Stitches out at last, but one more day covered up until I can get hand wet again.
Looks a sorry sight, but rest assured it feels a lot worse than that 😉
There’s small but noticeable raised bump where the bones have re-positioned themselves. It may decrease in a size due to decreasing swelling, but I think this will be a “feature” of my wrist now.
From here, it’s a case of stretching and encouraging safe mobility ranges. I need to work on a lot of hand and wrist strengthening too. Back to low weight dumbbells!
I opted to have the screw removed from scaphoid as I was noticing acute pain in that specific area. I had the operation on the 27th March 2015, and unwisely, elected to have it out with local anesthetic, not general anesthetic. Being awake for this ideal was not optimal, but we were unfortunately pressed for time for a appointment and having general anesthetic would have made this impossible. It’s hard to unsee something like this and I cringe occasionally at flashbacks. As readers if this blog will know, my wrist’s flexion is poor. Yet to get access to the scaphoid my wrist needed serious flexion to obtain access. So, pumped up with a (surprisingly painful) load of local anesthetic, the doc made his first cut…. A serious amount of cutting followed and wrist manipulations that caused a lot of bone cracking, nerve twinges and me wandering what the hell I was doing awake for this. Locating the exact position of the screw required in-situ x-rays. Took some time, but it was found. An electric screwdriver was used to extract it and I felt the torque it had on the bone as it pressed against the others. Charming experience. Another 10 minutes and I was stitched up and released into the world outside the hospital. Was told it wouldn’t hurt too much afterwards. Well, that was a one-way joke. Loaded up on Endone only to feel nauseous and pathetic pain-targeting. I switched to Panadeine Forte (current) and am hoping pain subsides soon. Anticipate a follow up to this in 10 days time or so when the stitches are removed.
This update represent a 12 month follow-up from my previous appointment back in Jan 2014.
The good news is that my scaphoid is no worse than before, and possibly marginally improved if anything. A bit of lesser bad news was that the capitate bone had displaced itself and possibly was becoming arthritic at the point of contact with the scaphoid/lunate. But in the scheme of things, this is minor.
The more significant bad news is that the the distance between the carpal bones that I damaged and the radius has halved. In the CT Scan image you can see how close the scaphoid is to the radius. Actually, the screw is making contact with the radius. There are two interpretations of this:
- The cartilage at the wrist joint would have undergone trauma and some time would have been required for it to settle down. Now if it had settled down prior to the image captured 12 months ago then the halving of this distance should be taken as a negative. This means that the area is progressing towards arthritis; but how soon is anyone’s guess.
- However if the cartilage had not settled down prior to the image captured 12 months ago then the normal distance was not measured at the time. If so, this is more positive news. That is the measured distance today may be closer to normal and it is not accelerating to arthritis.
Only time will tell which is the case.
My hands extension/flexion is currently something like 30%/50%. If these measures decrease significantly to say 10% each, OR, pain increases dramatically at the joint then I will need a full wrist fusion.
So all up, a bit of mixed news.
I can manage up to a 3hr mtb ride and then it’s time for a rest for the rest of the day. My hand also feels way better in Summer than Winter. Might have to retire in Vietnam….
My solution is to enjoy each day and ride as often (and safely) as I can as if it’s my last chance.
This update comes one week shy of 8 months since the accident back in May 2013.
Today, I had an all important diagnosis of a CT scan of the scaphoid (taken only in the days prior). To my complete shock and happiness the hand surgeon concluded that my scaphoid had not only successfully joined at the fracture site, but there was no signs of avasuclar necrosis at the proximal pole. It has for all intents and purposes, healed. There does appear to be a slight change in density of the bone at the proximal pole, but this is something that he feels will improve anyway. This is an amazing result. I really couldn’t have expected this given an injury whereby my hand was effectively severed and the scaphoid physically displaced in two. This is a happy day, but I feel too numb to appreciate it. Sometimes we dodge a bullet, for me, it feels like such an occasion.
The CT scan also identified a satellite bone (1 cm) that has settled on the top of my wrist at the join. This is superficial and can be removed if it becomes an issue. Also, he noted come calcification of the bones that may cause me arthritis down the track, but this is a long way down the track and even that can be treated at the time should it occur.
As for my hand in general, I feel the last month has brought about a noticeable improvement in the overall feel. A lot of the numbness has subsided and soreness in my knuckles, while still present, has not been as sensitive/painful as prior. There still exits considerable resistance in my hands mobility at critical angles, but maybe the Summer heat is making it hurt less than normal.
I now have permission to mountain bike again, but need a different brace, one that is more strap-up type. For all I know, mountain biking may make my hand ache, I just have no idea and will test on some gentle trails at the outset. But at least now I feel I can live life as I want to.
I am down for another CT scan in 12 months to assess changes from now until then.