Item added to basket

product name

Basket total £ 0.00
  • product added £ 0.00
checkout

Physiotherapy Exercises following a Broken Wrist (Scaphoid Fracture)

Stuart, in Norwich, England asks:

"I broke my scaphoid bone. It's healed but I still dont have full mobility in it. Could you advise on any physio exercises I can do."

David Wales, Clinical Specialist Physiotherapist responds:

"The Scaphoid bone is the most commonly fractured of the eight wrist bones that make up the wrist complex. These fractures occur relatively commonly following a fall onto an outstretched hand. Because of the poor blood supply to the Scaphoid, there are often problems with fracture healing, but other complications related to a lack of mobility and residual stiffness are also quite common.

"The traditional management of Scaphoid fractures is to immobilise the wrist using a plaster cast. As with all cast immobilisation this produces short term stiffness around the wrist. In most patients this stiffness can benefit greatly from physiotherapy treatment such as massage, moblisation of surrounding joints and exercise, although symptoms remain in some wrists.

"Recent advances in surgical techniques have changed the management of Scaphoid fractures. In patients where conservative treatment using immobilisation has failed to produce a healed fracture, where the fracture fragments are displaced (not in close proximity) or where the patient's occupational demands require a more swift, certain outcome, then surgical treatment is indicated.

"Conventional open surgery involves a small screw being inserted into the Scaphoid in order to unite the fracture fragments. This may be followed by 6 weeks of wrist immobilisation in a cast or immediate mobilisation, depending on the preference of the surgeon.

"New surgical techniques using wrist arthroscopy are now becoming more popular. The arthroscope allows the surgeon to inspect the bones and soft tissues of the wrist, giving more useful information than x-ray films. Arthroscopy has an advantage over 'open' surgery in that it is less invasive and there is less associated soft tissue damage. This means the duration of rehabilitation is reduced.

"Recent studies have reported the findings in patients who have undergone arthroscopic surgery for the treatment of Scaphoid fractures. These findings have shown that more than a third of patients suffered wrist ligament and cartilage injuries, in addition to their Scaphoid fractures. These injuries have been described as 'Combined Wrist Injuries' (Wong et al, 2005) and would explain why wrist symptoms continue in patients who have had a Scaphoid fracture that has been shown to have healed on x-ray.

"Without arthroscopic surgery it may not be possible to diagnose Combined Wrist Injuries, even with investigations such as MRI. Once found, management of these injuries is dependent upon exactly which soft tissue is involved. Torn ligaments can be re-attached to the wrist bones using surgical wire. This is usually followed by immobilisation in a plaster cast for six to eight weeks, at which point the wires are removed and physiotherapy treatment begins.

"Another common finding in Combined Wrist Injuries was damage to the fibro-cartilage disc, which is known as the Triangular Fibro Cartilage Complex (TFCC). The TFCC sits between the Ulna (one of the forearm bones) and the bones of the wrist area and its function is to increase the stability of the wrist. Damage to the TFCC can be repaired with arthroscopic surgery, where the articular disc is either repaired using sutures or partially shaved off.

"If you are still experiencing symptoms in your wrist then you should return to your orthopaedic doctor for their opinion. If the Scaphoid is fully healed then it may be possible that you have a Combined Wrist Injury, and soft tissue lesions are producing your symptoms. Degeneration is also relatively common following Scaphoid fractures, so your doctor will have to review this.

"If you do have a Combined Wrist Injury then the latest evidence suggests that arthroscopic surgery is the most effective treatment in the long term. Physiotherapy treatments, such as hot wax baths and mobilisations may be effective in relieving the symptoms of wrist pain and stiffness in the short term, but ultimately a surgical approach may be necessary."


