A scaphoid fracture involves a break of one of the bones on the thumb side of the wrist. The scaphoid bone plays a role in the ability to move the wrist joint. There are surgical and nonsurgical treatments for these fractures.
Scaphoid fractures can have a few causes, including falls. When a scaphoid fracture occurs, it interferes with a person’s ability to move their wrist joint. Prompt treatment can help prevent complications and promote correct healing.
The article below provides information on scaphoid fractures, symptoms, causes, and treatment options.
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A scaphoid fracture involves a break of the scaphoid bone in the hand. It is one of the most common fractures of the carpal bones, accounting for 60% of carpal breaks. It also accounts for 11% of hand fractures.
Healthcare professionals describe scaphoid fractures based on their location in the bone. The most common breaks are typically in the middle of the scaphoid bone, called the “waist.” Breaks can also occur at the proximal end (near the wrist) or the distal end (near the thumb).
The scaphoid bone helps move the wrist and also affects the stability of the wrist joint. When the bone becomes fractured, it affects a person’s ability to fully move their wrist.
Typical symptoms of a scaphoid fracture include:
A fracture can also occur due to trauma from a car accident or sports activity. Uncommon causes include a fracture due to a tumor.
Imaging tests confirm a diagnosis. Different options are available, such as:
- X-rays: An X-ray creates a picture of the bones. It can detect a fracture and shows whether pieces of the bone have moved and formed a gap around the fracture. This movement causes the bones to become misaligned, which doctors call a displaced fracture.
- MRI: An MRI creates a detailed 3D image of the bones. It might identify a fracture more clearly than an X-ray.
- CT: A CT combines data from multiple X-rays to build a 3D image. This can be useful when a doctor is looking for a fracture.
- Ultrasonography (USG): USG is also an option to create a clear picture of the scaphoid bone and detect a fracture. A 2018 study involving 114 people found that the accuracy of detecting a scaphoid fracture using USG was over 98%.
Treatment for a scaphoid fracture may depend on the severity of the break. There are both surgical and nonsurgical options.
Nonsurgical treatment for a scaphoid fracture may involve keeping the wrist immobile in a cast or splint.
If the fracture is nearer to the thumb, it should heal in a matter of weeks, as long as movement is restricted and the area protected.
However, healing may take longer if the fracture is closer to the forearm.
In some cases, a doctor may recommend surgery to treat a scaphoid fracture. For instance, if pieces of the bone cause a misalignment, a doctor may recommend surgery.
Surgery can realign the bones into the correct positions and promote more effective healing. In some cases, a surgeon will insert a metal implant to hold the scaphoid in place until the bone heals.
Individuals should talk with a doctor about whether they need surgery. Surgery may not always be the most appropriate option for a fracture.
A 2022 meta-analysis compared functional outcomes in people who had nonsurgical treatment versus surgery to treat a minimally displaced scaphoid fracture. The researchers found no difference in how well the wrist functioned after 12 months following surgical versus nonsurgical treatments.
Recovery time may vary depending on the severity of the fracture, a person’s age, and whether they smoke. Typically, a person may have to wear a splint for up to 6 months after a fracture. This is because scaphoid fractures often heal slowly.
A doctor may recommend certain exercises to promote the range of motion while a fracture heals. In addition, they may explain activities to avoid, such as contact sports, throwing with the injured hand, and activities with a high risk of falling.
In some cases, a scaphoid fracture can lead to complications, including the following:
- Failure to heal: A bone that does not heal is called a nonunion. It can develop if there is reduced blood supply to the scaphoid bone.
- Necrosis: Necrosis involves disrupted blood supply to the bone. The lack of blood affects the nutrients delivered to the bone, leading to cell death.
- Arthritis: If the scaphoid bone does not heal well, it increases the risk of arthritis developing later.
A scaphoid fracture is not always obvious, and pain may not become severe. Anyone that injures their hand or wrist and has pain should contact a doctor.
If someone has decreased range of motion in their wrist or hand and ongoing pain after breaking a fall with their hands, it is best to talk with a doctor.
Here are some answers to frequently asked questions about scaphoid fractures.
Is a scaphoid fracture serious?
A scaphoid fracture is not a life threatening injury. However, it can lead to complications that affect the mobility of the wrist.
Does a scaphoid fracture require a cast?
A person may need a cast for a scaphoid fracture, with or without surgery. In some cases, a splint is an option instead of a cast.
Does a scaphoid fracture hurt immediately?
Most people feel pain from a scaphoid fracture as soon as it occurs. However, the pain is mild in some cases.
A scaphoid fracture involves a break of one of the carpal bones in the hand. It occurs most often due to breaking a fall with an outstretched hand.
Treatment may include wearing a cast or surgery, depending on the severity of the fracture.