What to do if scaphoid necrosis

Some people accidentally fell and injured their wrists while playing ball. After going to the hospital for an X-ray, they were diagnosed with soft tissue contusion. The doctor said it was nothing serious. After resting for a while, the patients felt that their wrists were basically fine, so they continued to play ball, but they always felt uncomfortable in their wrists. At first, they thought that the recovery period of soft tissue contusion was relatively long, but later they changed to another hospital for examination, and the diagnosis was actually scaphoid necrosis.

1. What is the navicular bone?

The navicular bone is a small bone in the wrist. The navicular bone is close to the radial side of the rib and is shaped like a boat, hence its name. But it is irregular, with a long and narrow back, rough and uneven, and forms a joint with the radius. When a person falls and gets injured, the palm of the hand lands on the ground, and the navicular bone is the first to be hit. It is compressed between the radius and the capitate bone, causing a fracture. The navicular bone is difficult to heal due to its high shear force and poor blood supply.

2. Clinical manifestations 1. Slow onset, swelling and pain in the wrist joint, fatigue, aggravated by activity and relieved after rest. As the pain worsens, the wrist becomes swollen, movement is restricted and work cannot be continued. 2. Mild swelling on the back of the wrist and obvious tenderness in the navicular area. All movements of the wrist joint may be restricted, with dorsiflexion being the most obvious.

3. Examination and treatment

Examination: 1. There are no abnormalities in the early X-ray film. After a few months, the density of the scaphoid bone is increased, the shape is irregular, and there is punctate absorption in the center of the bone. There is osteoporosis in the surrounding carpal bones. 2. Radionuclide bone imaging can detect abnormal concentrations in the navicular bone at an early stage.

Treatment: In the early stage, conservative treatment such as immobilization, physical therapy and symptomatic treatment is the main approach. If the pain is severe or joint movement is limited, surgery may be considered.

4. What is osteonecrosis

Osteonecrosis is one of the diseases, and the so-called osteonecrosis refers to the necrosis of the living tissue components of the human skeleton. Traditional Chinese medicine calls bone necrosis bone erosion. Bone necrosis can occur in many parts of the human body. There are many causes of bone necrosis. In clinical practice, femoral head necrosis is the most common. Most of the articles focus on introducing the causes, symptoms, treatments, exercises and prevention of femoral head necrosis. As for bone necrosis, it can occur in any part of the human body. More than 40 cases of ischemic necrosis have been found, and the incidence of femoral head necrosis is the highest.

5. Precautions after osteonecrosis surgery

After about three months of hospitalization and rehabilitation after the operation, the foundation for functional recovery has been laid. At this time, the scar will enter the softening period. The patient must insist on functional exercise (insist on calf traction at night for 1.5 years). The function will continue to improve. During the exercise, you are required to feel mild to moderate pain (tolerable). No pain, no effect. If any movement is painful, you should practice it more. The more painful it is, the more you should practice. After 2 to 3 years of functional exercise, you can achieve more satisfactory function. At this time, avascular necrosis of the femoral head has been basically cured clinically and the treatment goal has been achieved.