Veda Medical

Scaphoid Union & Non Union Fractures

Veda Medical provides comprehensive and specialized care for various hand and wrist conditions, including scaphoid fractures. The scaphoid bone, one of the small bones in the wrist, is unique in its shape, position, and blood supply, making it especially prone to fractures and complications in healing, such as non-union fractures.

Scaphoid fractures often result from falls or direct impact on the wrist and can significantly impact the wrist’s movement and function if left untreated or improperly managed. Moreover, due to the scaphoid bone’s peculiar blood supply, with most of the blood entering from the distal end (farthest from the wrist), fractures can disrupt this blood flow, leading to a non-union fracture where the bone fails to heal.

Our team at Veda Medical comprises expert orthopedic surgeons skilled in treating union and non-union scaphoid fractures. For union fractures, where the bone is expected to heal properly, treatment typically involves immobilization with a cast or splint. Surgical intervention may be required for non-union fractures or cases where standard treatment fails. Our surgeons are proficient in advanced surgical techniques, including bone grafting and internal fixation, to stimulate bone healing and restore normal wrist function.

Post-treatment, we provide robust rehabilitation support to ensure optimal recovery. Our goal is not just to heal your fracture but also to minimize the impact of the injury on your daily life and activities.

At Veda Medical, we believe in comprehensive, patient-centric care. Trust us to guide you through your healing journey from a scaphoid fracture, providing you with the highest standard of care every step of the way.

What is Saphiod Union Fracture

The scaphoid bone, located on the thumb side of the wrist, plays a critical role in wrist movement and stability. It is uniquely shaped, resembling a cashew nut, and its particular positioning makes it one of the wrist’s most commonly fractured carpal bones. When a scaphoid fracture heals properly, and the bone successfully fuses back together, this is referred to as “scaphoid union.”

Understanding scaphoid union requires an appreciation of the scaphoid’s unique anatomy and blood supply. The scaphoid bone is tubular, with a proximal pole (closer to the wrist) and a distal pole (further from the wrist). It has a retrograde blood supply, with the primary blood vessels entering from the distal pole and supplying most of the bone, including the proximal pole. This unique blood supply pattern significantly affects the bone’s ability to heal after a fracture.

When a scaphoid fracture occurs, typically from a fall on an outstretched hand, the treatment goal is to achieve scaphoid union – the successful healing and fusion of the fracture site. This healing process depends on various factors, including the fracture’s location, the degree of displacement (misalignment of bone fragments), the patient’s overall health, and the promptness of treatment.

The treatment approach to achieve scaphoid union primarily depends on the fracture characteristics. Non-displaced fractures can often be treated non-surgically when the bone fragments have not moved out of their normal position. This involves immobilization with a cast that includes the thumb and spans from the elbow to the knuckles. The cast holds the scaphoid bone still, allowing the body’s natural healing processes to reunite the bone fragments over time. Depending on the fracture’s specifics, immobilization can last several weeks to a few months.

If the fracture is displaced or involves the scaphoid’s proximal pole, achieving scaphoid union becomes more challenging due to the area’s limited blood supply. In these cases, surgery is often necessary. The surgical approach can involve internal fixation using screws or wires to hold the bone fragments together, promoting the union. In cases with significant bone displacement or late presentation, a bone graft may be used to stimulate healing.

Regular imaging (usually X-rays or MRI) monitors the bone’s healing progress throughout treatment. Once the bone shows signs of the union on imaging, and the patient can move the wrist without pain, the cast can be removed, or the patient can begin rehabilitation post-surgery.

After achieving scaphoid union, physical therapy plays a crucial role in the recovery process. After weeks or months of immobilization, the wrist and hand are often stiff and weak. Physical therapy helps restore the wrist’s range of motion, strength, and functionality. The rehabilitation program typically involves exercises to improve flexibility, strength training, and later activities to regain fine motor skills.

Scaphoid union is critical in preserving wrist function and preventing long-term complications. Untreated or poorly managed scaphoid fractures can lead to non-union, where the bone fails to heal, or avascular necrosis, where the bone dies due to insufficient blood supply. Both conditions can cause chronic wrist pain and arthritis, significantly impacting the patient’s quality of life.

