Scaphoid Non-union

Scaphoid Non-Union is the result of a previously fractured scaphoid not healing due to various reasons. It can cause pain or swelling along the thumb-side of the wrist.

The operation involves freshening the fracture ends, re-aligning the bone fragments, putting new bone into the gap between the two pieces of the scaphoid (bone graft) and fixing the scaphoid and the graft with a screw, or sometimes some wires.

You will find that a dressing and padded bandage with temporary plaster incorporated has been applied to the hand. It is important to keep these dressings clean and dry and begin moving fingers after the operation to stop them stiffening. To reduce swelling, keep the arm elevated in the sling provided or resting upon pillows. Pain killers can be taken as when felt necessary.

A new plaster cast will be applied 10-14 days after the surgery usually by the hand therapist after wound check and suture removal. After 10-12 weeks an x-ray will be taken in order to assess the progress of healing and the mobilisation of the wrist may begin. In the best cases, heavy loading and contact sports may be reintroduced after four months and driving may begin when the patient feels confident enough to control a car which may take around three months.

Generally, this procedure is considered to be effective. However, some people may have problems. The commonest of these is tenderness of the scar, which is usually temporary and is helped by the massaging of tissues. Other problems are swelling and stiffness of the hand, which if severe is called reflex sympathetic dystrophy and is rare. Infection is also rare. The screw used in the operation is usually not removed and may cause some issues if it becomes loose or protrudes out of the bone which could require further surgery. There is a chance that the bone fails to heal which may require further operation.