Diagnosis Explanation:

A scaphoid fracture is a break in the scaphoid bone, one of the small bones in the wrist. This fracture commonly occurs due to a fall onto an outstretched hand (FOOSH) and can be difficult to detect on initial X-rays. Due to poor blood supply, scaphoid fractures have a higher risk of nonunion or avascular necrosis (bone death) if not treated properly.

Symptoms:

• Pain and tenderness in the anatomical snuffbox (the small dip at the base of the thumb).
• Swelling and bruising around the wrist.
• Pain with gripping or pinching.
• Limited wrist motion, especially bending the wrist backward.

Specific Work Modifications:

• If your job involves typing or writing: Use an ergonomic keyboard and wrist brace, and take frequent breaks.
• If your job requires manual labor: Avoid lifting, pushing, pulling, or using vibrating tools.
• If your job is desk-based: Keep the wrist neutral, use a soft wrist rest, and avoid leaning on the injured wrist.
• Avoid: Repetitive wrist use, weight-bearing activities, and forceful gripping.

Specific Activity Modifications:

• If you play sports: Avoid contact sports, racket sports, weightlifting, and activities that strain the wrist.
• If you do yoga or Pilates: Modify wrist-bearing poses (e.g., plank, downward dog) to reduce joint stress.
• If you play an instrument, knit, or garden: Use larger-handled tools and modify grip positions.
• Avoid: Impact activities, excessive wrist bending, and repetitive gripping motions.

Recommended Supplements:

• Calcium & Vitamin D – 1000mg/800 IU daily for bone healing.
• Collagen Peptides – 10g daily to support bone and soft tissue repair.
• Magnesium – 300-400mg daily for bone strength and muscle relaxation.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support bone healing.
• Eat Bone-Strengthening Foods (leafy greens, dairy, nuts, seeds) to aid fracture repair.
• Consume Anti-Inflammatory Foods (berries, turmeric, green tea) to reduce swelling.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to support bone regeneration.

Home Exercise Prescription (Rehabilitation for Scaphoid Fracture)

Early Phase (0-6 Weeks, Immobilization & Healing):

• Wrist Splint or Cast – Wear a thumb spica cast or splint for 6-12 weeks as directed by your doctor.
• Finger Flexion & Extension – Move fingers gently to prevent stiffness, 10 reps, 2x/day.
• Shoulder & Elbow Movements – Maintain mobility in the upper arm, 10 reps, 2x/day.

Strengthening Phase (6-12 Weeks, Restoring Mobility & Function):

• Wrist Flexor Stretch – Extend the arm, pull fingers back gently, hold 20 seconds, 3x/day.
• Wrist Extensor Stretch – Extend arm, pull fingers downward, hold 20 seconds, 3x/day.
• Light Resistance Wrist Curls – Hold a small weight, curl wrist up and down, 10 reps, 2x/day.

Advanced Phase (12+ Weeks, Preventing Recurrence & Maintaining Function):

• Grip Strengthening (Soft Ball Squeeze) – Squeeze a soft ball 5 seconds, repeat 10 reps, 2x/day.
• Forearm Pronation/Supination (Light Resistance) – Rotate forearm palm-up and palm-down, 10 reps, 2x/day.
• Wrist Circles – Slowly rotate wrists in both directions, 10 reps, 2x/day.

Helpful Books:

1. The Healthy Wrist Handbook: Exercises & Treatments for Wrist Pain & Injury – Dr. Ross Clifford.
2. Overcoming Wrist & Hand Pain: A Self-Help Guide – Susan J. Barnhart, PT.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.