Scaphoid Fracture Open Reduction and Internal Fixation (ORIF)

A scaphoid open reduction internal fixation, also known as a scaphoid fracture ORIF, stabilizes a fractured scaphoid bone with screw fixation. Learn more about scaphoid bone surgery, recovery, and more from our expert hand/wrist surgeons at Resurgens.

What You Need To Know About A Scaphoid Fracture ORIF

What Is a Scaphoid Fracture ORIF?

A scaphoid fracture ORIF (open reduction and internal fixation) is a surgical procedure used to treat a fracture of the scaphoid bone in the wrist. The scaphoid bone is one of the small bones located in the wrist's snuffbox, which is a triangular depression on the dorsum of the hand at the base of the thumb. This area is particularly susceptible to fractures.

The goal of scaphoid fracture ORIF is to restore the bone's alignment and stability, enabling it to heal properly. A scaphoid fracture ORIF is typically necessary in cases where the fracture is displaced or unstable and cannot be treated with non-surgical approaches such as immobilization or casting. The success rate of the procedure is generally high, with most patients experiencing pain relief and significant improvement in their wrist function.

Why Is a Scaphoid Fracture ORIF Performed?

A scaphoid fracture often results from a person falling and attempting to break the fall with their hand, causing the longer bone to snap under the pressure. While it may not be immediately apparent that the scaphoid bone is broken, it typically results in pain and difficulty using the wrist. The scaphoid bone is essential for controlling other wrist bones and the arm's radius bone, meaning that it can even become challenging to use the arm without discomfort if the scaphoid bone is fractured. If the bone is in a poor position and needs significant realignment, a scaphoid fracture ORIF is necessary.

How To Prepare for a Scaphoid Fracture ORIF

There are a few things patients can do to increase the safety and success of the procedure. Before scaphoid surgery, patients will have to undergo a preoperative evaluation, which may involve going over their medical history, undergoing physical examinations, and completing blood tests. Patients will need to fast or restrict their diet and fluids the night before the surgery.

We will advise you to avoid smoking or taking certain medications or supplements that may interfere with the surgery or increase the risk of complications. It is also essential to arrange for transportation and post-operative care, as patients will need help with daily activities during the scaphoid surgery recovery period. Feel free to discuss any concerns or questions with your dedicated Resurgens physician.

What Happens During a Scaphoid Fracture ORIF?

During a Scaphoid Fracture ORIF, the surgeon will first make an incision in the wrist area. Then, they will carefully move the tendons and ligaments out of the way to gain access to the broken scaphoid bone. Using specialized surgical instruments, the surgeon will reposition the fractured bone and use screws or pins to hold it in place. This helps to ensure proper healing and alignment of the bone. The screws or pins may remain in place permanently, or they may be removed at a later date if necessary.

The surgeon will then close the incision with stitches or staples and place a cast or splint on the wrist to protect it during the healing process. The entire procedure typically takes a few hours and is performed under general anesthesia. After the surgery, patients will be monitored closely and released once we ensure there are no complications.

Are There Risks Associated With a Scaphoid Fracture ORIF?

As with any medical procedure, there are associated risks with scaphoid fracture ORIF surgery.

  • Infection is unusual in the hand (less than 1% of cases) and can often be treated with oral antibiotics for local wound infections.

  • Nerve damage at the surgery site is possible.

  • Metalwork problems can occur if the fracture is slow to heal, and the screw starts to work its way loose or protrude out of the ends of the bone. The screw used in this operation is designed to be buried within the bone and usually not removed.

  • Scaphoid fractures sometimes do not heal, even with this sort of surgery.

  • Even when the scaphoid does heal up, most patients are left with some occasional discomfort in the wrist after this surgery and some stiffness.

Scaphoid Surgery Recovery

After a Scaphoid Fracture ORIF surgery, patients are advised to elevate the wrist to reduce inflammation and swelling. Pain medication may be prescribed to manage pain after scaphoid surgery, and the wrist may be placed in a cast to promote healing. It takes several weeks for the surgical site to heal, and complete wrist healing may take up to 12 weeks or longer. Scaphoid fracture recovery time after surgery varies for each patient, depending on the extent of the fracture and the patient's individual healing response. Physical therapy is usually recommended to avoid stiffness and regain control and mobility.

Patients should wear a cast or splint for up to 6 months or until their fracture has healed, as scaphoid fractures tend to heal slowly. During this time, patients should avoid activities such as lifting, carrying, or pushing heavy objects, participating in contact sports, climbing ladders or trees, and using heavy machinery or equipment that vibrates. Smoking should also be avoided as it can delay or prevent fracture healing and affect healing after surgery.

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