Scaphoid Screw Fixation: Your Journey from Preparation to Full Recovery
A week before surgery, medications such as blood thinners, aspirin and anti‑inflammatory drugs are usually stopped, and you should inform your care team about all prescriptions, vitamins and supplements. Avoid eating or drinking anything for at least 8 hours before your operation.
The night before surgery, wash your hand and wrist with soap, remove dirt, trim fingernails and avoid lotions. Wear loose clothing because a bulky dressing or splint will be applied after surgery, and follow fasting instructions—do not eat or drink after midnight.
On the morning of surgery, arrive at the hospital at the instructed time with your medication list. Do not eat or drink anything; remove jewelry and nail polish. You will receive postoperative instructions and pain‑control prescriptions at the hospital.
Expect a bulky dressing and splint for 10–14 days. Keep the splint clean, dry and intact and avoid immersion of the operative arm. Elevate the arm and apply ice 20–30 minutes every 2 hours to reduce swelling. You are non‑weight bearing in the splint; begin shoulder pendulum and active elbow/wrist motions within the first day unless instructed otherwise, but formal therapy usually starts around six weeks.
Do not lift or bear any weight with the operative hand until your first post‑operative appointment (about two weeks). Once the cast is removed at your second appointment (around four weeks), you may bear light weight up to two pounds. Heavier lifting and full weight‑bearing are delayed until radiographic healing is confirmed, often 8–12 weeks after surgery due to the scaphoid’s limited blood supply.
During the first week, keep the postoperative splint on at all times; you may remove it briefly for bathing and to perform gentle wrist and hand exercises. Start exercises by soaking the hand/wrist in warm water then performing range‑of‑motion movements two to three times per day, but avoid firm gripping, weight bearing or lifting heavy objects. Support your forearm on pillows when resting and avoid prolonged sitting or long travel.
Follow‑up visits are usually scheduled four weeks after surgery to remove sutures and the splint and to apply a cast【340482589643600†L81-L89】, and again about eight weeks after surgery to remove the cast and obtain x‑rays. Additional appointments may be arranged at 12 weeks or later to monitor healing and start occupational therapy. Call your provider if you develop fever, chills, excessive redness, swelling or pain.
Once the cast is removed (around eight weeks) and the fracture shows signs of healing, gentle active range‑of‑motion and light activities can begin; occupational therapy typically starts about four weeks after surgery. A thumb spica orthosis or wrist orthosis may be worn while increasing motion, and strengthening exercises usually begin three to four weeks after initiating ROM.
Because the scaphoid heals slowly, complete recovery and return to unrestricted activities often take three to six months. Cast immobilization may last up to 16 weeks depending on fracture stability and healing. Full weight‑bearing and heavy activities are only allowed once the fracture shows clinical and radiographic union.