Article published: 8th August 2005

Related Articles

Injury A to Z: Scaphoid Fracture >

Further Reading

  1. Bernstein, M.A., et al (2004) A comparison of combined arthroscopic triangular fibrocartilage complex debridement and arthroscopic wafer distal ulna resection versus arthroscopic triangular fibrocartilage complex debridement and ulnar shortening osteotomy for ulnocarpal abutment syndrome  Arthroscopy: The Journal of Arthroscopic & Related Surgery Volume 20, Issue 4, Pages 392-401
  2. Conca, M., Conca, R., and Dalla Pria, A. (2004) Preliminary experience of fully arthroscopic repair of triangular fibrocartilage complex Arthroscopy: The Journal of Arthroscopic & Related Surgery Volume 20, Issue 7Pages e79-e82
  3. Garcia de Lucas, F., et al (2003) Evaluation of the 42 TFCC tears by arthroscopy and MRI  The Journal of Hand Surgery Volume 28, Supplement 1, Page 48
  4. Jui-Tien Shih, Hung-Maan Lee, Yao-Tung Hou and Chuan-Ming Tan (2005) Results of Arthroscopic Reduction and Percutaneous Fixation for Acute Displaced Scaphoid Fractures  Arthroscopy: The Journal of Arthroscopic & Related Surgery Volume 21, Issue 5, Pages 620-626
  5. Wong, T.C., Yip, T.H., and Wu, W.C. (2005) Carpal ligament injuries with acute scaphoid fractures – a combined wrist injury  The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand Volume 30, Issue 4, Pages 415-418

PhysioRoom Hand Grip Exercisers - Build Grip Strength, Hand Injury Rehab

£2.89 inc VAT

Durable handles and resistance springs demonstrates the high quality of the Hand Grip Exerciser by PhysioRoom.com. Use it to strengthen muscles in the hands, arms and wrists.
More Details

PhysioRoom Hand Grip Exercisers - Build Grip Strength, Hand Injury Rehab has a rating of 4.0 stars from 2 reviews (2 reviews)

Quantity

PhysioRoom Hand Grip Resistance Strengthener With Foam Handle - Increase Grip Strength - Hand Gripper

£2.24 inc VAT Was £2.98 Save £0.74 (25% OFF)

The hand grip strengthener features a foam handle to ensure of a comfortable grip. The hand grip strengthener has durable foam handles and resistance springs to increase the strength of the forearm and the hand grip.
More Details

PhysioRoom Hand Grip Resistance Strengthener With Foam Handle - Increase Grip Strength - Hand Gripper has a rating of 5.0 stars from 1 reviews (1 review)

Quantity

PhysioRoom Hand Grip Resistance Strengthener With Foam Handle - 2 Pack - Increase Grip Strength - Hand Gripper

£4.48 inc VAT

The x2 hand grips with foam handles ensure of a totally comfortable grip. The hand grips with foam handles feature resistance springs which help to increase the strength of the forearm and hand grip.
More Details

PhysioRoom Hand Grip Resistance Strengthener With Foam Handle - 2 Pack - Increase Grip Strength - Hand Gripper has a rating of 5.0 stars from 1 reviews (1 review)

Quantity

PhysioRoom Instant Ice Pack - Mouldable Pouch for Pain Relief of Sports Injuries - Single Use

From £0.46 inc VAT     1+ £0.76 each
    6+ £0.68 each (Save 10%)
  12+ £0.61 each (Save 20%)
  30+ £0.53 each (Save 30%)
  60+ £0.46 each (Save 40%)

A mouldable pack that becomes an instant, single use ice pack, without the need for refrigeration.
More Details

PhysioRoom Instant Ice Pack - Mouldable Pouch for Pain Relief of Sports Injuries - Single Use has a rating of 5.0 stars from 22 reviews (22 reviews)

Quantity

Physicool Cooling Bandage - 10cm x 2m - Cold Therapy Bandage - Pain Relief for Sports Injury - Reusable

£8.99 inc VAT

Physicool is an innovative and uniquely designed reusable strapping that combines the healing characteristics of cold therapy with the support qualities of a compression bandage. Differing from the more traditional treatments currently available, Physicool works by drawing heat away from the body to provide an instant long-lasting cooling effect which can be utilised for extended periods.
More Details

Physicool Cooling Bandage - 10cm x 2m - Cold Therapy Bandage - Pain Relief for Sports Injury - Reusable has a rating of 5.0 stars from 7 reviews (7 reviews)

Quantity

Physicool Cooling Bandage + Bottle of Recharging Coolant - Injury Pain Relief, Reduce Swelling & Inflammation

£14.99 inc VAT

The Physicool combination pack supplies you with one specially formulated cooling bandage and one bottle of recharging coolant which will rejuvenate and refresh the dressing. Small and compact this kit is ideal for wrist, elbow and ankle injuries providing between 2-3 hours of cold therapy and compression.
More Details

