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Our eight-year-old son is admittedly overweight. When he fell playing soccer, he broke his wrist from the force of his body weight behind the fall. They say this type of fracture (scaphoid bone in the wrist) will take a long time to heal. Is that because of his size?

The scaphoid is the bone fractured most often in the wrist. It is kidney shaped with three distinct fracture patterns involving the middle of the bone called the waist and the two ends on either side called poles. The distal pole (thumb side) and the proximal pole (wrist side) make up the two other segments. The bone isn't really divided anatomically into three parts -- it is just shaped in such a way that makes it easy to categorize fractures based on their location in any of these three locations. Some of the factors that affect healing of this bone include displacement (separation) of the fracture, location (waist or proximal pole fractures take longer to heal), longer time between injury and treatment, and the presence of osteonecrosis (bone death). Healing times vary from six to 15 weeks, depending on these factors. Scaphoid wrist fractures in children can be a complex problem. The open physes (growth plates), presence of scaphoid cartilage that hasn't turned to bone yet, and poor blood supply to this area can make treatment challenging. Late-presenting (chronic) fractures have the worst record for healing and recovery. Body-mass index (BMI or size) may make a difference but the specific effects of size on the recovery time from scaphoid wrist fractures has not been reported.

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