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Scaphoid fracture

The typical mechanism of fracture of the scaphoid is the fall on a pose hand in hyperextension for wedging the scaphoid against the dorsal edge of the radius. There is always a surgical indication with plaster cast for 6/10 weeks application (not more than 3 months). The functional recovery is not possible without a personalized rehabilitation program.

The first goal of rehabilitation is the recovery of the physiological ROM (usually very small) through passive and active mobilizations in flexion, extension, pronation and supination of the wrist, interphalangeal joint mobilization of both the thumb of the adjacent fingers. In this phase, physical therapies (ice, laser, ultrasonic immersion) and massotherapy draining and upper limb relaxant are useful to control pain.

After reaching the full range of motion it is possible to progress to the second phase of rehabilitation that focuses on the recovery of the strength of epicondylus and epitrochlear muscles with exercises against manual resistance and weights and on the recovery of the trophism of the intrinsic muscles of the hand with rubber bands, balls of different consistencies, pliers and retinas.

The rehabilitation program ends with the last phase on the sports field with proprioceptive exercises for neuromotor recovery of hand function and others that bring the patient to perform sports specific gestures to launch exercises/gripping objects and push ups on unstable surfaces for prevention of falls.

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