![]() ![]() The outcomes from surgery versus plaster cast have never been comprehensively compared in terms of speed of healing, complications and pain for the patient, or cost effectiveness. This surgery was carried out because doctors thought that, with a shorter time in plaster, patients could return to work and normal activities more quickly. But since the late 1980s, surgeons have increasingly operated to repair the break with a tiny headless screw. Immobilising the wrist in a plaster cast for 6-10 weeks is generally sufficient for full healing. Young active men are the most likely to sustain this injury and could have arthritis in the wrist for the rest of their lives. But if it is does not repair normally, arthritis may develop in the wrist. Breaks across its midpoint, or waist, account for most fractures.Ī broken scaphoid bone is usually a straightforward injury. The scaphoid is the small bone on the thumb side of the wrist. It found that healing was similar with either approach but the surgical option was significantly more expensive. The Scaphoid Waist Internal Fixation for Fractures Trial (SWIFFT) compared the two ways of treating the break. However, before this study, there was little research into which method has the best outcome for patients and is most cost-effective. Traditionally, they have been healed by immobilising the wrist in a plaster cast but over the last two decades, surgeons have increasingly fixed the injury in surgery, by putting a small screw across the break. The views expressed are those of the author(s) and reviewer(s) at the time of publication.įractures of the scaphoid bone in the wrist are among the most common broken bone injuries. Electrodiagnostic tests identify the area of nerve entrapment and the extent of the pathology.This is a plain English summary of an original research article. Activities that involve repetitive or prolonged wrist extension, such as cycling, karate, and baseball (specifically catchers), may increase the risk of ulnar neuropathy. In ulnar neuropathies of the wrist, the typical presentation is wrist discomfort with sensory changes in the fourth and fifth digits. Nerve entrapment at the wrist presents with pain and also with sensory and sometimes motor symptoms. The diagnosis is based on history and examination findings of a positive Finkelstein test and a negative grind test. Radial pain involving mostly the first extensor compartment is commonly de Quervain tenosynovitis. Overuse of the muscles of the forearm and wrist may lead to tendinopathy. In these cases, the differential diagnosis is wide and includes tendinopathy and nerve entrapment. Subacute or chronic wrist pain usually develops gradually with or without a prior traumatic event. ![]() If a suspected scaphoid fracture cannot be confirmed with plain radiography, a bone scan or magnetic resonance imaging can be used. Specialized views (e.g., posteroanterior in ulnar deviation, pronated oblique) and repeat radiography in 10 to 14 days can improve sensitivity for scaphoid fractures. Conventional radiography alone can miss up to 30 percent of scaphoid fractures. A fall onto an outstretched hand can lead to a scaphoid fracture, which is the most commonly fractured carpal bone. Patients with wrist pain commonly present with an acute injury or spontaneous onset of pain without a definite traumatic event.
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