Two options to fix a broken wrist, need advice

samsam7 · June 2010

Ok so I've got a scaphoid fracture and I need to figure out which route I want to go with fixing this. My two options are:

1. Being in a cast for three months. College starts back up in mid August and I just started moving into a new apartment so fml.

2. Getting a titanium screw implant. Ill be in a cast or removable splint for 4-6 weeks. The screw stays in for life.

Both offer basically a full chance of recovery and normal use after therapy.

So is there any downside to having a screw in for life? Will I set off detectors? I already know I wont be able to do CAT scans or be by absurdly powerful magnets.

Esh · June 2010

Screw means you'll technically be a cyborg.

Get the screw.

Pali · June 2010

I would go for the cast, cause if you break it again with the screw your well.. screwed

nuka · June 2010

They tell you that you can't be around magnets because it gives you super powers.

Actually though I'd just get the screw in because it's better than going three months in a cast. I've fractured my wrist before, I was in a cast for only 2 weeks and boy was I glad it was off, my wrist was getting rank. You can't take those things off to wash yourself.

Also, if you hurt the hand you write with college is going to suck ass in a cast.

Noxy · June 2010

I would personally go with the cast. Three months is not that long in my opinion.

dukederek · June 2010

Broke my hand in November, was offered a similar choice.

1: cast for 4-6 weeks and the knuckle will always be "dropped" (actually was only 1 and then taped it up for another week and was careful - I guess that's irrelevant to your situation)

2: surgery and metal in me

I chose the cast just because surgery sucks.

Yes permanent casts get rough, when I had mine off the nurse left me in a room with a sink to have a wash. Half an hour and I'd pretty much got the smell away. Still think it's better than what will probably be painful surgery and an inability to be subject to certain medical tests in the future.

I assume your insurance doesn't care which you have?

Leracas · June 2010

I've got two screws in my knee and they've never set off a detector. And if they do, I've got a card from the hospital saying that there's metal in my knee.

Also, CAT scans are no problem at all. What might not be possible are MRIs, but that depends on the implant. The surgeon will be able to tell you whether it's possible.

rfalias · June 2010

The metal they use for screws are non-ferrous and don't generally affect MRI's to the point of them ripping out of your leg. At worst it might cause artifacts in the imaging.

Rook · June 2010

Fonjo wrote: »

I would personally go with the cast. Three months is not that long in my opinion.

If you can avoid getting shit stuck in your body, I would really recommend it. Surgery (no matter how minor) always caries a risk, and screws in the body can lead to complications later on in life requiring even more surgery.

Tofystedeth · June 2010

I've broken my carpal scaphoid on both hands and each time I they put me in a cast for about 6-8 weeks with a brace for the next 6-8. The first one extra sucked since it was my dominant hand on the day before final exams started. The professors were kind and let me type essay questions and dictate my calc exam to a proctor. (Programming in C++ sucks with only your left hand. so many {} and ().

)

Bagging it up to shower was annoying, and getting a tux on over it was difficult (and looked silly). But I have full use of them. I even had a summer job painting dorms both years that I managed to do with the cast.

Rye · June 2010

Tofystedeth wrote: »

I've broken my carpal scaphoid on both hands and each time I they put me in a cast for about 6-8 weeks with a brace for the next 6-8. The first one extra sucked since it was my dominant hand on the day before final exams started. The professors were kind and let me type essay questions and dictate my calc exam to a proctor. (Programming in C++ sucks with only your left hand. so many {} and (). )

Bagging it up to shower was annoying, and getting a tux on over it was difficult (and looked silly). But I have full use of them. I even had a summer job painting dorms both years that I managed to do with the cast.

Did people think you were faking it when you came back a year later with the cast on the wrong hand?

MushroomStick · June 2010

Would the screw be one of those things that causes a dull ache for the rest of your life?

Bionic Monkey · June 2010

samsam7 wrote: »

So is there any downside to having a screw in for life? Will I set off detectors? I already know I wont be able to do CAT scans or be by absurdly powerful magnets.

I have a metal plate in my skull that doesn't prevent any of that. Most likely, the screw will be titanium.

ceres · June 2010

If you can avoid the screw, I'd avoid the screw. It sounds like the only thing it will save you is a few weeks of inconvenience. If it were the a question of a full recovery versus some kind of permanent impairment, I'd say go with the screw, but a few months in a cast isn't that big a deal and your prospects are the same without it.

Plus the cast is probably MANY MONIES cheaper than the screw + surgical installation.

Noxy · June 2010

MushroomStick wrote: »

Would the screw be one of those things that causes a dull ache for the rest of your life?

Probably just as likely as not having a screw. Sometimes broken bones do that but it is not usually the case.

My sister had a spiral fracture in her arm that had 75 different breaking points, her arm has rods and screws in it. She lost some range of motion but that is due to the type of break. She has never complained of long term aches.

