Scaphoid Fractures

Overview

Scaphoid fractures are an extremely common wrist fracture that occur usually from falling. Despite being common, these fractures are often missed leading to issues healing known as a nonunion.

The patient has tenderness over the area between the thumb and wrist known as the radial snuffbox. He routinely sees professional athletes as second opinions for these injuries as they are commonplace in the world of sports.

Dr. Anup Patel Advantage

Dr. Anup Patel has a strong experience with this injury leads him to obtain a dedicated scaphoid xray often with CT scans to prevent missing these injuries. After reviewing the images, he works with the patient to determine the best course of action, either immobilization or surgery.

If surgery, he often combines the disciplines of plastic surgery to bring bone with its own blood supply to improve healing rates and orthopedic surgery to place a screw perfectly down the axis of the scaphoid to reduce nonunion rates.

Scaphoid Fractures and Scaphoid Nonunion

Symptoms

  • Pain and swelling over the wrist
  • Loss of motion over the cyst

Causes

  • Trauma
  • Unrecognized scaphoid fracture leading to nonunion
  • Primary operation fails

Treatments

Non-Surgical

  • Casting

Treatments

Surgical

  • Placement of headless, compressive screw
  • Use of bone graft, often vascularized (where the bone carries its own blood supply), to fill the void when the dead bone is removed

Patient Examples

Patient 1

17 year old male who presents with a motorcycle crash sustaining a scaphoid fracture. We used a headless compression screw and the patient has no issues 10 weeks later.

Patient 2

16 year old Lacrosse player who presents with a missed scaphoid fracture leading to a nonunion after being struck in the hand with a helmet 8 months previous. We utilized a vascularized bone graft (bone with its own blood supply) and a compression screw to return the patient to lacrosse 5 months later who is being recruited by Division 1 programs.

Patient 3

16 year old football player who presents with a missed scaphoid fracture leading to a nonunion. We utilized a vascularized bone graft (bone with its own blood supply) and a compression screw to return the patient to football catching touchdowns 4 months after surgery. Please see the video of our patient catching touchdowns.

Patient 4

25 year old aircraft mechanic presents with an unrecognized scaphoid fracture for over 2 years with a nonunion. We utilized a vascularized bone graft (bone with its own blood supply) and a compression screw to return the patient to repairing commercial airlines that many of you fly on.

Patient 5

21 year old construction worker presents with one-week history of wrist pain. He has an acute scaphoid fracture. We used a headless compression screw and the patient is now building homes 10 weeks later.

Patient 6

18 year old football player who presents with a missed scaphoid fracture leading to a nonunion after being struck in the hand with a helmet 6 months previous. We utilized a vascularized bone graft (bone with its own blood supply) and a compression screw to return the patient to football 4 months after surgery.

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Dr. Anup Patel

Dr. Anup Patel is a board-certified plastic and reconstructive surgeon trained in aesthetic, hand/upper extremity and reconstructive surgery. He completed his plastic and reconstructive surgery training at the premier Yale University followed by a hand and microsurgery fellowship at the New York University Institute of Reconstructive Plastic Surgery and Mount Sinai Department of Orthopedics. Dr. Patel received his MD and MBA from the Yale University School of Medicine and Yale University School of Management, respectively. He graduated as the valedictorian of his class at the University of Florida majoring in economics, biochemistry and molecular genetics and valedictorian of his high-school class at Lake Highland.

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