Anatomy of the Finger
The finger joint is a hinge-joint that allows bending and straightening of the fingers. Each finger is composed of 3 phalanges joined by 2 interphalangeal joints (IP joints). The joint near the base of the finger is called the proximal IP joint (PIP joint), and the joint near the tip of the finger is called the distal IP joint (DIP joint).
What is a Scaphoid Fracture?
A Scaphoid Fracture is a condition where the end of the finger is bent and does not straighten.
How does Scaphoid Fracture Occur?
Scaphoid Fracture occurs when the extensor tendon at the back of the finger is damaged.
Some Common Causes of Scaphoid Fracture
Scaphoid Fracture occurs due to sports activities (such as baseball) or other activities that cause a direct and forceful impact on the fingers that jam the finger.
Signs and Symptoms of Scaphoid Fracture
The main symptoms of Scaphoid Fracture are drooping of the finger at the distal joint, pain and swelling around the area and limited range of motion at the joint.
Impact of Scaphoid Fracture
The injury either causes a rupture of the extensor tendon without a bone fracture or rupture with a small or large bone fracture.
Diagnosis
The diagnosis of Scaphoid Fracture involves a physical examination and obtaining an X-ray of the injured finger. In some cases, other imaging techniques such as MRI scan may be ordered.
Untreated Scaphoid Fracture
If left untreated, Scaphoid Fracture can develop into a finger joint deformity referred to as a swan neck deformity.
Treatment for Scaphoid Fracture
Generally, Scaphoid Fracture can be treated non-surgically using specially designed splints that immobilize the finger and promote natural healing. In cases of fracture, complete bone healing may take 6-8 weeks, followed by physical therapy for strengthening. In severe cases that don’t respond to conservative treatment and when your fingers are required to perform occupational tasks, surgery is recommended. Internal splints can be placed surgically with metal pins in the affected bones. The pins can be removed after 6 weeks of healing.
If you fail to achieve adequate relief, you will be recommended surgery that involves repairing the torn tendon. If the Scaphoid Fracture involves a fracture of the bone fragment, then it can be stabilized and fixed using pins and a special K-wire.
Postoperative Care following Scaphoid Fracture Surgery
After Scaphoid Fracture surgery, you will be recommended for physical therapy or occupational therapy for flexibility and strengthening exercises.
Risks and Complications of Scaphoid Fracture Surgery
The common risks and complications associated with Scaphoid Fracture surgery include:
- Avascular necrosis (bone death from lack of blood supply)
- Infection
- Stiffness
- Nail-bed damage
- Chronic tenderness