In conclusion, achieving scaphoid union is a complex process requiring expert medical care, appropriate treatment—non-surgical or surgical—and dedicated rehabilitation. At Veda Medical, we offer comprehensive care for scaphoid fractures, with a team of skilled professionals committed to guiding you through the healing process and helping you regain your wrist’s full functionality.

What is a Non-Union Facture

Non-union fractures represent a significant challenge in the field of orthopedics. They occur when a broken bone fails to heal properly after a fracture. Instead of the bone ends knitting back together to form a continuous, solid structure – a process known as “union” – they remain separate, leading to ongoing pain, instability, and impaired function.

The human body has an innate capacity for healing, and in most cases, fractures will mend naturally over time. However, various factors can interrupt this healing process and result in a non-union fracture. These factors include the severity and location of the fracture, the patient’s age and overall health, smoking, and certain medications. Non-union fractures are often categorized into three types: hypertrophic, atrophic, and oligotrophic.

  1. Hypertrophic non-unions occur when there is sufficient blood supply, but the bone ends are not properly aligned or stabilized. This misalignment prevents the bone from healing, despite the body’s repeated attempts, leading to the formation of excess bone at the fracture site.
  2. Atrophic non-unions, on the other hand, occur when there’s inadequate blood supply to the fracture site, preventing the body from mounting a sufficient healing response. This can happen when the bone’s blood vessels are damaged during the injury, or when the patient has an underlying condition that affects blood supply. Atrophic non-unions are typically characterized by a lack of new bone formation at the fracture site.
  3. Oligotrophic non-unions fall somewhere in between hypertrophic and atrophic non-unions, with sufficient blood supply but inadequate healing response.

Non-union fractures are usually diagnosed through physical examination and imaging studies. Patients with non-union fractures typically experience persistent pain and the inability to use the affected limb for weeks or months beyond the expected healing time. On X-rays, the fracture line remains visible instead of seeing progressive bone healing, and the bone ends can appear rounded or sclerotic.

Once diagnosed, the treatment goal for non-union fractures is to stimulate the bone to heal. The exact treatment approach depends on the non-union type and the patient’s overall health status.

Surgery is typically performed for hypertrophic non-unions to realign and stabilize the bone ends. This can involve using plates, screws, rods, or external fixators. Once stability is achieved, the body can usually heal the fracture.

More complex interventions are often needed for atrophic and oligotrophic non-unions with inadequate healing responses. This could involve a bone graft, where bone tissue is taken from another part of the body or a donor and placed at the fracture site to stimulate healing. Several bone graft substitutes are available, such as demineralized bone matrix, synthetic bone-like materials, and bone growth factors.

In some cases, electrical stimulation or ultrasound may promote bone healing. The theory is that these modalities stimulate the cells involved in bone repair, promoting healing at the molecular level.

Despite the complexity of non-union fractures, with the right treatment, it’s possible for the bone to heal and for patients to regain function in the affected limb. This often involves a multidisciplinary approach, including surgery, physical therapy, and possibly lifestyle modifications like quitting smoking or managing underlying health conditions.

In conclusion, non-union fractures significantly disrupt the body’s natural healing process. However, with the advances in modern medicine, these challenging fractures can be successfully treated. At Veda Medical, our orthopedic specialists are experienced in diagnosing and treating non-union fractures, using the latest surgical techniques and a personalized treatment approach to help you recover and regain your quality of life.

Other Services We Provide

  • Bursitis
  • Carpal Tunnel Syndrom
  • Carpometacarpal Boss
  • Cubital Tunnel Syndrome
  • Dupuytren’s Contracture
  • Fingers
  • Ganglion Cysts
  • Nail Bed Injuries 
  • Nerve and Tendon Injuries
  • Power Saw Injuries
  • Psoriatic Arthritis and Rheumatoid Arthritis
  • Stiffness in the Hand and Wrist
  • Thumb
  • Trigger Finger, and Jammed and Mallet Finger
  • Wrist Facture
  • Wrist Sprain

Question & Answer

Question: I had a fall and landed on my outstretched hand. The pain in my wrist is not subsiding, and I’m worried I might have a scaphoid fracture. What symptoms should I look out for, and how is it diagnosed at Veda Medical?

