Could You Have A
Scaphoid Fracture?

A scaphoid fracture is not the most common wrist fracture. If you’ve been diagnosed with this injury, you’ll want to understand your options. How is a fracture of the scaphoid different than other fractures? Learn what you can do to help minimize your wrist joint pain.






Wrist Anatomy

The wrist is comprised of the radius, ulna, and the first row of the carpal bones of the hand. The scaphoid bone is located on the thumb side of the wrist. Of the carpal bones of the hand, the scaphoid is the most like bone of the hand to become fractured.


wrist anatomy



Cause of Scaphoid Fractures

The most common way of fracturing the scaphoid is a fall on the wrist in an extended position. Other causes can include direct contact such as with a baseball hitting the wrist or even trauma from a punch.


Typical Symptoms

Fractures of the scaphoid are often difficult to detect partially because there is generally no visible deformity. Wrist joint pain, swelling, and bruising are common right at the base of the thumb. Functional activities such as gripping and twisting the wrist can reproduce pain.



The most common area of tenderness is in the region called the anatomical snuff box. This space is located just below the thumb, near the wrist. When the thumb is extended, two tendons become more visible. This snuff box is located between these two tendons. If applying pressure in this space reproduces pain, an injury to the scaphoid may have occurred.


anatomicala snuff box


Diagnosis

Determining if there is a fracture of the scaphoid is generally made via x-ray. One of the issues is that x-rays don’t always show the fracture. If the symptoms and mechanism of injury are consistent with a possible fracture, the wrist will generally be treated as a fracture even if the x-rays are negative. Follow up x-rays may be recommended in a couple of weeks and other tests such as an MRI or bone scan may also be recommended.

The scaphoid bone is unusual in that it has a very limited blood supply. A fracture to this bone can often damage this blood supply, resulting in the fracture being unable to heal. Because of this limited blood supply, early diagnosis of the injury is necessary in order to insure proper treatment.


Typical Treatment

In the case of a fracture, x-rays will be repeated in periodic intervals to monitor healing progress. Because of the limited blood supply, scaphoid fractures can take up to 12 weeks to heal. If healing is not occurring at a reasonable rate or if there is a displaced fracture, surgery will be required. Surgery involves pinning the bone to reconnect the ends of the fracture followed immobilization.

In some cases, even with surgery, healing of the bone does not occur. This situation is called avascular necrosis which simply means the bone tissue has died secondary to a lack of blood supply. In such cases, the use of a bone graft with its own vascular supply may be recommended.

For a simple fracture, immobilization of the injured region is recommended for the first four to six weeks. Either a cast or splint is used to minimize movement. If swelling is present a splint will be utilized over a cast. With use of an immobilizer, removing the brace periodically to use ice will help to reduce the swelling and minimize pain.

After healing of the fracture has occurred, physical therapy may be recommended to help restore range of motion and strength. Protection of the area using a wrist guard is recommended during high risk activities.

A scaphoid fracture can be a type of wrist fracture and requires immediate medical attention to help ensure the best possible outcome.




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