Note: The following symptoms are not meant to diagnose a condition. If you have these or other symptoms, you should be evaluated by a qualified hand surgeon.

• Pain on the thumb side of the wrist after a fall on an outstretched hand.
• The pain may go away initially, only to return weeks to years later if left untreated.
• Stiffness in the wrist.
• Swelling in the wrist.
• Redness or heat in the wrist.
• Limited and/or painful use of the involved wrist.

• History and Physical Exam : The hand specialist will obtain a history of the problem and perform an appropriate physical exam to find the area of concern.
• Imaging : Usually, imaging of the wrist begins with x-rays. If more information is needed, the hand specialist may order a CT scan or an MRI of the wrist.

• Surgery : The goal of treatment is for the Scaphoid fracture to heal with an adequate blood supply to the entire bone. Options for surgical treatment include placing a screw in the bone to realign and support the fracture. Bone graft may also be used to aid in fracture healing.
• Bone grafting options vary depending on the level of fracture, how old the fracture is and the blood supply to the scaphoid bone.
• Bone grafts may be broadly divided into two groups.
• Non vascularised bone grafts. These are bones taken from the iliac (part of hip) bone or around the elbow. Except for mild pain for a few days , taking bone grafts does not cause any disability.
• Vascularised bone graft : Bone graft is taken along with its blood supply. Usual donor sites are radius ( around wrist ) or femur ( around knee joint). Commonly used vascularised bone graft for scaphoid nonunion is known as 1,2 ICSRA.

• If a decision for surgery is made after seeing one of our Hand Surgeons, you may require preoperative medical clearance by our Anesthesia department. This depends on your other medical conditions.

• After surgery your wrist shall be immobilised in a plaster from thumb to below the elbow. You will be able to move all your fingers, tip of your thumb and elbow freely.
• If you have undergone a closed surgery , you may be advised to visit your consultant after one week. Next visit for you will be after 5 weeks for plaster removal and x ray.
• If you have undergone open surgery, your wounds will be dressed every 3 days and sutures will be removed on the 12th day after surgery. A new plaster will be applied . your next review will be after one month.
• Recovery is variable depending on the patient’s medical history, and the location of the fracture. Generally, the patient is immobilized in a cast or splint for 3 to 6 months, with restrictions on use of the hand during the postoperative recovery.
• Someone should be with you for the first 24 hours after surgery.
• You will be given a prescription for post-operative pain medicine. Do not take it with other pain medicines unless directed by your doctor. Do not drive, drink alcohol, or smoke while taking the pain medicine.
• Do not smoke, use smokeless tobacco, nicotine gum, or nicotine patches. Nicotine is a vasoconstrictor, and can impede healing by limiting blood flow to the surgical site(s).
• You must remain non-weight bearing (no use) with the surgical hand and arm until cleared by your consultant. This may be several weeks to months, depending on your healing. Your doctor will provide you with specific restrictions.
• If your cast becomes wet or soiled, you should come into the hospital for a new cast.
• To evaluate healing of the non-union at your follow-up appointments, the doctor will order imaging such as x-rays or a CT scan.
• After several weeks to months of immobilization, you will likely be stiff and weak in your hand / wrist. Often, patients are sent to an Hand Therapist, with the goal of regaining functional use of the operative hand. Remember, you are an active participant in your care, and active participation can give back your wrist with a good range of movements.