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Category: Wrist


“Mr Powell-Smith saw my scaphoid fracture one day after I broke it, and advised me with sheer professionalism. He was able to arrange an operation, which was done almost immediately, with little discomfort.

The whole process has been so fast and smooth, that I have been left with such a positive experience, from consultation to operation. Ed communicated well at each step of the process, and I’m so glad to have found his services should I ever need it again. A huge thanks to Mr Powell-Smith and his team.”


Dan Linfoot.

British Superbike Rider

Scaphoid Fractures

The Scaphoid is a small kidney bean shaped bone in the wrist that is vulnerable to injury, especially in high-energy situations as British Superbike rider Dan Linfoot discovered after a crash during round 6 of the championship at Brands Hatch. As the photos show he was lucky that the accident wasn’t more serious.




The Scaphoid although small has a number of extremely important functions within the wrist including preventing the wrist from buckling under pressure. It is also unique in that the bone is almost entirely covered with articular cartilage, this means that it is unable to heal in the same way that most broken bones would and so must be kept absolutely still so new bone formation can occur across the fracture site. This coupled with the fact that the Scaphoid has a very poor blood supply means that it can often take 10-12 weeks of immobilisation in a plaster to heal. If the bone fails to heal (a non-union) then due to the alteration in wrist biomechanics patients will often go on to develop a well recognised pattern of arthritis in the wrist know as a SNAC wrist (Scaphoid non-union advanced collapse). This is not something that happens immediately but over a period of years following the injury. This means that if cast immobilisation has been unsuccessful then an operation to add bone graft to the fracture site and stabilise it can be done to prevent a SNAC wrist in the future.


Treatment of an acute un-displaced fracture is either in a plaster to immobilise the wrist or the Scaphoid can be fixed using a special type of orthopaedic screw (a variable pitch headless compression screw). The screw is placed under x-ray guidance in the operating theatre through a very small incision of only 1-2 mm. The implant then compresses the fracture and provides the stability that the fracture needs to heal without the need for a plaster cast. This should in turn allow a faster return to normal activities, or in Dan’s case we are hoping to get him back on his bike for round 9 at Silverstone.

Congratulations to Harrogate’s St George’s Archery Club

A Huge congratulations to Harrogate’s St George’s Archery club who won the club team title at the National Clout Archery Championships 2 weeks ago. I would especially like to congratulate Carol Fairbrother who has come back from a serious injury to her wrist to reclaim her title as the British Lady Barebow Champion of the seventh time. Not only is this a fantastic achievement but the competition also took place in the middle of storm Brian making the conditions particularly tough.

I would like to wish you every success for next year.

How to manage a fractured wrist

With winter here and the icy weather setting in trips, slips and falls are all too common. Instinctively we put out our arms to break the fall meaning that your wrist will all to often bare the full brunt of the impact. Broken wrists are very common and account for up to a quarter of all fractures seen in adults.

If you are unfortunate enough to have injured your wrist then it is likely that you will have been to the Emergency Department and had your arm put into a plaster cast. The initial plaster is a back slab or half plaster, secured with a bandage to allow any swelling to settle whilst holding the break still for pain relief and to allow healing.

The most important thing to do at this point is keep your hand elevated, higher than the level of your heart, and gently work your fingers into a fist. This will help to settle the swelling and prevent against stiffness.

If your wrist is badly broken then it may require an operation to restore the normal alignment. The aim of surgery is to stabilize the broken fragments into their original anatomical position to give the best possible outcomes. This is especially important if the break involves the smooth joint surfaces that need to be accurately restored. After surgery elevation and finger movement is the critical thing for the first week. At that point the plaster cast is usually removed and a lightweight splint used in combination with early movement of your wrist.

It takes about 6 weeks for most broken bones to heal. If you have had surgery then the implant supports the healing bone on the inside in the same way as a cast does on the outside. This allows early movement but you still need to be careful until the bone has fully healed.

If you would like to find out more or have been unlucky enough to have had an injury and wish to discuss options for treatment if you then please call to book an appointment. 01423 226580