Answer: Symptoms of a scaphoid fracture can be subtle but usually include pain and swelling in the wrist, particularly on the thumb side, difficulty gripping objects, and pain when moving your thumb or wrist. If you’re experiencing these symptoms, seeking medical attention promptly is crucial, as a delay in diagnosis and treatment can lead to complications, including non-union fractures.

At Veda Medical, we start with a thorough physical examination of your wrist. We may then order imaging tests such as X-rays to visualize the fracture. In some cases, due to the unique characteristics of the scaphoid bone, the fracture may not be immediately visible on an X-ray. If a scaphoid fracture is still suspected, a follow-up X-ray, a CT scan, or an MRI might be necessary to confirm the diagnosis.

Question: What is the difference between a scaphoid union and a non-union fracture? How does this impact my treatment at Veda Medical?

Answer: A scaphoid union refers to successfully healing a scaphoid fracture, where the broken bone segments knit back together to form a single, continuous bone. In contrast, a non-union fracture occurs when the bone fails to heal, and the fractured segments remain separate.

The difference between union and non-union has significant implications for your treatment. In the case of a scaphoid union, treatment may involve immobilization with a cast or splint to allow the bone to heal. On the other hand, a non-union fracture is more complex and often requires surgical intervention to stimulate healing. This can involve techniques such as internal fixation with screws or wires; sometimes, a bone graft may be necessary.

At Veda Medical, we tailor your treatment plan to your specific needs and the nature of your fracture. We offer non-surgical and surgical treatments and will work closely with you to ensure the best possible outcome.

Question: I have been diagnosed with a non-union scaphoid fracture. What treatment options are available for me at Veda Medical, and what is the recovery process like?

Answer: Veda Medical specializes in treating complex cases like non-union scaphoid fractures. Treatment options typically involve surgery to stimulate healing. This could include realigning the bone fragments and using screws or wires for internal fixation. A bone graft might stimulate new bone growth if the bone has lost vitality.

Post-surgery recovery involves a period of immobilization to allow the bone to heal. Once healing is confirmed via imaging studies, you will begin physical therapy to regain strength and mobility in your wrist. The timeline can vary, but typically, patients can expect to start using their wrists for light activities within a few months post-surgery.

At Veda Medical, we provide comprehensive care throughout your healing journey, from diagnosis to rehabilitation, ensuring you receive the support and treatment you need to recover effectively.

Meet Dr. Mohan

Board Certified in Plastic and Reconstructive Surgery Fellowship Trained in Hand, Wrist, and Microsurgery. Dr. Pradeep S. Mohan is a highly-skilled, Board Certified Plastic and Reconstructive Surgeon. After completing his General Surgery Residency at Seton Hall University, he attended Yale University and Southern Illinois University to complete fellowships in Hand and Microsurgery and Plastic and Reconstructive Surgery. He has received extensive training in all aspects of Cosmetic Surgery and Non-Surgical Rejuvenation. 

Dr. Mohan takes pride in his work, and his patients love him for his transparency, excellent bedside manner, and ease of explanation of the procedures. He believes in having educated and informed patients. Dr. Mohan is known for his individualized and comprehensive treatment plans and dedication to perfection, resulting in total patent satisfaction. He is here to help you achieve your desired goals.

Contact Us Today!

Are you ready to regain optimal hand and wrist function, alleviate pain, and enhance your quality of life? Look no further than Veda Medical, where our experienced team of hand specialists is dedicated to providing exceptional care and personalized treatment options. We are committed to delivering outstanding outcomes with our expertise in hand and microsurgery, state-of-the-art facilities, and compassionate approach. Contact Veda Medical today to schedule a consultation and take the first step towards restored hand and wrist health. Let us be your trusted partner on your journey to improved function, comfort, and a brighter future.

Phone: 210-566-8332/210-361-6617


Veda Medical

+1 210-361-6617

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