Scaphoid Bone Fracture Emergency
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- Опубліковано 15 вер 2024
- Our patient in this video sustained a scaphoid fracture while skateboarding after falling backwards on outstretched hands. We review scaphoid fractures and demonstrate four examination steps that will help the clinician confirm this diagnosis. I think this is going to be one of the best scaphoid examination videos on UA-cam...in my humble opinion.
Awww... the poor navicular. It lives a dangerous life, often abused, never appreciated. Thank you, mon ami, for a good explanation. Great patient cooperation for the demonstration!
A super professional and informative video. We see far too few of these on UA-cam. Also the girl was amazingly polite. Another thing we don’t see enough these days.
Thank you for sharing. As a med student these videos are very interesting and fun to watch!
You are welcome!!!
Was not expecting ya to tell her the origins of the snuff box hahaha That's a fun fact she'll keep for a while. Love these types of educational videos. Thanks Larry
Thanks for watching!
Awesome video as always! You are a truley gifted educator and possess a bedside manner second to none. Thanks Doc!
Hi Ben, Thanks for the kind comments. You are welcome.
My daughter (age 10) fractured her scaphoid bone pretty badly during a travel basketball game. She required 1 cast for 6 weeks then a new cast for another 6 weeks then a hard brace for 4 weeks. Longest 16-18 week recovery ever for a girl who plays 3 travel sports year round but thankfully no surgery because mama can’t handle that. 😫 Thankfully she has since fully recovered. ❤️
As a newly certified EMT and a newly subscribed fan I absolutely love your content!
Thanks Moselle!
Yeah this injury sucks. Just got out of my cast after 12 weeks and now I’m in the brace, but I only wear it out of the house. Feels much better now though
thanks for the video sir.....it really helps showing the real clinical content and then explaining its theory with slides to get an overview !!!!
You are welcome!!
Very good and informative video Dr. Mellick.. I’ve seen and diagnosed this kind of injuries at least 3-4 times and it’s easy to miss the diagnosis even with a good X-ray.. pain in the “Tabatiere” or Snuff-Box + Swelling of the Back of the Hand are mostly because a probable Scaphoid fracture..
I just posted a comment seeking help at home to treat a scaphoid fracture. Could you please review it and perhaps offer some advice? Thank you for your time!
Thank you Dr. Mellick!
You are welcome!
Great vision from the GoPro, thanks!
Thank you. I'm loving the GoPro8.
@@lmellick i had a question i just commented but i thaugh maybe youd see my comment faster when i write it here i punched the ground with all my strwnght and my pink hurted now 24 hours later my pink is way better but my wrist started hurting it snow better but i will wait till tomorrow to see further i commented more detailed if you could see that comment i would be happy
That child gets my absolute respect. I've had literally hundreds of broken bones due to osteogenesis imperfecta (and yes, I've had this kind of fracture too) and it's nearly impossible to keep it together and polite when you're going through that trauma and pain. Do you know what eventually happened with her hand and that fracture? I'd be very curious.
Im having this as well, my scaphoid broke after a fall from my bike, i didnt had so much pain so i continued working for like 5 weeks, i only had 1 problem i couldnt move my wrist backwards after all those weeks, so i decided too go too the doctor, who said too me that i had too make a picture of it in the hospital, and after all that i heard that my scaphoid was broken (wrist fracture) so its 4 weeks ago now since i had my surgery where they had too put a screw in the 2 pieces of bone and also scrape some bone from another part below the wrist because if they didnt it would not match with each other too fix it.. And now i am wearing a plaster for 4 weeks (2 weeks left till it may go off) and then the wrist exercises will start.. So that is my story, hopefully i will recover quickly
Thank you very much sir , this is immensely helpful
She landed primo after trying a switch trey flip down a ten stair.
VOLUME WARNING headphone users
Sorry, I don't have a good sense of sound fluctuations for my videos.
@@lmellick The voice audio is great. It is the intro. It was so loud it was distorted. Thanks for the upload. I broke my L arm the same way when I was about her age.
