I’ve heard that smoking makes it harder to heal from certain types of surgery, such as spine surgery. Does smoking also affect wrist surgery?

Smoking seems to slow down healing from bone fusion surgeries. In some cases, it may even prevent the bones from growing together. Researchers think that nicotine restricts the blood supply that bones need in order to heal. Even though the wrist has a better blood supply than the spine, it isn’t free from this negative effect.
In a study of patients who had ulnar osteotomy–a procedure to shorten the ulna bone near the inside edge of the wrist–smokers took almost twice as long to heal as nonsmokers (seven versus four months). Smoking also decreased the chances that the surgery would take. Compared to nonsmokers, smokers more often had long delays in healing. Their surgeries were more often unsuccessful, meaning that their wrists showed no improvement after a year. 

Unfortunately, smoking affects many parts of the body. Even in the wrist where there’s a rich blood supply, smoking takes a toll.

I fractured the scaphoid bone near the base of my thumb and need to get back to work right away. My doctor says I can either have surgery or a cast. What’s my best bet?

A recent study showed that having surgery to implant a screw into the broken bone leads to faster healing than a cast. Patients who had surgery healed five weeks faster than those who had casts. They also returned to work seven weeks sooner. Both kinds of treatment produce good results, but if time is an issue, research suggests surgery may be the better option.

I broke a small bone in my wrist a few weeks ago. The doctor said it was the scaphoid bone near the base of my thumb. She gave me a choice between having a cast or surgery, and I chose the cast. Now I’m hearing about the stiffness and muscular problems people have after their casts come off. Did I make the wrong choice?

You really can’t go wrong with a cast. Surgery may lead to speedier healing, but it isn’t for everyone. Casts are a tried-and-true way of treating a fracture of the scaphoid bone, and using a cast to heal this kind of injury rarely leads to complications. You can expect some stiffness after your cast is removed, but chances are it won’t last long.

Research suggests that, whether you choose a cast or surgery, you’ll have about the same wrist health after two years. A recent study showed that people who only wore casts had about the same grip strength and wrist movement two years afterward as those who had surgery. And patients in both groups were equally satisfied with their treatment. So you can put your worries to rest and let your body heal!

I fractured the scaphoid bone near the base of my thumb, and the doctor wants to put a cast on it. Meanwhile, I’m having flashbacks to the cast I seemed to have worn forever in the second grade. Is there anything faster than this prehistoric treatment?

Casts–those old dinosaurs–are still around because they’re safe and they work. However, newer treatments are equally effective and may not keep you tied up as long. You may want to ask your doctor about surgery to implant a screw into the broken bone. This procedure fixes the wrist from the inside, just as a cast fixes it from the outside. Research shows that people who have this procedure heal about five weeks faster than those who have casts. Surgery isn’t for everyone, and this decision will need to be made jointly with your doctor.