Scaphoid Fracture Waiver

[cnstoll]

Hello,

I'm new to the boards. My name is cnstoll and I have been in the process of applying to OCS for over a year now. I have some biographical information on my profile, but the most relevant is that I am a college senior in good health and fitness, but with a medical issue.

The story goes that in March of 2009 I was on the verge of submitting my packet to a board, having completed everything but my PRT, when I suffered a Scaphoid Fracture from riding my bike to school.

The fracture was diagnosed immediately and I had surgery to insert a screw to repair it. The cast came off in May and I began physical therapy to restore range of motion. That part of my rehabilitation has been a success. I have recovered full range of motion from the affected wrist (right) and in terms of strength it seems to be just fine.

The problem is that despite the favorable results, it appears that the fracture has not yet fully healed. After several months of more x-rays, there is still a slight black line where the fracture is located. Now, it has been heal-ing, as in there has been progress, but it is not yet completely healed. In August I received an ultrasonic bone stimulator which seems to have been helping the progress.

So I come here looking for advice, and what the possibilities are with regards to waivers. I know from my research and sources in the Navy that the orthopedic hardware itself, the screw in my case, is not disqualifying. What I don't know is what degree of healing do I need to receive a waiver for my problem. Do I just need a working wrist that allows me to do everything in my daily life? Or do I need a completely healed bone with no evidence of a fracture?

If there is anyone with experience in this sort of situation, I would be glad to hear from you. Otherwise, I would appreciate any general advice. Thanks for your time.

 

[beaverslayer]

I know from my research and sources in the Navy that the orthopedic hardware itself, the screw in my case, is not disqualifying. What I don't know is what degree of healing do I need to receive a waiver for my problem. Do I just need a working wrist that allows me to do everything in my daily life? Or do I need a completely healed bone with no evidence of a fracture?

You're right that the hardware itself is not disqualifying. I fractured my scaphoid as well, and had a screw put into it. They even took a chunk of bone from my hip to put in the middle in order to stimulate new growth. When I went to MEPS I had to get it checked out, but after the Doctor looked at it he cleared it pretty much immediately.

I'm honestly not sure whether or not you will need to let it heal completely before getting a waiver, but I'm going to guess that's what they'll say. With other processes (PRK for example) the healing process has to be complete, not just functional, before you can get it waivered. I just wanted to let you know that there is a light at the end of the tunnel, and this injury is possible to overcome. Keep doing everything you can to get a waiver!

On a side note, physical therapy after getting that cast off sucked balls huh?

 

[feddoc]

cnstoll,

In general terms, you should be ok as long as you are pain free and without symptoms. Given your situation with the incomplete heal, you may have to wait a bit longer. There will always be evidence of a fracture in someone your age.

Has your doc said anything about returning to normal activities?

 

[cnstoll]

You're right that the hardware itself is not disqualifying. I fractured my scaphoid as well, and had a screw put into it. They even took a chunk of bone from my hip to put in the middle in order to stimulate new growth. When I went to MEPS I had to get it checked out, but after the Doctor looked at it he cleared it pretty much immediately.

I'm honestly not sure whether or not you will need to let it heal completely before getting a waiver, but I'm going to guess that's what they'll say. With other processes (PRK for example) the healing process has to be complete, not just functional, before you can get it waivered. I just wanted to let you know that there is a light at the end of the tunnel, and this injury is possible to overcome. Keep doing everything you can to get a waiver!

On a side note, physical therapy after getting that cast off sucked balls huh?

Well that certainly is encouraging news. As an aside, my doctor has been considering a bone graft like yours if it doesn't heal on it's own soon. It's good to know that it was successful in your case.

Here's a question for you, what sort of materials did you need to get from your orthopedic surgeon to take to MEPS? And do you remember roughly how long it took for yours to heal?

Yeah man therapy was rough at first. It came out of the cast and I couldn't move it at all for a few weeks. The only thing I don't really feel comfortable with doing right now is a normal pushup with palms flat. On my knuckles it's pretty easy, but it's not completely comfortable putting my palm flat on the ground in that position. Was yours that way at first too?

In general terms, you should be ok as long as you are pain free and without symptoms. Given your situation with the incomplete heal, you may have to wait a bit longer. There will always be evidence of a fracture in someone your age.

Has your doc said anything about returning to normal activities?

The physical therapist said I should be able to return to normal activity, and the surgeon said he was leaning that way at first, until we realized it wasn't completely healed yet after a few months.

The feeling I'm getting from them is that the fracture is stable and that it's not in danger of being broken again unless there is another "incident", like falling badly like I did the first time. But at the same time, he wants me to avoid activity that loads it, in the hopes that it will help healing. The main thing he told me to avoid was weight lifting, which I had started doing again in June, but stopped again in October after meeting with him again.

 

[cnstoll]

I'm going to throw another wrench into the discussion.

Before my wrist, the only medical mark on my record was that I fractured my left arm when I was like 3. It fully healed, there's no orthopedic hardware, and there's nothing wrong with the arm.

