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I am a piano major at the University and just found out I have a scaphoid wrist fracture. I'm looking everything up I can find about this problem before seeing the surgeon tomorrow. Can I avoid surgery? I have concerts, recitals, and outside music gigs I can't afford to miss.

Treatment for scaphoid bone wrist fractures varies from patient to patient and surgeon to surgeon. Sometimes all that's needed is a short arm cast. You won't have any wrist motion but you may be able to use your fingers.

In other cases, a long arm cast (includes the elbow) is needed. With either the short arm or the long arm cast, your thumb may have to be included. This is called a thumb spica cast. The scaphoid bone is close to the thumb so immobilizing the thumb joint may help stabilize the scaphoid.

If surgery is needed, there are many additional choices. The surgeon may have to use an open incision to repair damaged ligaments and bone. Cast immobilization is almost always needed after this type of operation.

Your best bet is to ask the surgeon about percutaneous fixation without immobilization. Percutaneous means through the skin. Fixation is with a headless screw. So the screw is inserted through the skin and inserted into the broken bone. A special X-ray imaging called fluoroscopy is used to do this.

With percutaneous fixation, no cast or other immobilization is used. The patient is free (and encouraged) to move the wrist and fingers right away. Early mobilization gives patients a faster recovery and shorter rehab time. Strength returns faster and the bones are protected from loss of bone mineral density from disuse.

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