Scaphoid bone fracture

　　This disease is often caused by indirect violence, such as falling and the palm of the hand touching the ground. The scaphoid is the first to bear the impact, compressed between the radius and the capitate bone, the wrist is strongly dorsiflexed, slightly radially deviated, the radius cuts off the scaphoid on the dorsal side, forming a fracture.

　　What complications can scaphoid bone fracture lead to: Due to the large shearing force at the location of the scaphoid, poor blood supply, it is prone to delayed healing of fractures and late-stage avascular necrosis, which can lead to destructive arthritis and wrist joint instability. This disease is also often accompanied by median nerve compression syndrome, so if treatment is not timely, it may lead to necrosis of the affected hand.

　　1. Swelling, pain, and dysfunction of wrist joint movement, with明显 tenderness in the nasal fossa.

　　2. During the examination, have the patient hold their palm, with the hand radially deviated, bending the thumb and index finger, and when tapping the metacarpal head, there will be明显 pain in the scaphoid.

　　How to prevent scaphoid bone fracture:

　　1. Pay attention to the safety of production and life, and avoiding trauma is the key to the prevention and treatment of this disease.

　　1. Postoperative medical instructions are crucial for the prognosis, and the time and method of functional exercise, as well as activities to be avoided or prohibited, should be detailedly explained to the patient. Different patients have different personalities and psychological factors. Both excessive impulsiveness and overly娇气 avoidance of movement are contrary to medical principles, and the prognosis is difficult to predict. Only proper exercise under the guidance of a doctor can achieve good results.

　　1. The examination of this disease mainly involves X-ray examination:

　　2. X-ray films need to be taken in three directions: the wrist joint, the lateral position, and the scaphoid position. They can often show the fracture line. Sometimes, fractures without displacement may be negative on early X-ray films. For suspected cases, re-examination of the radiograph should be performed two weeks later, as the bone absorption at the fracture site after injury increases the fracture line width and makes it visible. For old fractures, the fracture line is obviously widened, the fracture end is ossified or cystic, which is the manifestation of bone nonunion. If the density of the proximal bone block increases or deforms, it may be ischemic necrosis.

　　Dietary taboos:

　　1. Avoid eating too much pork bones:If a large amount of pork bones are consumed after a fracture, it will promote an increase in inorganic components in bone tissue, leading to a disorder in the proportion of organic matter in bone tissue, which will hinder the early healing of fractures.

　　2. Avoid malnutrition:Fracture patients often have local edema, congestion, hemorrhage, muscle tissue injury, and other conditions. The body itself has resistance and repair ability to these, and the repair of tissue and swelling mainly relies on various nutrients.

　　Precautions before the treatment of scaphoid fracture:

　　1. Fracture

　　The forearm cast is fixed in the functional position, and the range of the cast should extend from below the elbow to the distal palmar transverse crease, including the proximal phalanx of the thumb. During the fixation period, it is necessary to persist in finger functional exercises to prevent joint rigidity. For结节fractures, fixation for 4 to 6 weeks, for lumbar or proximal fractures for 3 to 4 months, and sometimes even half a year or a year. Regular radiographs should be taken every 2 to 3 months, and fixation should continue until bone healing is achieved. For patients suspected of having a fracture but with negative X-ray films, the cast should be applied first, and the cast should be removed after 2 weeks for re-examination of the radiograph. If a fracture is confirmed, continue the fixation.

　　2. Old Fracture

　　Patients with asymptomatic or mild symptoms may not need treatment, just reduce the amount of wrist joint movement and continue to follow up. For those with obvious symptoms, if there is no evidence of ischemic necrosis or bone nonunion,石膏fixation can be tried, usually it takes 6 to 12 months to achieve the goal of bone healing. For those with bone nonunion or ischemic necrosis, bone grafting can be performed according to specific conditions, such as radial osteotomy, drilling bone grafting, proximal bone block resection, or radial styloidectomy, etc. For patients with severe traumatic arthritis of the wrist joint, wrist joint fusion can be performed.