Flexor Pollicis Longus "FPL" is a tendon that rests between two sesamoid bones and is covered by fibrous canal, annular ligament, which is responsible for trigger thumb mechanism. Insertion is at the palmer surface of the base of the distal phalanx of the thumb. It flexes the interphalangeal joint of the thumb; continued action, flexes the MP and CMC articulations. The thumb functions mostly independent of the digits, but in some people the tip of their thumb index finger function simultaneously.

FPL may have accessory proximal head, which can cause contracture of the thumb secondary to elbow injuries as accessory head attaches to the medial epicondyle of the humerus. The muscle belly may be involved in isolated anterior interosseous compression syndromes, in localized ischemic contracture, or in lacerations.http://www.rad.washington.edu/atlas/flexorpollongus.html

The "distal pole of scaphoid (they misspelled "scaphoid") near FPL" is located on the thumb side of the wrist, in the area where the wrist bends. Your surgeon is looking at the MRI of your wrist to check for fractures, irregularities in the tendons, or other problems: http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=253&topcategory=Hand

#1---"How necessary is surgery?"

The decision for surgery is between you and your hand surgeon. The hand is a delicate instrument yet it is extremely strong at the same time. You may have fallen and put all of your body weight on your wrist/thumb which injured your scaphoid bone which may be why you feel something in your thumb area. Or, worse case scenario, you may have Kienbock's disease which is osteonecrosis of the lunate bone in the wrist due to a loss of blood supply for whatever reason. This may be another reason your surgeon ordered an MRI to identify any signs of disease and to stage the disease because Kienbock's requires conservative casting unless it is in a later stage of the disease when surgery is necessary.

#2---"What is the recovery time?"

Approximately 10% of scaphoid fractures take more than 6 months in a cast to heal. A decision to operate and stabilize the bone with a special screw will usually cut healing time from 6 months in a cast without surgery to 3 weeks with surgery. The screw is like a substitute for wearing the cast and allows earlier rehabilitation of your wrist/thumb.However, usually patients aren't allowed to resume heavy activities until the bone has healed completely usually in about 12 weeks.

#3---"What would next step be if MRI doesn't show anything?"

If the MRI doesn't show anything, then the next step will be an EMG to find out if it is caused by a problem with the muscles in your wrist/thumb hand or forearm.