I just don't like the idea of a foreign body being inside me if it is not necessary. Also, if you can avoid surgery, you should. Surgery is controlled but it is still trauma to the body and you can never be sure of what could happen because of it. Odds are you would be fine with no complications but why take a risk?

Tofystedeth · June 2010

That's true, surgery does add the risk of infection or bad anesthesia reaction and stuff.

Also yes, probably way more expensive.

Fats · June 2010

I say cast as well, you might as well save the hardware for when there's no other choice.

samsam7 · June 2010

Thanks for the responses guys. So the full story is that three different doctors looked at my x rays with the final being a specialist using a significantly more advanced machine. None of them are 100% certain that the scaphoid is even broken, but if it is, it's a serious situation (and a hairline crack). So the specialist says it should be treated like a hairline, and gave me the two options. I only asked a few questions when he first told me, and I'll be going back in to ask more questions. Ultimately, the only thing I care about is having my wrist normal again. I'm also gonna ask what happens if there is no pain come surgery time next week which would indicate it was a sprain and not a broken bone.

amateurhour · June 2010

I broke my leg in five places and had to go three months in a cast, and I had three screws put in my ankle. One was a temporary pin to set things, and the other two are still in there.

I've never set off a metal detector and I can be in an MRI machine.

Also, I don't know if it's just from the break or the pins, but yes, when the pressure changes outside, or it gets cold, my ankle fucking hurts.

edit:

Since you just responded, go with the pin. I had a hairline fracture on the other ankle back in high school and chose the cast (although it wasn't a long time cast, just a few weeks) and it's more fucked up then the ankle with the pins.

NotYou · July 2010

surgeons make mistakes rarely, but it happens. There is significantly less chance of mistakes happening with a cast. So I'd choose a cast. However, I really don't see anything wrong with going with a screw.

samsam7 · July 2010

So I just came back from my boxing gym (got the fracture/sprain from throwing a left hook). The trainers are all pro or retired boxers, and they thought it was crazy to consider surgery without at least an MRI. They also said that it's really slim odds that I could have produced the force to break my scaphoid with a punch+gloves+wraps., and I should at least give it a week to see how my wrist feels.

Also, I've been boxing for only about a month and I've got pretty skinny arms and little muscle. Whatever force they think it takes to break a bone punching, I definitely cannot produce it. However, this also means my wrists aren't very strong either, though the wrist that is injured is my dominant hand and I've never had problems with it before.

So right now it looks like the next step is an MRI.

Bionic Monkey · July 2010

For what it's worth, my plate doesn't hurt a bit, but it's also not in a place where bones are moving at all, so it may not be really analogous to a surgical screw. Just wanted to give you some more info.

Tofystedeth · July 2010

samsam7 wrote: »

So I just came back from my boxing gym (got the fracture/sprain from throwing a left hook). The trainers are all pro or retired boxers, and they thought it was crazy to consider surgery without at least an MRI. They also said that it's really slim odds that I could have produced the force to break my scaphoid with a punch+gloves+wraps., and I should at least give it a week to see how my wrist feels.

Also, I've been boxing for only about a month and I've got pretty skinny arms and little muscle. Whatever force they think it takes to break a bone punching, I definitely cannot produce it. However, this also means my wrists aren't very strong either, though the wrist that is injured is my dominant hand and I've never had problems with it before.

So right now it looks like the next step is an MRI.

1.) There's a reason they call it a Boxer's Break.
2.) I broke mine (enough that they could easily tell it was broken, not sprained) by falling a couple feet.

Fats · July 2010

I thought the boxer's fracture was the 5th metacarpal; I did that to myself by punching another kid in the back of the head in 6th grade, and I certainly didn't have much muscle.

Tofystedeth · July 2010

Dunno. For me it was the carpal scaphoid and the ortho guy called it a boxers break.
Point is I didn't hit terribly hard.

Though if it's minor enough they think it may be a sprain 3 months in a cast seems a lot.

samsam7 · July 2010

Saw my family doctor today, and she couldn't find anything on the x-ray. She told me she would call up the hand specialist because she thought it was crazy he would suggest surgery so quickly and that I should wait till Monday to do another set of x-rays which would better show what the damage is.

This hand specialist is a clinical professor associated with a university, I'm just wondering (and I don't know much about medical residencies/internships) if the point of a surgical solution was to provide hours for some students. He had an assistant that was heavily involved with looking at my x-rays and with talking to me about the surgery, and of course, plenty of my friends/family thought I was being taken for a ride.

Evil_Reaver · July 2010

I've got two screws in one of my ankles and I've never set off an airport (or otherwise) metal detector.

I get mild arthritis in that ankle when the weather changes, but that's because I broke my ankle and not from the screws.

The screw will help your bones heal faster.

Get the screw.

Penny Arcade

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Two options to fix a broken wrist, need advice

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