Fractures of the scaphoid occur in the fall on a bent wrist, a direct hit on the hand or fist to hit a solid object. Usually navicular broken into two parts. Sometimes the same time with a fractured scaphoid lunate dislocation occurs and bones. Then the damage is called de Quervain perelomovyvih.
The patient complains of pain and swelling in the wrist joint of the thumb. The load on the first and second fingers increases the pain. The pain increased as the compression hand into a fist, which often becomes impossible.
To clarify the diagnosis X-rays are produced in three projections. However, sometimes X-rays can not be considered a line break. Therefore, when informed of suspected scaphoid fracture without radiological confirmation, we treat the fracture. After 10 days of repeated images. During this time, if the patient had a fracture, the bone near the fracture line is subjected to resorption (osteoporosis) and fracture line becomes more visible. Fractures of the scaphoid bone of the body are intraarticular or extraarticular, when there is a gap between scaphoid tubercle.
Treatment. The easiest is fractured scaphoid tubercle. Such a change usually heals well and does not require immobilization for more than a month. Fractures of the scaphoid bone of the body are fused within 6 months. It depends on the characteristics of supply and blood supply to the navicular bone. If one of the fragments left without adequate food, it may undergo resorption. Often the fracture site formed a false joint and the cyst in the body of the navicular bone.
If bias is found, a plaster bandage from the base of the fingers to the upper third of the forearm, and the first finger zagipsovyvayut, leaving free only half of the terminal phalanx. After 2.5-3 months of plaster is removed and produce an X-ray control.
If the fracture healing has not come, plaster cast is applied repeatedly for up to two months. If the X-rays were detected displacement of bone fragments, surgical treatment is: screw fixation, the spokes. Perhaps treatment with external fixation. In this case the fracture union time reduced to two months. In all cases, we recommend early initiation of physical therapy, movement of fingers brush. Complications of scaphoid fractures are false joints and delayed fracture healing. In these states, operations are performed varying complexity depending on the qualifications of trauma surgeons.
Fracture of the lunate bone
Fracture of the lunate bone is rare. The mechanism of fracture - fall on the wrist or a direct blow to the wrist. The patient complains of pain in the wrist, aggravated by straightening the back of the hand and the load on the third and fourth fingers. To clarify the diagnosis carried out X-rays.
Treatment. Anesthesia. The imposition of the cast from the upper third of the forearm before the metacarpal bones. The term fracture union 1.5-2 months. Complications of fractures of the lunate bone usually does not happen.
Fracture of the pisiform bone
The mechanism of fracture of pisiform bone - a direct blow to the wrist or hand hit the side surface of a solid object. The patient complained of pain in the side of the wrist sustva, in the elevation of the little finger. The pain is worse when you try to bend a finger or a brush to compress into a fist.
The diagnosis is established by means of X-rays in special projections.
Treatment consists of immobilization in a plaster splints for a period of one month