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A scaphoid fracture is a break of the scaphoid bone in the wrist. [1] Symptoms generally includes pain at the base of the thumb which is worse with use of the hand. [ 2 ] The anatomic snuffbox is generally tender and swelling may occur. [ 2 ]
The most common complication after surgery is pain persisting in the thumb. Over long term, there is pain relief, but on short term, patients experience pain from the surgery itself. The main complaint is a burning sensation or hypersensitivity over the incision. Some patients develop a complex regional pain syndrome. This is a syndrome of ...
Scapholunate advanced collapse is the most common form, followed by scaphoid non-union advanced collapse (SNAC). [3] Other post-traumatic causes such as intra-articular fractures of the distal radius or ulna can also lead to wrist osteoarthritis, but are less common.
The differential diagnosis includes scaphoid fractures and wrist dislocations, which can also co-exist with a distal radius fracture. Occasionally, fractures may not be seen on X-rays immediately after the injury. Delayed X-rays, X-ray computed tomography (CT scan), or Magnetic resonance imaging (MRI) can confirm the diagnosis. [citation needed]
Orthopedic surgery: Risk factors: Wrist trauma: Diagnostic method: Radiographic: Differential diagnosis: Scaphoid fracture, distal radial fractures, avascular necrosis of the scaphoid, gout, pseudogout, rheumatoid arthritis, Kienbock disease, lunate fracture vs dislocation dorsal intercalated segmental instability: Treatment
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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The surgery is performed by arthroscopy, after the joint is cleaned of calcified cartilage. Through use of an awl, the surgeon creates tiny fractures in the subchondral bone plate. [10] Blood and bone marrow (which contains stem cells) seep out of the fractures, creating a blood clot that releases cartilage-building cells.