Scaphoid Fracture: A Delayed Case Managed with Surgical Fixation

Introduction

Scaphoid fractures are among the most common wrist injuries, especially after falls. However, delayed diagnosis or treatment can lead to complications like non-union and long-term wrist dysfunction.

This case highlights the importance of timely diagnosis and appropriate surgical management.

Case Overview

Patient: 30-year-old male
History: Presented 2 months after a fall injury
Complaint: Persistent wrist pain and discomfort

Diagnosis

Radiological evaluation revealed:

Left Scaphoid Fracture
Likely delayed presentation increasing risk of complications

Treatment Approach

Due to delayed healing and fracture characteristics, surgical management was planned.

Procedure Performed:

Open Reduction and Internal Fixation (ORIF)
Fixation using Herbert screw
Cancellous bone graft harvested from the distal radius

(Procedure performed with informed consent)

Surgical Team & Guidance

This case was managed under the guidance and support of experienced seniors:

Dr. Kishor Khatri
Dr. Gopal Gnawali
Dr. Som Ale
Dr. Utsav Regmi
Dr. Ramesh Aryal

With active involvement of:

Dr. Prakash Timilsina
Dr. Utsav Regmi

Outcome

✅ Surgery was successful
✅ The patient is recovering well
✅ No immediate complications reported

Key Takeaways

Early diagnosis matters — delayed scaphoid fractures are harder to treat
Persistent wrist pain after a fall should never be ignored
ORIF with Herbert screw provides stable fixation
Bone grafting improves healing in delayed cases

Who Should Be Careful?

This condition is more common in:

Young active individuals
People with fall injuries (sports, accidents)
Patients ignoring wrist pain after trauma

Final Thoughts

A scaphoid fracture may look like a “small wrist injury,” but delay in treatment can turn it into a complex surgical case.

If pain persists after a fall—get it checked early. Your future wrist function depends on it.