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The invisible killer of wrist fractures: Why are scaphoid fractures not easy to see on X-rays?
Among many wrist fractures, scaphoid fractures are known for their hidden nature. Even if typical symptoms are present during clinical examination, such as pain at the base of the thumb and tenderness in the "cigarette box" area, this fracture may still be missed on the initial X-ray examination, resulting in missing the optimal time for treatment. This not only affects the patient's recovery progress, but may also cause long-term complications.
The scaphoid is the most commonly fractured bone in the wrist, but its unique blood supply makes its recovery process risky.
Symptoms of Scaphoid Fracture
Scaphoid fractures often cause pain in a specific area of the wrist and are more common in men. Symptoms of this fracture include:
- Tenderness and swelling in the cigarette pack area.
- Interferes with daily use of the hand, especially with severe pain when applying force.
- More widespread joint stiffness that may develop over time.
Patients with scaphoid fractures need to be alert to complications such as femoral neck necrosis (Avascular Necrosis, AVN). This is because the scaphoid's blood supply is primarily oxygenated proximally, so proximal fractures increase the risk of subsequent necrosis.
"If not treated correctly, scaphoid fractures can lead to early degenerative arthritis of the wrist."
Bone Fracture Diagnosis Process
Although X-rays are a common diagnostic tool, the fact is that in a quarter of cases, clinical signs may indicate a fracture, but its presence is not visible on X-rays. Due to the limitations of X-rays, doctors usually immobilize the patient after clinical diagnosis and rescan after one to two weeks.
Some doctors believe that MRI can provide clearer images in such cases and help clarify the diagnosis.
Appropriate treatment
Treatment of scaphoid fractures usually varies depending on the location of the fracture, the displacement, and the individual patient's circumstances. For non-displaced or minimally displaced fractures, a cast on the wrist is often recommended to reduce the likelihood of surgical complications.
Prognosis and Recovery
Studies show that the return to sports rate for patients who do not undergo surgery is about 90%, while for those who do undergo surgery, the rate is as high as 98%. However, whether or not surgery is performed, patients should follow their doctor's advice during the recovery process, including regular checkups and physical therapy as necessary.
Conclusion: Beware of invisible crises
Although a scaphoid fracture may seem unremarkable, the potential consequences can be serious. By understanding the importance of diagnosing and treating scaphoid fractures, can we better protect our wrists in the future?
