Post-Surgery Complications After Scaphoid Fracture: Pain and Weakness Explained

After surgery for a scaphoid fracture, the fingers have transitioned from numbness to pain, and there is weakness in fist clenching?

Hello Doctor, I suffered a traffic accident and have a closed fracture of the scaphoid bone with a third of the bone displaced in my left wrist.
I underwent surgery using a self-funded 2mm compression screw.
Within 20 days post-surgery, I experienced numbness and weakness in all five fingers.
After 20 days, my middle and ring fingers showed redness, swelling, and pain around the nails, which appeared noticeably purple.
The other three fingers (thumb, index, and little finger) have less numbness.
The only constant issue is the weakness when making a fist with my left hand.
Additionally, I can feel a tightness in the center of my forearm when rotating it.
I discussed these symptoms with my attending physician, who suggested that this is sympathetic dystrophy and that it would improve after rehabilitation.
It has now been exactly one month since the surgery.

I would like to ask the doctor:
1.
Is it normal to have weakness in making a fist after a scaphoid fracture surgery?
2.
What do the symptoms of numbness and weakness in the fingers, along with redness, swelling, and pain in the middle and ring fingers, and the tight feeling in the forearm indicate? Is it really sympathetic dystrophy? I have researched online and feel it resembles carpal tunnel syndrome or early-onset wrist arthritis, but it shares similarities with sympathetic dystrophy, such as pain, sensory deficits, and joint stiffness.
3.
Should I seek further evaluation at another hospital? Should I consult an orthopedic surgeon, a neurologist, or a rehabilitation specialist? Thank you, Doctor.
I appreciate your help.

Mr. Fan, 30~39 year old female. Ask Date: 2021/09/06

Dr. Zhan Xian reply Orthopedics

Hello Mr.
Fan, I am unable to answer your questions due to a lack of understanding of your surgical situation.
Further evaluation, including physical examination and imaging studies, is necessary.
You may visit a major hospital's orthopedic department for consultation.
Wishing you a speedy recovery.

Reply Date: 2021/09/06

More Info

After a scaphoid fracture surgery, it is not uncommon to experience complications such as pain, weakness, and sensory changes. Your symptoms, including the numbness and weakness in your fingers, as well as the swelling and discoloration of your middle and ring fingers, warrant careful consideration. Let’s address your questions one by one.

1. Is it normal to have weakness in the fist after scaphoid fracture surgery?
Yes, it is relatively common to experience weakness in the hand and wrist following surgery for a scaphoid fracture. The scaphoid bone is crucial for wrist stability and function, and surgical intervention can lead to temporary muscle atrophy and weakness due to immobilization. The surrounding muscles may also be affected by the surgical procedure itself, leading to decreased strength. Rehabilitation and physical therapy are essential for regaining strength and function over time.

2. What do the symptoms of numbness, swelling, and pain indicate?
The symptoms you describe, particularly the numbness in your fingers and the swelling and discoloration of your middle and ring fingers, could be indicative of several conditions. While your doctor mentioned complex regional pain syndrome (CRPS), which can occur after an injury or surgery and is characterized by pain, swelling, and changes in skin color, it is also important to consider other possibilities such as carpal tunnel syndrome or early-onset arthritis. Carpal tunnel syndrome can occur due to swelling and inflammation in the wrist, leading to compression of the median nerve, which can cause numbness and weakness in the fingers. The "tight" feeling you experience during forearm rotation could also suggest nerve irritation or entrapment.

3. Should you seek further evaluation from another hospital?
Given your ongoing symptoms, it would be prudent to seek further evaluation. You may want to consult with a specialist in orthopedics, as they can assess the integrity of the surgical site and the healing of the scaphoid. Additionally, a neurologist could evaluate for potential nerve-related issues, such as carpal tunnel syndrome or other neuropathies. A rehabilitation specialist can also provide guidance on physical therapy to improve strength and function in your hand and wrist.

In summary, while some degree of pain and weakness can be expected after scaphoid fracture surgery, the specific symptoms you are experiencing—particularly the numbness, swelling, and discoloration—should be thoroughly evaluated. It is essential to communicate your concerns with your healthcare provider and consider a multidisciplinary approach involving orthopedic, neurological, and rehabilitation specialists to ensure comprehensive care and optimal recovery. Early intervention can help prevent long-term complications and improve your overall function.

Similar Q&A

Post-Surgery Care Challenges for Scaphoid Fractures: Understanding Pain and Recovery

Hello Doctor: I was involved in a car accident on October 27, 2019, which resulted in a fracture of my right scaphoid bone. At that time, the emergency physician did not diagnose it, so I switched hospitals and was finally diagnosed four months later (March 6, 2020), after which ...

Dr. Chen Bochen reply Orthopedics
1. Scaphoid fractures are prone to nonunion, especially when diagnosed later. 2. Surgery does not guarantee healing (but the likelihood of healing is higher compared to non-surgical treatment). 3. Healing with a slight discrepancy of a few millimeters usually does not cause pain;...

Post-Surgery Recovery: Understanding Scaphoid Fracture Complications

Hello, Doctor. About ten years ago, I had a car accident, and it has only now been confirmed that I have a non-union fracture of the left scaphoid and a tear of the triangular ligament. I underwent surgery at the end of April this year, where the ligament and fragmented bone were...

Dr. Shi Guozheng reply Orthopedics
The range of motion in the wrist is not limited to this; rehabilitation is necessary to further increase mobility. Additionally, it is normal to experience numbness in the skin after surgery, and it typically takes a longer period to see if it will recover.

Post-Surgery Complications After Clavicle Fracture: What to Expect

Hello Dr. Lee, On July 9, I fell off my bike and fractured my left clavicle. Although it was a comminuted fracture, the doctor recommended conservative treatment with a figure-eight strap for stabilization. Aside from some inconvenience in movement, I experienced no discomfort o...

Dr. Li Wenlin reply Orthopedics
Hello, In response to your question, it is reasonable to still feel some discomfort one week after surgery on September 15th. This is because the procedure involves incising the skin, separating the fascia and muscles, and carefully detaching the scar tissue around the fracture...

Understanding Post-Surgery Rehabilitation Challenges After Hip and Wrist Surgery

My mother underwent an open reduction and internal fixation surgery for her acetabulum and distal radius due to a car accident. She has been actively rehabilitating after the surgery, but nearly six months post-operation, she still lacks strength when climbing stairs and squattin...

Dr. Huang Weiqing reply Rehabilitation
Hello, it may be necessary to consult the original surgeon for a diagnosis. There are many reasons for postoperative weakness. Generally speaking, in addition to the muscle endurance at the surgical site not having fully recovered, one must also consider the possibility of nerve ...