/ ARTICLE: What every Climber should know about their Scaphoid Bones

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UKC Articles 05 Aug 2019
A normal X ray of the right hand – palm up. The scaphoid is the cashew shaped bone on the right forming part of the wrist Medical experts and climbers Dr Jeremy Windsor and Mr Tim Halsey share a helpful guide for a commonly occurring yet not widely discussed injury: the dreaded scaphoid fracture...

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Pina 05 Aug 2019
In reply to UKC Articles:

Is it just me or do all the x-ray images look the same?

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snae 05 Aug 2019
In reply to UKC Articles:

A scaphiod fracture ended my climbing career about 8 years ago.  I was by no means prolific, but I was climbing indoors a couple of times a week and in the mountains at the weekend fairly often.  It was a mountain bike fall that did it for me.  I hit probably the last bit of ice of the winter on a flat forest road going hell for leather (having removed my spikes the weekend before...), bike went out from under me and I hit the ground really hard.  Got massive bruising on my left hip and a bit of a sore wrist - had to cycle about 20km back home after the fall but didn't think that much of it, other than knowing I'd had a hard fall.

Woke up the next day with swelling in the wrist and restricted movement so went to hospital.  X-ray showed a broken scaphoid and they told me it would need an operation to heal properly, where the two bits would be screwed back together.  This was all done, was in plaster for about 8 weeks or so and then had physio.

Its not been right since - basically couldn't put any weight on it or pull on it for months and getting my thumb into awkward positions was really uncomfortable, my left arm had wasted a bit too.  Climbing just really hurt and after a year or so of trying in the end I just kind of gave up.  For the first couple of years, loads of things could trigger pain - if I held a bag wrong, something got twisted round my thumb etc.  Day to day now , its not painful as such any more.  There is some nerve damage and a dull ache most of the time and only hurts when it gets tweaked or pulled on funny, but it does mean climbing is difficult.  I don't miss climbing so badly any more (I say commenting on a climbing website which I visit pretty often!) and have switched over full time to running, but just another story to add on the topic.

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SV 05 Aug 2019
In reply to Pina:

The first one looks completely different to me - no crack through the middle of the cashew / scaphoid, and a crack is clearly visible in the other two xrays.

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Pina 05 Aug 2019
In reply to SV:

I suspected I was missing something. Can see it now.

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richgac 05 Aug 2019
In reply to UKC Articles:

From my experience it is not just a fracture of the scaphoid bone that can lead to a grim outcome for the wrist but also damage to the connected ligaments - particularly the scapho-lunate ligament. If you have an injury but X-Ray does not reveal a break try to also get MRI for identifying soft tissue damage such as this. I had a historic injury in this ligament and through lack of diagnosis / treatment now have a SLAC (scapho-lunate advanced collapse) wrist with advanced and painful arthritis for the which the likely outcome is also full fusion.  The pain of ctrl-alt-delete is pathetically familiar to me, although satisfying climbing has so far still been possible with some heavy taping.

I wonder if either of the two patients in the article have climbed since their surgery? I would love to know, since it is probably my future. Please pm me if you are reading this, Steve or Neil. Thanks.

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Siderunner 05 Aug 2019

Great article - thank you Jeremy and Tim for so kindly sharing your professional knowledge with the climbing community.

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Alkis 07 Aug 2019
In reply to richgac:

That worries me more than a little. 10 years ago, I injured my wrist climbing. My GP suspected I snapped a ligament, I heard and felt a snap while undercutting something with the wrist flexed and lost feeling on the fingers fed by the ulnar nerve for a few days, but would not refer me onwards. It took a couple of years for it to feel strong again and it has not been completely right since. It has a ganglion that comes and goes and cannot flex all the way to 90 degrees without significant pain. I'm not sure how I could go on getting it seen properly at this stage.

Post edited at 20:40
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gobuybike 08 Aug 2019
In reply to UKC Articles:

Great article as always Jeremy & Tim. Was diagnosed with scaphoid # 2 1/2 years ago which turned out to be a scapho-lunate ligament in the end. Thanks again for advice given in the past and now back to a bit of light climbing again getting the strength back! 👍

Post edited at 18:40
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mooseloose 14 Aug 2019
In reply to UKC Articles:

Excellent article, clear and informative, many thanks.

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BruceM 15 Aug 2019
In reply to UKC Articles:

Thanks for the good info and advice. But how do you see all of the recommended experienced medics, and get the recommended tests?  Go to private sports medicine clinics --which must be expensive. Up here in Scotland it is difficult to even see a NHS GP within a few weeks wait for an appointment, let alone ask for exotic tests. I simply got a phone consultation when I damaged my ankle badly in a mountain bike crash and was worried about a fracture. 

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