A scaphoid fracture is a break in the scaphoid bone, located below the thumb in the wrist. This injury often results from falling onto an outstretched hand, causing pain and swelling on the thumb side of the wrist.

Scaphoid Fracture

Causes and Types

Scaphoid fractures usually occur from falls onto an outstretched hand. They are classified into:

  • Nondisplaced Fracture: The bone remains aligned, but may not be visible on initial X-rays. It may become evident as healing progresses.
  • Displaced Fracture: The bone fragments are out of alignment, requiring more complex treatment due to unpredictable healing.
Scaphoid Fracture

Symptoms

Signs of a scaphoid fracture include:

  • Pain on the thumb side of the wrist
  • Swelling and bruising in the same area
  • Difficulty gripping objects

These fractures are sometimes mistaken for wrist sprains, so accurate diagnosis is essential.

Diagnosis

Diagnosing a scaphoid fracture can be challenging. Initial X-rays may not show abnormalities. It may take one to two weeks for an X-ray to reveal a nondisplaced fracture, and an MRI can help diagnose the injury sooner if needed.

Treatment

Scaphoid Fracture

Treatment aims to relieve pain, restore mobility, and prevent arthritis. Options include:

  • Cast Immobilization: For nondisplaced fractures, a cast extending over the thumb is often used to immobilize the wrist and thumb. Healing typically takes 10 to 12 weeks, with regular X-rays to monitor progress.
  • Surgery: Displaced fractures may require surgery to realign the bones, usually with a screw. Surgery can reduce the risk of nonunion and shorten immobilization time but carries risks like infection and tissue damage. Athletes and active individuals may choose surgery for faster recovery.

Recovery

After surgery, a cast is usually needed for up to six months. During recovery, avoid lifting heavy objects, high-impact sports, climbing, and heavy machinery. Smoking should be avoided as it can impede healing.

Complications

Potential complications include delayed or nonunion, particularly if the fracture is misdiagnosed or treatment is delayed. The scaphoid bone’s unique blood supply can complicate healing. Nonunion may lead to long-term pain, avascular necrosis (tissue death), and wrist arthritis.

Conclusion

Scaphoid fractures are common wrist injuries with treatment varying based on fracture type and individual factors. Nondisplaced fractures often heal with cast immobilization, while displaced fractures may require surgery. Treatment choices depend on the fracture’s specifics and the patient’s needs.