A scaphoid fracture is a break in one of the small carpal bones of the wrist, called the scaphoid bone, located near the base of the thumb.

Common Symptoms

• Pain and swelling in the wrist and thumb area
• Bruising on the thumb side of the wrist
• Difficulty moving the wrist or thumb
• Pain when lifting objects

Cause & Anatomy

The primary cause is falling onto an outstretched hand, putting high pressure on the wrist. It can also occur from direct trauma to the wrist, such as in a car accident or during sports like skating, skiing, or gymnastics.

The scaphoid bone is one of eight small carpal bones in the wrist, located between the radius bone of the forearm and the base of the thumb. It has a unique peanut-like shape and plays a crucial role in wrist motion and stability.

Diagnosis

• Physical examination to check for pain, swelling, and limited range of motion
• X-rays to visualize the bone structure and identify fractures
• MRI or CT scans may be needed for clearer imaging

Prevention

Wearing wrist guards during activities with a high risk of falling, such as skating, snowboarding, or skateboarding, can help prevent scaphoid fractures.

Treatment

Nonsurgical:
Immobilizing the wrist in a cast or splint for 6 – 12 weeks for fractures that are not displaced.

Surgical:
For fractures near the forearm or middle of the scaphoid, surgery may be required to insert screws or wires to stabilize the bone, followed by casting for several weeks or months.

Surgery

The surgical procedure involves making a small incision in the wrist, inserting screws or wires to hold the scaphoid bone in place, and then applying a cast to immobilize the wrist during healing.

Rehabilitation

After cast removal, physical therapy is typically recommended to regain strength, flexibility, and range of motion in the wrist. Heavy lifting and high-risk activities should be avoided until full recovery.

FAQ’s

Is a scaphoid fracture serious?
While not life-threatening, it can lead to complications like nonunion (failure to heal) or arthritis if not treated properly. The scaphoid is notorious for not showing up on initial x-rays. It requires an early diagnosis to prevent serious long term problems in the wrist.

Does it require a cast?
Yes, either a cast or splint is typically used for immobilization during healing.

Does it hurt immediately?
Pain may be mild initially, but it usually worsens with movement of the wrist or thumb. It may feel better after a couple weeks and then fail to heal without treatment.