Best doctor examine
Tells the kid the wonders of the snuff box lol
Great video as always. Thanks!!!
Thank you!
Wonderful... Thanks a lot Dr. Mellick
This isn’t a thumb spica right? A scaphoid cast or a cup holding cast would be a better term for it if I’m not mistaken. Great video!
*Hey doc, if I poke you in the eye does it hurt?*
*Hahaha. I enjoy your videos. I’m a paramedic.*
Thank you!!
Great video. Learnt about scaphoid fractures. Thank you!
Thank you! You are welcome.
broke mine when i was a kid as well. painful little break too
Nizzy10, surprisingly enough, this girl didn’t complain at all. The only thing that alerted me that she needed to be checked, was that she couldn’t open a packet of fruit snacks. It only bothered her when she did something that involved her squeezing something between her thumb and forefinger. The bruising was minimal also.
When I fractured my scaphoid 2 months ago (February 14th didn't get seen til the 15th) I got told they should have casted it, to relieve pain and pressure, but they refused to do so because I am autistic, and they insisted if I received a cast I would use it as a weapon... I don't think it healed right, but Welp it happened
I've fractured both my left and right scaphoids in sports-related accidents. The first injury took about 9 months to heal with surgery, and the second took about 6 months to heal with surgery. It is a really serious injury, and since it feels a lot like a sprain, people neglect to have it treated. I've heard stories of patients waiting 9 months before getting treatment, thinking it's just a stubborn sprain, only to find out that the bone has died and they now need a wrist fusion. Bad stuff.
They didn't find my fracture for over a year. Scaphoid was snapped in half they missed the break like many do. I've had a surgery but it's still non union and hurts some days more than others. This was almost 20 years ago. Such a bs bone.
@@user-dd1bb4tw4r That sounds terrible.
@@joslinnick give it time your arthritis will start setting in over the years. Some days it will hurt just picking your fork up to eat dinner. Hurts like a b**** when it's cold or wet
@@user-dd1bb4tw4r it's been over 10 years since my first procedure, and I don't have any chronic pain. I can lift heavy weights without any discomfort. I feel fortunate, but I hope that I don't develop arthritis later in life.
@@joslinnick I can lift a lot too you'll have plenty of strength but some days it will act up and you'll have to baby it the next couple of days until the inflation goes down
Excellent presentation....
Glad it was helpful!!
Very informative ...love it..
These videos are amazingggg
The inner most side of the scaphoid receives some what limited blood flow so healing time may be increased. Just adjacent to the lunate.
Thank you👍
Your production is become more and more better. Keep it up sir :)
Thanks a ton!
Interesting, many thanks.
I go see an ortho asap. ER said xray was inconclusive but I show every sign of a scaphoid fracture. This video covered everything I am experiencing. I also have a lump on the underside of my wrist at the bottom of my thumb and cannot lift it to give a thumbs up. There is weakness like ... idk, it's limp ... when I try to raise it.
It wasn't painful til I went to work (merchandising reset specialist, VERY hands on).
I am uninsured and scared I will be dismissed at the ortho without treatment.
This is a very late comment, but I am hoping you can give me some instruction on a way I can wrap it to immobilize in the event my covid-impacted impoverished state prevents proper medical treatment? Like at what angle should I start moving which direction, where to figure 8, etc???
Hi doc I fell on my bike. Turns out I fractured my scaphoid. Is it most likely to need surgery afterwards? I got a temporary cast and go get a hard one in a couple days.
Hello Asstrummm,
Everything seems fine. Your doctor will make the decision if they see your X-rays after 1st recover.
Godspeed,
Dr philippè Jaàcobè
Excellent!!
Many thanks!
so helpful
Is that REALLY why it's called the "Snuff box"?
The story may be apocryphal, but that is what is taught.
Its called scaphoid cast or glass holding cast here in india. 👍 thumb splint or cast is different
Love your channel
Amazing
Thanks!
when u get bore after understanding three types of Conditions in scaphoid bone fracture 😆😆😆
and see practical ❤️❤️❤️❤️
Glad it was helpful!
