What Is a Scaphoid Fracture?

If you’re suffering from lingering pain following a wrist injury, you may have something known as a scaphoid fracture. What is a scaphoid fracture? This is a very particular injury that impacts a small bone in your wrist. Though only a tiny part of the body is impacted by the injury, it can cause a great deal of pain. Your hands and wrists are extremely important for everything from typing and writing to driving and dishwashing. Don’t let a scaphoid fracture go untreated. Find out how to diagnose and treat this type of injury promptly.

What Is a Scaphoid Fracture?

A scaphoid fracture is a break in the scaphoid in one or more places. The scaphoid is one of eight small carpal bones that make up the wrist. Also known as the carpal navicular, this bone is positioned on the radial side of the proximal row. This means that the scaphoid sits just past the radius bone of the forearm on the thumb side of the hand. The scaphoid has a long, curved shape and helps link the two rows of wrist bones. Thus, it plays a critical role in facilitating motion within the wrist.

Scaphoid fractures usually occur when you fall and land on your outstretched hand. This type of fracture is also common in car accidents and sports injuries. Scaphoid fractures are most common in teenagers and young adults under the age of 30.

Symptoms of a Scaphoid Fracture

If you’ve fallen on your hand or wrist and experience resulting pain that doesn’t resolve within 24 hours, you may have a scaphoid fracture. Prompt diagnosis makes it easier to properly treat a scaphoid fracture, so you should see a doctor if you have any of the following symptoms for more than a day or so:

• Pain in the wrist and/or thumb, particularly when pinching.
• Difficulty gripping or lifting without pain.
• Swelling.
• Bruising.
• Loss of motion in the hand and/or wrist.
• Tenderness directly over the scaphoid bone.

Diagnosing a Scaphoid Fracture

It’s easy to answer the question of ‘what is a scaphoid fracture’ in the theoretical sense, but it’s much harder to identify this injury in person. Your doctor will look for swelling, bruising, and tenderness around the scaphoid bone as an initial indicator of a fracture in this area.

The scaphoid is such a small bone that a fracture won’t always show up on an X-ray. Pain can be mild for some individuals as well, which means that many scaphoid fractures go undiagnosed. Diligent physicians who pursue the case further may be able to spot a scaphoid fracture with an MRI or CT scan.

If a non-displaced scaphoid fracture is treated within two weeks of the injury, there’s an 88% to 95% chance of a full recovery. The longer you wait, the more complex treatment and recovery will become. If a scaphoid fracture goes untreated, it can result in nonunion where the wrist bones are improperly aligned. Over time, this can contribute to a degenerative arthritis pattern known as scaphoid nonunion advanced collapse (SNAC).

Non-Surgical Treatment for a Scaphoid Fracture

Distal pole scaphoid fractures that occur closer to the thumb will usually heal without surgery. Your doctor will probably recommend immobilization for this injury using a cast or splint. To properly stabilize the joint, it should be immobilized from the forearm to the base of the fingers. You will need to restrict your activity for some time to allow the fracture to properly heal.

Scaphoid waist fractures located in the middle of the bone may heal without surgery, but they require careful examination as they might require a surgical intervention. A non-displaced fracture where the bone fragments still align properly will heal more easily without surgery. Your doctor may choose to immobilize the joint with a cast for a non-displaced fracture. The cast is usually larger for a scaphoid waist fracture and may begin above the elbow and incorporate the thumb.

Surgery for a Scaphoid Fracture

A displaced fracture in which the bone fragments have shifted out of place is more likely to need a surgical intervention. Proximal pole scaphoid fractures that are closer to the wrist typically require surgery as well.

Surgery for a scaphoid fracture begins with a process known as reduction where the surgeon repositions the fragments of the bone so they align properly. This is often done through a small incision using small tools to manipulate the bones. Once the pieces of the scaphoid bone are in proper alignment, your surgeon inserts screws, wires, and plates to hold the bones in place while they heal. This is called internal fixation. Your surgeon may use a bone graft in place of or along with internal fixation.

Recovery Time From a Scaphoid Fracture

In most parts of the body, blood runs from the area closest to the heart to the area furthest from the heart. However, the scaphoid is a unique exception. In this bone, blood runs from the part of the bone that’s closest to the hand inward toward the side of the bone that’s nearer the forearm. For this reason, distal pole fractures heal more quickly than proximal pole fractures.

Recovery time varies by patient. A non-displaced scaphoid fracture can heal in six to eight weeks. Fractures that are displaced or located in the waist or proximal pole are more likely to take three to six months to heal. You should resume physical activities gradually after your fracture has healed. Always follow your doctor’s recommendations regarding rehabilitation exercises and limitations on your physical activity.

Professional Care for a Scaphoid Fracture

If you suspect that you might be suffering from a scaphoid fracture, you should seek medical treatment as soon as possible. Our specialists at The Hand and Wrist Institute can help. We’re experts in injuries to this part of the body and can provide an expert diagnosis and treatment plan. Don’t wait with a painful wrist injury. Request an appointment online now or contact us to learn more about our practice.

Dr. John Knight

Dr. Knight is a renowned hand, wrist and upper extremity surgeon with over 25 years of experience. Dr. Knight is a Board Certified Orthopedic Surgeon and Fellowship trained. Dr Knight has appeared on CNN, The Doctors TV, Good Morning America, The Wall Street Journal, The Washington Post, Forbes, The Huffington Post, Entrepreneur, Oxygen network and more.