If you are over 65 years old and you break your wrist in Great Falls, Montana, will you get the same treatment as if you are over 65 and the injury occurs in California or Florida or Colorado? Researchers from Dartmouth Medical Center noticed that there aren't a lot of studies on the optimal treatment for distal radial fractures. So, they used Medicare records to answer a few questions about the current state of affairs.

Right now, most doctors prefer to fix an acute scaphoid fracture (fracture of the small bone on the thumb side of the wrist, where the wrist bends) with surgery if the break moves the bones, or displaces them. The chances of the bones not joining or not fusing properly are higher, so surgery's role is fairly obvious.

The scaphoid bone, the small wrist bone at the base of the thumb, is easily broken, particularly if someone falls on an outstretched hand. Treatment of such a fracture is debatable among some surgeons as some prefer to do casting, while others prefer surgery for optimal healing. For casting, it's estimated that 90 percent to 95 percent of scaphoid waist fracture are healed by cast in about three months.

The bone at the base of the thumb, by the wrist, is called the scaphoid bone. It's a small bone that can be broken if you fall onto your outstretched hand. The treatment for the break depends on how severe the break is and if the bone was moved out of place. Usually, if the bone has moved and the broken ends don't meet each other, surgery is needed. If the bones aren't moved, doctors are torn as to which method is best.

Ruby Gerwal, MD, and Graham J.W. King, MD.

It sounds like your children broke the scaphoid bone, which is the bone at the base of the thumb side on the thumb's of the wrist. It's not very big and can be easily broken given the right conditions.

I had a bad bone taken out of the left side of my right wrist. They put on a partial wrist fusion. It has been a nightmare. No movement and tons of pain. It's been four months. Is is possble to just take off the hardware - see what happens?

Hi
My problem started four and a half years ago when I tore my right rotart cuff.
This was fixed two years ago, while I was trying to work I used my left alot, and that brought wrist pane.
I thought it was a ganglion. But nope.
In Jan. they did a MRI and in six weeks I was at the orthopods office and he told me a bone in my wrist was not getting the proper blood supply, he also it was rare for this to happen on its own.

Immobilizing a broken bone in a cast is needed to keep the bone fragments from moving around while the body tries to heal itself. But when union of the bone fragments doesn't happen, then it's time to look at what's causing this delay in bone healing.

Most of the studies of scaphoid wrist fractures that don't heal have been done on small numbers of patients. But there has been one study from the Department of Orthopaedics and Sports Medicine at the University of Washington in Seattle that included 30 patients. All had scaphoid fractures that didn't heal with immobilization.

Surgery is often done to remove the cysts, but that doesn't always guarantee that they won't come back. Also, some people avoid surgery because they'd rather not have the scarring that they fear may result. Because of this, some doctors will try nonsurgical methods first. This usually involves splinting the joint to reduce movement and limit the irritation to the cyst. It's hoped that this will reduce the inflammation and the cyst will go away.