What Is Scaphoid Fracture of the Wrist?
A scaphoid fracture is a break in one of the small bones of the wrist. This type of fracture occurs most often after a patient falls on an outstretched hand.
More Information About Scaphoid Fracture of the Wrist
Causes
A scaphoid fracture usually occurs when the outstretched hand takes the full weight of landing on your palm during a fall. The radius, or the end of the larger forearm bone, may break with this type of fall. A scaphoid fracture can also occur during sports activities or vehicle collisions.
Symptoms
Scaphoid fractures usually cause pain and swelling over the “anatomic snuffbox” and on the thumb side of the wrist. The pain may be severe when the patient moves the thumb or wrist or tries to pinch or grasp an object.
Unless the wrist is deformed, it may not be immediately apparent that a scaphoid bone is broken at all. With some scaphoid fractures, the pain is not severe and may be mistaken for a sprain.
Pain in the wrist that does not subside within a day of injury may be a sign of a fracture—so it is important to consult a doctor if pain persists. Prompt treatment of a scaphoid fracture will help to avoid potential complications.
When a scaphoid fracture occurs, the patient may experience pain and swelling in the thumb side of the wrist. The pain may be more severe when the thumb or wrist are moved or when trying to pinch or grasp an object.
Treatments
Treatment for a Scaphoid Fracture is dependent on several criteria:
- The location of the break in the bone.
- Whether the bone fragments are displaced.
- When the injury occurred.
Non-Surgical:
- Fracture near the forearm. If the scaphoid is broken at the waist or the middle of the bone or closer to the forearm (proximal pole), healing can be more difficult. These areas of the scaphoid do not have a good blood supply.
If the doctor treats this type of fracture with a cast, the cast may include the thumb and extend above the elbow to stabilize the fracture. - Bone stimulator. The doctor may use of a bone stimulator to assist the healing fracture. A bone stimulator delivers low-intensity, ultrasonic or pulsed electromagnetic waves that stimulate healing.
Surgical:
If your scaphoid is broken at the waist or proximal pole or if pieces of bone are displaced, the doctor may recommend surgery. The goal of surgery is to realign and stabilize the fracture, offering a better chance to heal.
Procedures for this condition include:
- Reduction: During this procedure, the doctor will manipulate the bone back into proper position. In some cases, this is done using a limited incision and special guided instruments. In some cases, it is performed through an open incision with direct manipulation of the fracture.
- Internal fixation: During this procedure, screws and/or wires are used to hold the scaphoid in place until the bone is fully healed. The location and size of the surgical incision is dependent on which portion of the scaphoid is broken.
- Bone Graft: In some cases, a bone graft may be required. A bone graft is new bone that is placed around the broken bone and stimulates bone production and healing. The graft may be taken from the forearm bone in the same arm or from the hip.
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