Scaphoid Fracture

Scaphoid boneThe scaphoid is one of the small group of bones in the wrist called the carpal bones. It is the most common carpal bone to fracture among athletes and is often caused by falling onto an outstretched hand.

Scaphoid fracture symptoms

Symptoms of a scaphoid fracture include pain in the wrist at the time of injury and rapid swelling at the back of the wrist. Pain may settle down soon after the fall but the patient will have difficulty gripping things. There will be tenderness when pressing in on the wrist compared with the non injured wrist.

Scaphoid fracture treatment

The exact area of tenderness is called the anatomical snuff box and is located between two tendons on the thumb side of the wrist. Compression of the thumb inwards towards the wrist causes pain. Initially treatment of a scaphoid bone fracture would be to apply ice or cold therapy, protect the wrist with bandaging or strapping and seek medical attention.

What can a Doctor do?

A doctor will X-ray the wrist to confirm diagnosis of a scaphoid bone fracture. However, the injury may not always show up on an X-ray. If the doctor suspects a fracture but the X-ray is normal then it cannot be ruled out. In this case an MRI or bone scan will reveal the fracture.

Plaster cast for the wristThe wrist will be Immobilized for 8 weeks in a plaster cast extending from just below the elbow, over the wrist and base of the thumb. A scaphoid fracture cast of this size is needed to properly immobilize the wrist and allow the bone to heal. After 8 weeks the scaphoid fracture is re-assessed and rehabilitation exercises can begin along with a gradual return to sport. It is important to fully strengthen the wrist following so many weeks in a cast as the muscles will waste away.

Scaphoid fracture surgery

Scaphoid fractures have a risk of not healing properly due to the poor blood supply. If this happens then in some cases the fracture is immobilized again for a further 4 to 6 weeks. Immobilizing beyond this time is unlikely to be beneficial so in this case surgery is often required and many surgeons would do this sooner rather than opting for a further period of immobilization. See scaphoid fracture surgery for an interview with a wrist and hand surgeon.