Is this something that I should worry about compounding the issue with my wrist? I don't know if I have to get a waiver for that or not, but what my OR had said was that I should try and get some medical paperwork from the hospital about it. Since it's so old, I was not able to do that.

Basically I just wanted to know if I should worry about this or not.

 

[beaverslayer]

Here's a question for you, what sort of materials did you need to get from your orthopedic surgeon to take to MEPS? And do you remember roughly how long it took for yours to heal?

Yeah man therapy was rough at first. It came out of the cast and I couldn't move it at all for a few weeks. The only thing I don't really feel comfortable with doing right now is a normal pushup with palms flat. On my knuckles it's pretty easy, but it's not completely comfortable putting my palm flat on the ground in that position. Was yours that way at first too?

Well mine was kind of complicated because I broke it and had surgery done while I was on a study abroad trip to Northern Ireland. When I was submitting paperwork to MEPS I just called them and asked them to send everything relevant directly to MEPS, so I never actually saw the material. If you just ask your surgeon/orthopedic office to put everything together and explain the purpose, they will be able to figure out what is relevant and necessary.

How long has it been since your surgery? Mine was back to what yours sounds like after about 3 months--I could do just about everything except for pushups, same as you. Just keep stretching it out, and try to do a few pushups palm down whenever you go work out. Within another few months it should be good to go.

 

[cnstoll]

Well mine was kind of complicated because I broke it and had surgery done while I was on a study abroad trip to Northern Ireland. When I was submitting paperwork to MEPS I just called them and asked them to send everything relevant directly to MEPS, so I never actually saw the material. If you just ask your surgeon/orthopedic office to put everything together and explain the purpose, they will be able to figure out what is relevant and necessary.

How long has it been since your surgery? Mine was back to what yours sounds like after about 3 months--I could do just about everything except for pushups, same as you. Just keep stretching it out, and try to do a few pushups palm down whenever you go work out. Within another few months it should be good to go.

It's been about 8 months now, but it has felt about this good for the past 4 months.

 

[beaverslayer]

Well just keep stretching it as best you can. My physical therapist basically said that the more it hurt when I was stretching it, the more good I was doing and the faster it would heal. So as much as it sucks, keep doing it. It just takes a little time.

 

[cnstoll]

Well just keep stretching it as best you can. My physical therapist basically said that the more it hurt when I was stretching it, the more good I was doing and the faster it would heal. So as much as it sucks, keep doing it. It just takes a little time.

Fair enough, do you happen to know anyone who has used a bone stimulator?

 

[feddoc]

I'm going to throw another wrench into the discussion.

Before my wrist, the only medical mark on my record was that I fractured my left arm when I was like 3. It fully healed, there's no orthopedic hardware, and there's nothing wrong with the arm.

Is this something that I should worry about compounding the issue with my wrist? I don't know if I have to get a waiver for that or not, but what my OR had said was that I should try and get some medical paperwork from the hospital about it. Since it's so old, I was not able to do that.

Basically I just wanted to know if I should worry about this or not.

I would not worry about this break. The one that isn't healed....should result in you having to wait until it is healed.

 

[beaverslayer]

Fair enough, do you happen to know anyone who has used a bone stimulator?

Nope. I drank tons of milk, and took calcium supplements until my doctor told me I'd get kidney stones if I didn't stop. Then I just drank milk all the time and skipped the supplements.

 

[cnstoll]

Nope. I drank tons of milk, and took calcium supplements until my doctor told me I'd get kidney stones if I didn't stop. Then I just drank milk all the time and skipped the supplements.

Milk i've been drinking plenty of, but calcium supplements are a good idea.

 

[cnstoll]

Update

Ok so here's an update.

I'd like to begin by saying my wrist feels fine. I can do any everyday task with it without any discomfort.

The x-rays and a recent CT scan are a different story. It looks like it's still a non-union fracture, and that it may require a second surgery. This would either be to a) take out the screw and see if it heals better on it's own, or b) leave the screw in and do a bone graft.

What I want to know is how this would be likely to affect my app. I know it will probably delay me at least 6 months, maybe even another year, but if I get this thing healed should it be any kind of problem with getting selected?

Thanks.

 

[beaverslayer]

Dude... that sucks. Sorry about that.

From what the doc at MEPS told me, it sounds like what they care about most is functionality. Meaning, it doesn't especially matter how many surgeries you have to get to fix it, as long as it's fixed at the end of the road. So if getting another surgery will fix it, then do that. I don't recall seeing anything in the waiver guides that says getting multiple surgeries on a single bone will disqualify you. If you can show the doc that your wrist is fully healed, and fully functional, that is all that matters.

Keep in mind that this is only my knowledge from a limited personal experience, so YMMV. Good luck!

 

[cnstoll]

That's kind of my assumption as well. I'm wondering also if I'd even need a waiver if we end up taking the screw out.