The scaphoid fracture of the hand is the most common fracture of the carpus. It is a fracture of the os scaphoideum of the carpal bones. The injury mechanism is the fall on the outstretched hand.
In most cases the therapy can be performed conservatively. A rehabilitative physiotherapy supports the healing and restores the function of the hand. In some cases surgery is necessary to avoid possible complications and permanent damage.
Therapy
The therapy always depends on the individual patient. As a rule, in the case of stable fractures, consistent immobilization with a plaster cast or splint is sufficient to allow healing. This is followed by intensive physiotherapy to restore the mobility and functionality of the hand.
For this purpose, tissue that has lost elasticity due to immobilization is stretched and mobilized. Adhesions between the tissue layers are loosened and then the muscles of the hand and forearm, which have lost strength and mass due to immobilization, are trained again. The coordination of the fingers and hand is also practiced.
The scaphoid fracture, i.e. the scaphoid fracture, also involves the wrist, as this is made up of the scaphoid bone and the radius. Therefore, the function of the wrist and elbow joint should always be taken into consideration in therapy. Surgical therapy is necessary in the case of an unstable fracture where the fragments are no longer in an orderly position to each other, in the case of poor healing or comminuted fractures.
Immobilization also follows after surgery. Physiotherapeutic follow-up treatment should be carried out during or after immobilization. The goals of the therapy are the same, after an operation the therapist must always follow the load and movement instructions of the surgeon in order not to endanger the result of the operation.
In both cases, the main problem in the therapy of scaphoid fractures is the long period of immobilization. Immobilization can cause tendons and ligaments to shorten and lose elasticity. The wrist can also change and lose mobility.
This must be eliminated during post-treatment or prevented as much as possible during immobilization. (Without affecting the immobilization of the scaphoid). In addition to mobilizing and strengthening physiotherapy, the treatment also includes manual lymph drainage, which promotes the drainage of lymphatic fluid, reduces swelling and thus supports healing.
It is important to train the coordination of the hand after the healing process is complete. If possible, the hand should be able to resume its original function in everyday life. Further and more detailed information can be found in the following articles:
- Physiotherapy exercises
- Physiotherapy for a carpal fracture
- Muscle shortening
- Physiotherapy for a fracture
- Physiotherapy wrist
All articles in this series:
