Fellowship-Trained Expertise in Wrist and Hand Surgery
Scaphoid fracture fixation is one of the most precise procedures performed in orthopedic hand surgery. Because the scaphoid bone is small and has a limited blood supply, even a simple broken hand can lead to complications if not treated promptly and correctly. Dr. Thomas Neustein, a board-certified, fellowship-trained orthopedic hand and upper extremity surgeon, provides expert treatment for wrist fractures and reconstructive surgery at Specialty Orthopaedics in Duluth, Dawsonville, and Braselton.
Patients describe Dr. Neustein as a caring, very skilled surgeon with great personality and bedside manner. His amazing team of staff members ensures every patient has a comfortable, pleasant experience from diagnosis to recovery.
Understanding the Scaphoid Bone
The scaphoid bone sits on the thumb side of the wrist among the small carpal bones that connect the hand and forearm. Because of its unique shape and blood flow, it is the carpal bone most commonly fractured during sports injuries or falls. When broken, it often causes severe pain near the base of the thumb and limited motion in the affected joint.
When a scaphoid fracture is missed or untreated, bone healing can fail, resulting in arthritis or nerve damage to nearby structures such as the median nerve.
What Is a Scaphoid Fracture
A scaphoid fracture occurs when the scaphoid bone breaks—usually from falling on an outstretched hand. These wrist fractures are common in younger, active adults and athletes who brace themselves during a fall. The fracture may be incomplete, displaced, or result in small fragments that separate and delay bone healing.
Because symptoms mimic a sprain, many patients delay seeking orthopedic care, allowing the fractured bone to worsen. Dr. Neustein evaluates every case in great detail, reviewing your medical history and imaging to develop the most effective treatment plan.
Symptoms and Early Warning Signs
Common signs of scaphoid fractures include:
- Pain on the thumb side of the wrist
- Swelling and tenderness over the scaphoid bone
- Difficulty gripping objects with the dominant hand
- Limited range of motion in the wrist and fingers
- Persistent discomfort that does not improve after several weeks
If you experience these symptoms or severe pain after a wrist injury, contact a hand doctor for immediate evaluation. Even small scaphoid fractures can lead to permanent loss of function if not treated properly.
Diagnosing Scaphoid Fractures
Diagnosis involves a physical exam and imaging studies. During the exam, Dr. Neustein palpates the wrist bones and performs motion testing. X-rays confirm the fractured bone, while MRI or CT scans may be required for hidden fractures or nonunions.
By carefully reviewing the patient’s medical history and mechanism of injury, Dr. Neustein determines whether to treat scaphoid fractures conservatively or with surgical fixation.
Non-Surgical Treatment Options
Stable, non-displaced fractures can sometimes be treated in a thumb spica cast for several weeks. During this time, the wrist and thumb are immobilized to allow bone healing. Follow-up X-rays ensure proper alignment.
While casting can work for small, stable fractures, many patients prefer surgical repair for faster recovery and earlier return to work or sports. Prolonged casting may also cause stiffness in the fingers and wrist joints.
When Scaphoid Fracture Fixation Is Recommended
Surgery is recommended when the fracture is displaced, involves the proximal pole, or fails to heal after immobilization. Surgical fixation is also advised for patients with high activity demands, dominant hand injuries, or health issues that delay bone healing.
A fellowship-trained hand surgeon like Dr. Neustein performs scaphoid fixation at a specialized surgery center using advanced imaging and internal fixation techniques to achieve the best results.
Scaphoid Fracture Fixation Procedure
The procedure involves realigning the fractured bone and securing it with a compression screw or other fixation device. This internal fixation stabilizes the small bones of the wrist, promoting healing and restoring normal motion.
Under regional or general anesthesia, the surgeon makes a small incision, exposes the fracture, and uses live imaging to ensure precise placement. This careful alignment allows the fractured bone to heal in its natural position.
Surgical Technique and Approach
- The wrist is positioned for optimal exposure of the carpal bones.
- The fracture is identified, and the joint surface is cleaned of debris.
- A guide wire is placed across the fracture under X-ray guidance.
- A cannulated compression screw is inserted to hold the fragments securely.
- Bone grafting may be used in chronic or complex cases to encourage bone healing.
- The incision is closed, and a light dressing or splint is applied.
This approach ensures early motion, minimal scarring, and stable fixation that allows bone healing over several weeks.
Treating Complex or Chronic Scaphoid Fractures
For chronic nonunions or fractures with bone loss, reconstructive surgery may include bone grafting, sometimes using vascularized grafts to restore circulation. In rare cases, cartilage restoration or joint replacement may be necessary to preserve wrist motion in advanced arthritis.
Dr. Neustein uses both dorsal and volar approaches depending on fracture location, ensuring precise screw placement and strong fixation.
Post-Surgical Recovery and Rehabilitation
After surgery, the wrist is immobilized in a splint or cast for several weeks to protect the repair. Pain and swelling typically improve within days, and finger movement is encouraged early to prevent stiffness.
Once healing is confirmed, physical therapy begins to restore strength, range of motion, and function. Most patients regain full use of the wrist and hand within three months.
Physical Therapy After Surgery
Physical therapy focuses on stretching, wrist stabilization, and progressive strengthening. Patients learn safe ways to resume daily activities without risking re-injury. Therapy also helps improve circulation, reduce swelling, and restore comfort so the wrist and hand feel warm and flexible again.
Your therapist works closely with Dr. Neustein to guide each phase of the healing process.
Long-Term Healing Process
Bone healing time varies depending on age, bone quality, and health issues such as diabetes or smoking. With proper fixation, scaphoid fractures typically unite within six to twelve weeks. Follow-up imaging confirms union before unrestricted activity is allowed.
A well-healed scaphoid fracture leads to a stable, pain-free wrist with excellent range of motion and grip strength.
Potential Complications
While complications are rare, risks include infection, stiffness, or persistent nonunion. Some patients may develop temporary nerve irritation or carpal tunnel symptoms due to postoperative swelling affecting the median nerve.
Working with a very skilled surgeon and an experienced therapy team minimizes these risks and ensures top-notch outcomes.
Scaphoid Nonunion and Bone Grafting
If a fracture fails to heal, revision surgery with bone grafting is performed. Bone grafts fill gaps and stimulate healing by providing new cells and blood supply. Dr. Neustein’s reconstructive approach restores wrist alignment and prevents collapse of the carpal bones, protecting long-term joint health.
Preventing Long-Term Arthritis
Untreated fractures can lead to scaphoid nonunion advanced collapse (SNAC wrist), a form of degenerative arthritis affecting the wrist joint. Timely diagnosis and proper fixation prevent this outcome and preserve lifelong function in the hand and wrist.
Why Choose Dr. Thomas Neustein
Dr. Neustein is recognized among the best doctors in Georgia for complex wrist and hand surgery. His board certification, orthopaedic residency, and advanced fellowship training make him an expert in scaphoid fracture fixation. Patients appreciate his calm, compassionate communication style and clear explanations of treatment options.
As a hand doctor and caring surgeon, Dr. Neustein combines precision, empathy, and technical expertise. His patients often remark that they never feel rushed, and that the entire staff makes them feel valued and comfortable during every visit.
Patient Experience and Testimonials
Patients consistently describe Dr. Neustein and his office staff as courteous, professional, and efficient. Many highlight his great bedside manners, great personality, and dedication to patient care. The amazing team at Specialty Orthopaedics creates a warm, friendly environment that patients trust.
Every surgical experience—from pre-op preparation to postoperative visits—is handled with attention, compassion, and professionalism.
Returning to Work and Sports
Most patients return to light work within several weeks and to sports after three to four months, depending on bone healing and therapy progress. Those who use their dominant hand for manual labor may need extra time before resuming full activities. Early motion and therapy are essential for complete recovery.
Functional Outcomes
With accurate internal fixation and structured rehabilitation, patients regain full strength, motion, and pain-free function. Grip and wrist stability return to normal, allowing the hand to perform daily activities with confidence.
Schedule an Appointment for Wrist Fracture Evaluation
If you have sustained a wrist injury or broken hand and suspect a scaphoid fracture, early evaluation is critical. Dr. Thomas Neustein provides expert assessment and surgical repair to treat scaphoid fractures quickly and effectively. Trust the doctor who has helped countless patients across North Georgia recover from wrist injuries with exceptional results.