Most of that hurts for me I just don’t know how to test the last two. Should I get it checked out?
Try the jam jar test open it with the shonky wrist hand. If you dissolve onto the floor in pain it's probably a broken scaphoid.
How do you examine lunate displacement since it can happen in such falls ?
Tenderness locally and X-ray are the only tricks I know for the lunate.
Damn having the chance of avascular necrosis from a fracture would seriously suck. Is there any treatments for AVN of wrist area?
Vascularized bone grafting. From wrist area (1,2 ICSRA) or knee as a free flap (MFC)
@@wakedink91 Thanks for replying i'm not a medical student... just someone with a complex medical back ground. Seems like AVN of the hips is less complicated or at least i have been told it will be simple for me.
i had a surgery on my left hand scaphoid, implant a screw😷
How was it
@@co-op343 good, i got general anesthesia, i just slept and wake up,
Ya but how did it heal
@@co-op343 idk yet, it happen only 1 week operation, on monday im going to control
What do u mean by control
So long to pinky. Here comes the thumb.
Pls reply to my comment yesterfay i got soo angry i punched with all my strenght to the ground and my hand hurted soo much my pink hurted and wheni slightly touched it it felt like 1000needles on my pink 24 hours later it feels better i dont feel that pain anymore but my wrist hırts sometimes like when i bend it forward or bend it backwards bending it forward doesnt hurt much now but backwards hurts more i cant fully bend it backwards i did the techniques you did in the video and my wrist didnt hurt at all so i hope i dont have something broken there or in my pink i will wait 1 more day till tomorrow to see if it gets bad oh and my habf isnt blue or the places were it hurts isnt blue or more pale or red then normal if you could reply to my comment i would be rlly happy
Hi Mr. Slayer 1205 Wow, I hope you didn't break anything. Be sure to get it x-rayed if the pain doesn't get better.
@@lmellick thank you for replying. Today i feel way better i can bend it forward backwards. i only have a slight pain on like the first part of my pink after your knuckel when i touch it slightly it feels like 1000needles that go in and out.
@@lmellick i just noticed my wrist didnt hurt i did research on google and found out that it was my middlefingers metascalpal or something it hurts when i bend my hand backwards
Howdy
Sup fellow oddies
Backchodi bohot karte ho. Kaam ki cheez toh dilhaya hi nahi.
I broke my scaphoid from a fall on outstretched hand.. the gap is 3milimeter and it’s not displaced. The doctor recommended me Surgery but id rather heal it without surgery what do you recommend ?
Hey doctor question so I fractured the distal pole of my schapoid a month ago just got it x rayed today to verify that it was broken doctor said I just needed a splint and it should heal fine do you think by waiting a month to x ray and splint it could have messed up the healing process please answer sir I’d appreciate it
INDICATIONS FOR SURGICAL REFERRAL
Open fractures and those associated with neurovascular compromise require emergency (ie, immediate) surgical consultation. Indications for referral to a hand surgeon within several days include:
●Fractures of the proximal pole (ie, proximal one-fifth of scaphoid) [40]
●Non-waist fractures displaced more than 1 mm [41]
●Waist fractures displaced more than 2 mm [42]
●Waist fractures minimally displaced (≤ 2 mm) when earlier return to work or activity is important to the patient willing to undergo surgery
●Delayed presentation of acute fractures (more than about three weeks)
●Fractures associated with scapholunate ligament rupture
●Carpal instability (eg, lunate tilt on radiographs)
Indications for routine referral include evidence of nonunion or osteonecrosis at any time during the followup of patients being treated nonsurgically with immobilization.
Given the risk of nonunion and the close monitoring required during treatment, it is reasonable to obtain surgical consultation for any scaphoid fracture, even acute nondisplaced injuries. Studies consistently report that surgical treatment of nondisplaced or minimally displaced fractures leads to earlier return to work by about six weeks [43-48] and earlier return to sport by about 2.5 weeks [49]. This may be especially important in persons who require earlier return to sport or occupation (athletes, military, laborers) or those who cannot tolerate prolonged casting. Source: UpToDate