonunion. In Journal of the American Academy of Orthopaedic Surgeons. May 2007. Vol. 15. No. 5. Pp. 308-320.
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