Scaphoid Fractures: Recovery and Symptoms Explained

Scaphoid fracture

Hello Doctor,
I went to the emergency room on May 3rd due to a car accident.
At that time, no fractures were detected in my hand, so I received injections, medication, and rehabilitation treatment at a clinic for my hand discomfort.
However, on June 3rd, since my symptoms had not improved, I had another X-ray which revealed a scaphoid fracture with nonunion.
I was referred to an orthopedic hospital and underwent fracture reduction and internal fixation surgery on June 19th, using head screws for fixation and a cast on my left palm.
The cast was on for about five weeks.
Recently, on July 25th, after the cast was removed, I noticed that my fingers are stiff, my thumb cannot bend, and my palm is still swollen.
There is also a tingling sensation near the surgical site close to my thumb.
Are these symptoms normal? (Especially the tingling sensation in the palm near the surgical site close to the thumb.) When can I expect these symptoms to improve? Thank you for your response, and I wish you and your family good health.

Ms. Li, 50~59 year old female. Ask Date: 2023/07/29

Dr. Chen Yongxue reply Orthopedics

Hello, scaphoid fractures treated with headless screws generally have good outcomes.
There may be stiffness, which is likely due to prolonged immobilization in a cast.
With diligent rehabilitation, recovery should be achievable.
Thank you.

Reply Date: 2023/07/29

More Info

Scaphoid fractures are a common type of wrist injury, often resulting from falls or direct trauma to the wrist. The scaphoid bone is one of the eight carpal bones in the wrist, and it plays a crucial role in wrist stability and motion. Understanding the recovery process and the symptoms associated with scaphoid fractures is essential for effective management and rehabilitation.

In your case, it appears that the initial X-ray did not reveal the fracture, which is not uncommon with scaphoid injuries. These fractures can sometimes be subtle and may not show up on initial imaging. The symptoms you experienced, such as persistent discomfort and swelling, led to further investigation, ultimately confirming the fracture and non-union.

Recovery from a scaphoid fracture can be complex. The healing process typically involves immobilization in a cast or splint for several weeks, followed by rehabilitation exercises to restore mobility and strength. The fact that you underwent internal fixation surgery with screws indicates that the fracture was significant enough to require surgical intervention, especially given the risk of non-union associated with scaphoid fractures.

After the removal of the cast, it is common to experience stiffness in the fingers and wrist, particularly in the thumb, as you have described. The stiffness is often due to prolonged immobilization, which can lead to joint and soft tissue tightness. The swelling you are experiencing is also a typical post-operative symptom, as the body responds to surgery and the healing process begins. The "tingling" or "numbness" sensation in the palm near the surgical site may be attributed to nerve irritation or compression, which can occur during the healing process.

To address your concerns:
1. Stiffness and Swelling: These symptoms are generally normal after surgery and cast removal. Engaging in gentle range-of-motion exercises as advised by your healthcare provider can help alleviate stiffness. Physical therapy may also be beneficial in regaining full function.

2. Numbness and Tingling: This sensation can be concerning, but it is often temporary. It may take several weeks to months for the nerves to heal fully. However, if the symptoms persist or worsen, it is essential to follow up with your orthopedic surgeon to rule out any complications.

3. Timeline for Recovery: The timeline for recovery can vary significantly among individuals. Generally, it may take several weeks to months for full recovery, depending on the severity of the fracture and the effectiveness of the surgical intervention. Regular follow-ups with your orthopedic specialist will help monitor your healing progress.

In conclusion, while the symptoms you are experiencing are common after a scaphoid fracture and subsequent surgery, it is crucial to maintain open communication with your healthcare team. They can provide tailored advice and interventions to facilitate your recovery. Engaging in prescribed rehabilitation exercises, managing swelling through elevation and ice, and being patient with the healing process will be key to regaining full function in your wrist and hand. If you have any concerns about your recovery or if symptoms persist, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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