What is a scaphoid fracture?
A scaphoid fracture is a break in scaphoid, a small bone in the wrist located near the base of the thumb. The scaphoid is the most commonly fractured carpal bone in the wrist. Fractures range from a small crack through the middle of the bone to a complete separation of the bone in two pieces, called a displaced fracture.
Many people mistake scaphoid fractures for mild wrist sprains and assume they will heal on their own. Left untreated, scaphoid fractures may not heal properly. In some cases, this can cause a serious condition known as avascular necrosis, in which there is no blood supply to the bone.
What causes a scaphoid fracture?
The most common cause is a fall onto the palm of an outstretched hand. Many scaphoid fractures occur during athletic activities or from trauma such as a car accident.
What are the symptoms?
Symptoms of a scaphoid fracture include pain or swelling in the wrist or at the base of the thumb. Pain may be mild or intensify with movement or gripping.
If the pain persists for more than a day, it's important to see a doctor to determine its cause. Untreated scaphoid fractures may not heal properly.
How are scaphoid fractures diagnosed?
In addition to a patient history and physical exam, your doctor may order an X-ray, CT scan or MRI to confirm the diagnosis.
What is the treatment?
Patients with scaphoid fractures in which the bone is not displaced usually wear a cast for six to 12 weeks. X-rays are taken weekly to check healing. Once the fracture has healed, the cast is removed.
If the fracture fails to heal in the cast, or the bone is displaced, surgery may be necessary. In this procedure, called an open reduction, the surgeon inserts a metal screw or wire into the scaphoid to hold it in place until the bone is fully healed. Occasionally, a bone graft is needed to aid healing. The graft is taken from the forearm or hip, placed between the broken scaphoid and secured with a metal pin or screw, allowing the bones to fuse.
Following surgery, most patients spend up to three months in a splint. Once the bones have healed, rehabilitation with a Certified Hand Therapist is recommended to strengthen and stabilize the muscles around the wrist joint, and improve hand dexterity.