Hi Shylaja,
What do you think are the expected complications if the scaphoid fracture is not detected and treated at the early stage?
I enjoyed reading your post. A fracture in the scaphoid is causing an insufficient blood supply to the wrist joint, leading to possible avascular necrosis (Ramponi, 2012). Subsequently, avascular necrosis of the carpal bone, contributing to a decline in hand grip function and wrist movement (Waldman, 2014). Untreated or incomplete union of the scaphoid bone associated with a fracture may lead to various compications.
Below are the list of scaphoid fracture complications
Nonunion
Non-union may contribute with a disfigured scaphoid leading to major functional impairment and limited motion. Clinical studies of non- union of the possible scaphoid lead to osteoarthritis but it is not clearly justified (Singh & Dias 2012).
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Malunion
Complete or faulty union of the scaphoid is causing a flexion deformity of the scaphoid but and possibly an ulnar translocation or rotation of the distal fragment of the radius, although, the study remain unclear (Singh & Dias 2012). In a cadaveric research, the imitated scaphoid malunion contributing to limited wrist extension motion and this was correlative to the deviation of angulation (Burgess, 1987).
In addition Allen could not raise his arms against gravity, had flaccid lower extremities, and was without triceps or wrist extensor reflexes, and other muscle stretch reflexes were absent. If the fracture was at C4-5 Allen would not be able to shrug his shoulders and if the fracture was at C7 he could extend his flexed arms.
DOI: 1/23/2014. This is a 36- year old male relief driver who sustained injury while he was putting away the automatic tarper when he was struck on the right shoulder and got driven into the ground and twisted his right foot. Per OMNI, he was diagnosed with right shoulder strain, and back/neck/right foot fracture. As per office notes dated 6/3/16, the patient is complaining of numbness in all extremities specifically the bilateral feet, arms and bilateral elbows. He has had a flare-up of pain that past couple of weeks around lateral column of the right foot made worse with walking and standing. He has been taking Neurontin 300 mg thrice a day which is helping control his symptoms. He apparently had a bilateral upper extremity upper extremity
Connecting the humerus to the scapula is a ball-and-socket joint called the glenhumeral joint which allows the arm to move in a circular motion, as well as up and out from the body. A joint at the highest point of the shoulder, called the acromioclavicular (AC) joint, gives human beings the ability to raise their arm above their head. The acromioclavicular joint is creating by the joining of the clavicle and the scapula. A group of tendons and muscles in the shoulder make up the rotator cuff which stabilizes the shoulder and keeps the humerus in the glenoid, a shallow fissure in your scapula. I selected you as one of my patients due to your shoulder problems due to the fact that in my senior year of high school I had to go to a physical therapist for my shoulder.
Patient is a 57-year-old male fuel tank driver who sustained cumulative trauma on 2/7/2004 due to repetitive movement caused by delivering fuel. As per QME dated 1/25/14, the patient has numbness in the fingers and the patient is diagnoses that he has carpal tunnel syndrome. The left wrist had undergone carpal tunnel surgery; however, he gets numbness from the wrist up into his forearm and numbness in the fingertips. It was also noted that on 12/5/13, the patient complains of shoulder pain bilaterally at 7/10. It is constant and goes into noth arms, along with weakness with numbness in the hands, decreased ability to perform activities of daily living, and impared grip. The pain in the bilateral shoulders is constant and aching with intermittent
Claimant’s family members and colleagues concerning the accused loss of function in daily activities of living.
PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal
For the human joint anatomy project, our group decided to research and construct the elbow joint. The following is a report and summary of the project including roles taken, challenges faced, solutions derived, and ultimately, contribution and experiences of both partners.
HISTORY OF PRESENT ILLNESS: Ruby Pearce follows up today for reevaluation of her left proximal humerus fracture sustained secondary to a fall on July 9, 2015. She was seen in the office on July 15, 2015 and a course of nonoperative treatment for proximal humerus fracture was begun. She was given a prescription for physical therapy and instructed on home exercise program including pendulum motions and wall walking. She has not attended physical therapy, but has been diligent with her home exercise program. Her pain is intermittent and sometimes sharp, but is easily controlled with medications. She states she has a 5-6/10 at times. She takes Tylenol to control these symptoms. She notes no neurovascular
There are many specific types of fracture that occur in the thumb and first metacarpal, fractures of the proximal phalange and distal phalange are simpler to manage than the more complex Bennett and Rolando fractures which involve the joint between metacarpal and carpal bones (Day & Stern, 2010). If a fracture occurs in the first metacarpal, or proximal or distal phalange the patient will experience pain to the thumb, the area may appear bruised and will swell; patient also in most cases experience a loss in function and are unable to complete tasks such as pinching motions (The Royal Berkshire NHS Trust, 2013). Anne is not experiencing any loss of function in her arm and there is no swelling of the thumb; consequently, it is unlikely that Anne has fractured her first metacarpal, distal or radial
Scaphoid fracture is the most common type of wrist fracture and is an important health problem as it affects predominately young active individuals (mean age 29)1. They are therefore of significant social and economic importance. These fractures account for 2-7% of all fractures1. They commonly occur when a patient falls onto an outstretched hand or are sustained as a sporting injury. Scaphoid fractures are notoriously difficult to image and due to the poor blood supply, has issue with regard to non-union and avascular necrosis (AVN)1.
“The setback is serious enough to warrant close monitoring and treatment," Dr. Tehrany stated. "It will impact his future if it does not completely resolve over time."
3.) RA with telescoping digits, evident joint deformity (zigzag deformity), joint space narrowing of the carpal bones
Background and Purpose: Scapular dyskinesia is defined as abnormal positioning or motion of the scapula during scapulohumeral movement. Dysfunction of the scapula is multifactorial and can lead to a variety of symptoms. The purpose of this case report is to present a successful conservative treatment approach for scapular dyskinesia in conjunction with neural tension and neck and shoulder pain.
Introduction The scaphoid bone also known as the naviculair bone, is the second largest carpal bone and was so named from the Greek word scaphe meaning boat, because of its shape resemblance a boat. It has three named regions, including the proximal pole, the distal pole (tubercle), and the waist, which separates the two poles. Over 80%of the bone is covered with articular cartilage. It articulates with the distal radius, lunate, trapezium, trapezoid en the capitate and plays a significant role in the wrist joint. (1o)
PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal ligament and incised this