![]() ![]() ![]() If you put your thumb up in the air (like a hitchhiker) you will make a small depression at the base of your thumb. It is located in the thumb side of the wrist. The scaphoid is a small bone in the wrist on the thumb side. ![]() These bones are all connected by ligaments, making the wrist a very complex joint which is actually a collection of multiple joints. ![]() There are 8 carpal bones: the scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezoid, and trapezium. The wrist is a complex joint that is composed of the end of the radius (the big bone in the forearm, on the thumb side), the ulna (the small bone in the forearm, on the small finger side) as well as the carpal bones. When a scapholunate ligament tear occurs, the scaphoid bends forward (flexes) and the lunate bends backwards (extends) and a gap may form between the bones. Normally, the scaphoid and the lunate move together because the scapholunate ligament connects them tightly. The most important part of the ligament is on the back (dorsal side) of the wrist. The scapholunate ligament connects the scaphoid to the lunate. All rights reserved.Last Updated on Octoby The SportsMD EditorsĪlthough there are many ligaments and injuries in the wrist, a scapholunate ligament tear is the most commonly injured. The EAM can reliably return patients back to high demand activity earlier than a traditional protocol.Įarly range of motion Fracture du scaphoïde Mobilisation précoce Protocole de rééducation Rehabilitation protocol Scaphoid fracture.Ĭopyright © 2016 SFCM. The EAM protocol following scaphoid fracture ORIF is safe and effective. All patients were satisfied with surgery and all remained on active duty at 1 year. At a mean final follow-up of 15.4 months postoperatively, the average DASH score was 1.1☑.7 (Range: 0-4.5), Mayo wrist score was 97.5±4 (range 90-100), average number of push-ups was 57 (40-70) at the prior Army Physical Fitness Test. At 12 weeks postoperatively, the average DASH score was 8.8☑6 (range: 0-47.5), Mayo wrist score was 88☑0 (range: 75-100) and range of motion nearly symmetrical. All patients completed the EAM protocol and obtained CT all CT exams demonstrated healing at 8 weeks. Two patients used tobacco products and none had major health problems. All 8 patients were male, on active duty, with an average age of 26 years. At 1 year, a telephone survey was conducted and several data points were obtained including DASH and Mayo Wrist score, number of push-ups, satisfaction with surgery and ability to remain on active duty. At 12 weeks, Disabilities of the Arm Shoulder and Hand (DASH) score, Mayo Wrist score, and range of motion values were obtained. Eight consecutive patients having undergone ORIF of the scaphoid were enrolled in the EAM and followed for a minimum of 1 year. The purpose of this pilot investigation was two-fold: 1) describe a precise postoperative Early Active Motion (EAM) rehabilitation protocol following ORIF of scaphoid fractures and 2) record the outcomes of the EAM protocol. Scaphoid fractures are common injuries which traditionally have been treated with long periods of immobilization even after open reduction and internal fixation (ORIF). ![]()
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