Why the pain from old fractures?

And what remedial action can be taken?

I’m interested to know because an old wrist fracture of mine (broken scaphoid five years back) has started to play up this year; feelings of inflexibility and v. mild pain in the joint. I’m curious to know why this would happen.

Following a spill on the mountain bike at the weekend, where I gave the wrist a good old bang on a rock, the v.mild pain has become more serious. Time to break out the calcium supplements?

Likely arthritis and/or tendonitis.

Different people respond to different treatments, from painkillers, anti-inflamatories or hold/cold therapy.

Probably worth a diagnosis from a doc, to steer the treatment. I’ve been there.

It’s because you’re getting old. There is no cure.

If the pain persists, I would have that wrist xrayed again. Scaphoid fractures have a high frequency of not healing due to poor blood supply. It’s possible your old fracture never fully healed and you have reinjured that hand with your recent fall.

Most bones, in most people, only fracture after experiencing a substantial amount of force. Such force is often sufficent to cause local damage to nerves or small blood vessels; damage which may be transient, permanent or very slow to heal. Bones also do not always heal in their “original” position (a broken collarbone can functionally heal but leave a very substantial bump), and this may place further stress on local structures. Bones which are placed under uncontrolled stresses (patient decides to take off the cast; bone bears a lot of weight and patient did not use or was not advised to use crutches, etc.) may also heal badly. Sometimes healing is poor even if everything is done correctly (poor nutrition, just because, etc.)

The scaphoid, as mentioned, is a special case. This bone is highly susceptible top damage and poor healing due to a tenuous blod supply. Even minor injuries to this bone (often missed) still require a cast for six weeks. Fractures may not show up on an initial X-ray; patients may require a great deal of persuasion to keep a cast on for six weeks when this is the case.

Also, I forgot to mention, IAAD… an ER MD in fact, and we see a lot of what we call FOOSH or Fall on Out-stretched Hand and the scaphoid is frequently broken in that mechanism.

On a more personal note, I fractured my scaphoid when I was in high school, but didn’t have it x-rayed until I went to college 9 months later (as part of my freshman physical). By then my scaphoid was ‘non-union’ meaning the two parts of the bone were no longer in contact and healing would not be possible without surgery. I decided to hold off surgery until the end of my freshman season and had to have a bone graft from my hip as well as a screw placed. I was in a cast for 5 MONTHS! and then in a splint for another month. I had the hand re-xrayed when I was working the radiology department as a medical student (4 years later) and the radiologist said the bone was still non-union, but the screw was holding it in place and keeping me relatively pain free.

YMMV of course.