The scaphoid is one of the eight small bones in your wrist and is an important link in maintaining the smooth rotation of your wrist and hand. Because the scaphoid is a small yet highly mobile bone, it is particularly vulnerable to injury and is most often injured during a fall with your hand outstretched. This bone also has a poor blood supply, which can significantly slow the rate of healing. A non-union fracture is a break in the bone that has not shown signs of healing despite adequate time to do so. Non-union fractures can have serious complications, and if they remain unhealed after six months, surgery may be required. However, sometimes a non-union fracture can be corrected without surgical intervention. This usually requires physical therapy that will jump-start your body's natural healing process.
Immobilization
Non-union fractures typically result from a lack of proper treatment after the initial injury. After any fracture, the first step to recovery is immobilization. If you have not properly immobilized your wrist after fracturing your scaphoid bone, then the healing process may not begin, thus turning the fracture into a non-union fracture. Therefore, the first step to recovering from a non-union fracture is to immobilize your wrist by using a cast or a hard splint. You may be required to keep your wrist immobilized for six to eight weeks.
Heating Pad
Increasing blood flow to the area of the fracture is important and may help to start the healing process. Blood will carry nutrients to the bone and carry away toxins and dead cells that have accumulated around the area of the break. To increase blood flow, your physical therapist may use heat therapy on your wrist. Heat therapy involves placing a heating pad on your wrist, usually for about 20 minutes at a time several times a day.
Ultrasound
Ultrasound therapy is another way you can use heat to increase blood flow to the scaphoid and accelerate healing. An ultrasound device generates a high-frequency sound wave that travels through your wrist and causes your tissue to vibrate rapidly. This vibration generates a gentle heat by vasodilating, or enlarging, the blood vessels that supply your wrist with blood. Ultrasound therapy can be done every day under the direction of a physical therapist.
Flexibility Training
During the healing process, scar tissue may form in your wrist. Scar tissue limits mobility and can adversely affect your range of motion in your hand and wrist. Flexibility training involves performing a series of stretches and range of motion exercises to break up scar tissue and increase flexibility around your wrist joint.
Strength Training
Strength training can begin after you have regained sufficient range of motion in your wrist. Strength training will help rebuild any muscle tissue that has been damaged or lost during the immobilization phase of recovery. Rebuilding muscle will help support your wrist and protect it from future injuries.
References
- "Human Anatomy And Physiology"; Elaine N. Marieb; 2003
- "Therapeutic Exercise: Foundations and Techniques (5th edition)"; Carolyn Kisner and Lynn Colby; 2007
