Post-Surgery Care and Rehabilitation for Scaphoid Fracture Dislocation

Postoperative Care for Complete Dislocation of the Scaphoid Bone

Hello Doctor: I was in a car accident on June 24, which resulted in a dislocation of my right scaphoid bone.
I underwent surgery for reduction on June 27, during which I had a K-wire and a screw placed in my right hand.
I am scheduled to have the screw removed soon.
After the removal of the screw, should I undergo rehabilitation therapy? My attending physician has not informed me whether I should pursue rehabilitation, and I would like to know more information.
Thank you.

Mr. Li, 30~39 year old female. Ask Date: 2020/07/20

Dr. Zhan Xian reply Orthopedics

Hello Mr.
Li, the subsequent rehabilitation will depend on the healing status of your fracture.
You can ask your attending physician during your next follow-up appointment!

Reply Date: 2020/07/20

More Info

Post-surgery care and rehabilitation for a scaphoid fracture dislocation are crucial for ensuring proper healing and restoring function to the wrist. Given your situation, where you underwent surgery on June 27 for a scaphoid dislocation and are now preparing for the removal of the screws, it’s essential to understand the next steps in your recovery process.

Understanding Scaphoid Fractures
The scaphoid bone is one of the small bones in the wrist, and fractures in this area can be particularly challenging due to the bone's limited blood supply. This can lead to complications such as nonunion (where the bone does not heal properly) or avascular necrosis (where the bone tissue dies due to lack of blood flow). Surgery, as you have undergone, is often necessary to stabilize the fracture and promote healing.

Post-Surgery Care
1. Wound Care: After surgery, it is vital to keep the surgical site clean and dry. Follow your surgeon's instructions regarding dressing changes and signs of infection (such as increased redness, swelling, or discharge).

2. Pain Management: You may experience pain and swelling post-surgery. Over-the-counter pain relievers or prescribed medications can help manage discomfort. Ice packs can also be beneficial in reducing swelling.

3. Activity Modification: Avoid activities that put stress on your wrist. This includes heavy lifting or any movements that could jeopardize the healing process.
4. Follow-Up Appointments: Regular follow-ups with your orthopedic surgeon are crucial. They will monitor your healing progress through physical examinations and possibly imaging studies (like X-rays) to ensure the bone is healing correctly.

Rehabilitation After Screw Removal
Once the screws are removed, rehabilitation is typically recommended to restore strength, flexibility, and function to your wrist. Here’s what you can expect:
1. Physical Therapy: Engaging in a structured physical therapy program is essential. A physical therapist will guide you through exercises designed to improve range of motion, strengthen the wrist, and enhance overall function. This may include:
- Passive Range of Motion Exercises: Initially, these exercises will help maintain flexibility without putting too much strain on the healing bone.

- Active Range of Motion Exercises: As healing progresses, you will begin to actively move your wrist through its full range.

- Strengthening Exercises: Once you regain some mobility, your therapist will introduce resistance exercises to strengthen the muscles around the wrist.

2. Gradual Return to Activities: Your therapist will help you gradually return to daily activities and sports. It’s important to listen to your body and avoid pushing through pain.

3. Home Exercises: In addition to therapy sessions, you may be given a home exercise program to continue your rehabilitation independently.

4. Monitoring Progress: Regular assessments will help track your recovery. If you experience persistent pain or limitations, communicate this with your healthcare provider.

Importance of Rehabilitation
Rehabilitation is crucial for several reasons:
- Restores Function: It helps regain the full range of motion and strength in your wrist, which is vital for daily activities.

- Prevents Complications: Proper rehabilitation can prevent stiffness and loss of function, which can occur if the wrist is immobilized for too long.

- Enhances Recovery: Engaging in rehabilitation can speed up the recovery process and improve overall outcomes.

Conclusion
In summary, after the removal of your screws, it is highly advisable to pursue rehabilitation to ensure a full recovery from your scaphoid fracture dislocation. While your surgeon may not have explicitly mentioned it, physical therapy is a standard part of recovery for such injuries. Be proactive in discussing your rehabilitation options with your healthcare provider, and don’t hesitate to ask for a referral to a physical therapist. Your commitment to rehabilitation will play a significant role in your recovery journey. Best wishes for your healing process!

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