Fracture of the navicular bone of the wrist is the most common among injuries of the bones of the wrist. Of the eight bones located in this anatomical region, the scaphoid bone is most often injured.
Often a fracture of the navicular bone occurs due to a fall on the straightened arm of the with an emphasis on the open palm. There is an overextension in the joint of the hand and the maximum load concentrates on the scaphoid bone.
Much less frequently, fractures are the result of a direct trauma to the hand.
With untimely care and treatment, the break will heal very long and eventually it can lead to severe pain, stiffness of the joints in the joint of the first finger of the hand and even to reactive arthritis.
Contents of the article
Contents of the article
- Contents of the article
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- Diagnosis and trauma signs
- Diagnostic techniques
- Treatment of trauma
- Conservative treatment
- Surgical treatment
- Complications after fracture
- Rehabilitation
- Conclusions
- Radial fracture - important details
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Symptoms and signs of injury
When the scaphoid bone fractures at the site of the firstinterdigital space on the back surface of the wrist, there is a pain that increases when you try to unbend the brush or thumb, when performing axialth pressing on the first and second metacarpal bones pain is also intensified.
There is edema of a limited nature in the lesion site, it does not extend to other anatomical areas of the wrist. The contours of the anatomical snuffbox are smoothed out. With isolated fractures of the scaphoid bone, long and persistent pain occurs with impaired function.
Typically, such fractures remain unrecognized for a long time.
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It is important to know the symptoms of polyarthritis of the hands to start treatment of the disease on time and not to complicate it.
Diagnostic Techniques
First, the doctor asks a couple of questions about the circumstances of the injury and the symptoms that accompanied her. Then he examines the wrist, finds the places with the greatest soreness, estimates how limited the movements in the carpal joint and the joint of the first finger.
The doctor also determines the presence of impaired nutrition of the tissues of the fingers, the safety of pain and temperature sensitivity in them. 
Then the doctor usually prescribes an X-ray examination of the joint and bones of the wrist. X-ray examination does not always reveal a fracture, sometimes it may not be visible in the picture.
Therefore, radiography is carried out in three projections: direct, lateral and in 3D projection. On the radiograph obtained in the lateral projection, the entire profile of the scaphoid bone is clearly visible, as well as the fracture line, which may not be visible on the roentgenogram made in a direct projection.
Sometimes fracture is not detected even when radiographing in three projections, but a fracture of the scaphoid bone is present. Then the patient is impregnated with a plaster bandage, and after 14-20 days the study is repeated.
If there is a fracture, then during this time a resorption will take place along the fracture line and there will be a prominent slit on the roentgenogram that allows you to accurately diagnose.
For more accurate and accurate diagnosis of a fracture, the doctor sometimes directs the patient to a specialist in the field of hand surgery, which uses additional methods such as magnetic resonance imaging, computed tomography and radioisotope scanning of bones.
Treatment of trauma
Treatment of a fracture of the scaphoid bone of the hand is carried out with the help of conservative and surgical methods.
Conservative treatment of
The main component of treatment for trauma is the immobilization of the joint. The victim is immobilized by the wrist and the first finger of the brush, using plaster or a tire.
In the early days it is recommended that use cold packs of or ice to reduce swelling. To stop the pain, non-steroidal anti-inflammatory drugs are prescribed: dexalgin, ketones, ketorol and others.
When the edema subsides, a plaster bandage is applied to ensure complete immobilization of the wrist. They wear gypsum usually for about six weeks, but depending on the degree of severity of the fracture, variations are possible.
You should visit your doctor regularly after discharge to monitor the healing process and prevent complications.
Surgical treatment of
For fractures with bias and other more severe cases, surgery may be required. Operative methods are used when an impossible fusion of the fracture by conservative treatment.
The main types of surgical treatment:
- Osteosynthesis with the pin. It is carried out in case of presence of two large fragments of the scaphoid bone.
- In , the distal aspect of the radius. This operation allows you to reduce pain when moving with a brush, this is due to the increase in the space between the nearest bone structure and the damaged navicular bone.
- Plastic osteosynthesis. A bone graft is used to hold the fragments.
- Removal of bone fragments. Used in the presence of edge fractures, when the adhesion is impossible.
Complications after fracture
In the absence of treatment, the consequences after injury to the scaphoid bone of the hand can be quite severe, in particular, non-failure of the fracture. Subsequently, due to non-physiological movements of bone fragments, there may be a violation of the ratio of articular surfaces, which will lead to arthrosis.
In the absence of blood supply, the part of the scaphoid bone may die, which causes pain and severe impairment of brush movements.
Aseptic necrosis develops. You can see necrosis on the radiograph only after a few months. Therefore, all brush injuries require an evaluation of the doctor.
Rehabilitation
Rehabilitation after a fracture of the scaphoid bone using gypsum immobilization involves methods of physiotherapy that is used from the first 
days.
They are aimed at to prevent the development of contracture and stiffness of the brush .In the affected joint, it is impossible to perform movements, but finger movements by flexion-extension, as well as movements in the elbow and shoulder joint, are mandatory.
With a reduction in edema and no pain, the circular gypsum dressing is replaced with a gypsum lintage applied to the back surface.
Various physiotherapeutic procedures are used: paraffin ozocerite applications, magnetic therapy, UHF, laser therapy, calcium chloride and potassium iodide electrophoresis, massage and gymnastics.
All these procedures improve local blood flow, which helps to reduce inflammation and edema, and this can dramatically shorten the healing time of the fracture.
At operative treatment rehabilitation measures are the same. Physiotherapeutic procedures and massage are connected after the removal of stitches.
After 4-5 weeks, the control radiography is performed and the affected radiocarpal joint is actively developed, using exercise therapy and manual therapy. After 4-5 months, a complete recovery occurs.
Conclusions
Fracture of the scaphoid bone of the wrist is a fairly common injury requiring attention and compulsory examination of the doctor. A timely diagnosis and effective treatment can cure a fracture without any consequences and complications.
Fracture of the radius - about the important detail
How to minimize the possibility of bone fracture. What signs and symptoms indicate a fracture of the bones of the wrist?
