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Therefore, people with tenderness over the scaphoid (those who exhibit pain to pressure in the anatomic snuff box) are often splinted in a thumb spica for 7–10 days at which point a second set of X-rays is taken. [7] If a minimally displaced fracture was present initially, healing will now be apparent. Even then a fracture may not be apparent.
A spica splint is a type of orthopedic splint used to immobilize the thumb and/or wrist while allowing the other digits freedom to move. It is used to provide support for thumb injuries (ligament instability, sprain or muscle strain), gamekeeper's thumb, osteoarthritis, de Quervain's syndrome or fractures of the scaphoid, lunate, or first metacarpal. [1]
The cast restricts wrist movement while allowing elbow mobility, providing a balance between immobilization and functionality. In some cases, a thumb spica variant is added to include the thumb in immobilization, such as for scaphoid fractures or severe thumb sprains. Proper fit and careful alignment are critical to ensure effective healing and ...
A traction splint most commonly refers to a splinting device that uses straps attaching over the pelvis or hip as an anchor, a metal rod(s) to mimic normal bone stability and limb length, and a mechanical device to apply traction (used in an attempt to reduce pain, realign the limb, and minimize vascular and neurological complication) to the limb.
For Bennett fractures where there is more than 3 mm of displacement at the trapeziometacarpal joint, open reduction and internal fixation (ORIF) is typically recommended. Regardless of which approach is employed (nonsurgical, CRPP, or ORIF), immobilization in a cast or thumb spica splint is required for four to six weeks. [citation needed]
Anatomic illustrations of the wrist depicting the progressive stages of scapholunate advanced collapse. (A) Normal wrist demonstrating an intact scapholunate ligament (white arrowhead), normal scapholunate interval, and preservation of the joint spaces. (S = scaphoid, L = lunate, C = capitate, R = radius, U = ulna).
Wrist osteoarthritis is gradual loss of articular cartilage and hypertrophic bone changes (osteophytes). While in many joints this is part of normal aging (senescence), in the wrist osteoarthritis usually occurs over years to decades after scapholunate interosseous ligament rupture or an unhealed fracture of the scaphoid.
The scaphoid can be slow to heal because of the limited circulation to the bone. Fractures of the scaphoid must be recognized and treated quickly, as prompt treatment by immobilization or surgical fixation increases the likelihood of the bone healing in anatomic alignment, thus avoiding mal-union or non-union. [6] Delays may compromise healing.
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