Physicool Cooling Bandage + Bottle of Recharging Coolant - Injury Pain Relief, Reduce Swelling & Inflammation has a rating of 5.0 stars from 6 reviews (6 reviews)

Quantity

Physicool Cooling Bandage - 12cm x 3m - Cold Therapy Bandage - Pain Relief for Sports Injury - Reusable

£11.99 inc VAT

Physicool is a new and unique way to instantly apply cold therapy whilst on the move, this portable and reusable compression bandage is applied quickly and easily allowing the healing process to begin immediately. By taking heat away from the body Pysicool have developed a product which differs from move traditional methods meaning it can be used for longer periods.
More Details

Physicool Cooling Bandage - 12cm x 3m - Cold Therapy Bandage - Pain Relief for Sports Injury - Reusable has a rating of 5.0 stars from 13 reviews (13 reviews)

Quantity

PhysioRoom Wrist Brace with Thumb Splint - Wrist & Thumb Support for Sport & Pain Relief

£9.99 inc VAT

Adjustable, lightweight and removable wrist/thumb brace that can also be used as a protective cast. Protects the wrist and thumb following fractures and sprains while permitting full finger function.
More Details

PhysioRoom Wrist Brace with Thumb Splint - Wrist & Thumb Support for Sport & Pain Relief has a rating of 5.0 stars from 52 reviews (52 reviews)

Quantity

PhysioRoom Adjustable Wrist Support Wrap - Sports Support Brace for Wrist Pain and Injury Rehab

£2.69 inc VAT

The Elite adjustable wrist wrap provides firm, adjustable support and helps to relieve pain caused by an injury to the wrist as well as reducing the risk of a future injury.
More Details

PhysioRoom Adjustable Wrist Support Wrap - Sports Support Brace for Wrist Pain and Injury Rehab has a rating of 5.0 stars from 24 reviews (24 reviews)

Quantity

medi Wrist Support - Wrist Brace for Rehab - Wrist Immobilisation

£48.29 inc VAT


More Details

Delivered in 3 days

Quantity

Aircast A2 Wrist Brace - Adjustable Support for Wrist & Thumb Injuries - Wrist Pain Relief

£19.99 inc VAT SRP £22.00 Save £2.01 (9% OFF)

A lightweight and adaptable brace incorporating removable stabilisers designed to provide support for a range of wrist injuries.
More Details

Quantity

PhysioRoom Snug Wrist Support Grey - Adjustable Strap - Stabilising Wrist Brace for Sport & Injury Recovery

£14.20 inc VAT

The Snug wrist support with aluminium stay and gel pad is a lightweight support which helps to relieve wrist pain. The Snug wrist support ensures of total comfort by providing equal compression.
More Details

PhysioRoom Snug Wrist Support Grey - Adjustable Strap - Stabilising Wrist Brace for Sport & Injury Recovery has a rating of 5.0 stars from 1 reviews (1 review)

Quantity

Empi Direct TENS

£54.99 inc VAT

The Empi Direct TENS machine (transcutaneous electrical nerve stimulator) is a compact dual channel handheld device which utilises a range of nerve stimulation programmes to aid in the treatment and management of chronic and acute conditions.
More Details

Empi Direct TENS has a rating of 5.0 stars from 1 reviews (1 review)

Quantity

Aircast Hand & Wrist Cryo Cuff & Cooler - Reusable Injury Cuff - Reduce Wrist Pain, Swelling & Inflammation

£96.38 inc VAT

Ultimate hand & wrist ice therapy; provides 6 hours continuous cold and compression to minimise bleeding, swelling and pain.
More Details

Aircast Hand & Wrist Cryo Cuff & Cooler - Reusable Injury Cuff - Reduce Wrist Pain, Swelling & Inflammation has a rating of 5.0 stars from 1 reviews (1 review)

Quantity

Aircast Wrist Brace with Thumb Spica - Wrist Support, Thumb Support - Aircast A2

£23.59 inc VAT SRP £26.00 Save £2.41 (9% OFF)

It is a lightweight and adaptable brace for the wrist and thumb, which caters for a range of injuries through its customisable support.
More Details

Aircast Wrist Brace with Thumb Spica - Wrist Support, Thumb Support - Aircast A2 has a rating of 5.0 stars from 13 reviews (13 reviews)

Quantity