What to expect during surgery: 

Operative treatment of scaphoid fractures is generally performed on an outpatient basis. Surgery is generally called “open reduction internal fixation” to describing lining up and stabilizing your fracture. Dr. Holt will meet you on the day of surgery and review the plan. Anesthesia options include general or light sedation in combination with a regional nerve block. You will be taken back to the operating room where your wrist will be cleaned and draped.

Depending on the fracture pattern, an incision on either the back of the wrist or palm side of the wrist is used. The fracture will be reduced to line up the fragments as normally as possible and then a metal screw will be placed across the fracture to stabilize the bone. The incision will be closed with stitches a wrist splint will be placed to protect the wrist during the early healing period.

Pain Control:

Start with simple, but effective pain relief strategies such as ice and elevation. Especially for the first 2 - 3 days, attempt to keep your hand above your heart as much as possible. This will significantly limit pain and swelling. Next, try over the counter pain medications such as Tylenol and/or Ibuprofen. Most patients tolerate these medications well. Take them food, and make sure to check your allergies and/or other medications and medical issues to ensure it is safe to take them. Most patients use a small amount of narcotic medication after surgery which will be provided to you on the day of surgery as needed. Take them as directed and only as needed.

Dressing/Bandage:

Keep your dressing on until you return for follow up. Use a plastic bag or cover to keep it dry during showers/hygiene.

Activity:

You may use your hands immediately for light activities of daily living such as feeding yourself, dressing, and using a phone and/or computer. You should avoid lifting/pushing/pulling more than 1 pound and/or the use of power tools and highly repetitive activities until you return for follow up. Additionally, work on the attached finger range of motion exercises multiple times per day. It is very important to begin moving your fingers right after surgery and keep them moving to avoid stiffness.

Additional Information:

After surgery, you should expect some pain, swelling, and stiffness. Dr. Holt will talk to you about when it is safe to return to work. Most patients can return to light work (computer/desk work) within a few days, but it may take 3 months or longer to return to more demanding work (labor, construction, etc.). In most cases, patients will be placed into a cast at their initial follow up appointment for an additional 4 – 8 weeks depending on their fracture prior to being placed in a removable brace.  Scaphoid fractures generally heal around 3 months. However, even once the fracture has healed many patients will still have some stiffness/weakness/mild pain that may continue to improve for 9 – 12 months. Depending on your progress, Dr. Holt may recommend therapy.

Follow-Up: Your follow up appointment is generally 10 – 14 days after your surgery and should be in your discharge packet on the day of surgery.