A scaphoid fracture refers to a break in one of the small bones in your wrist, known as the scaphoid bone. This bone is located in the anatomical snuffbox of the wrist, and although it’s small, it plays an important role in the movement and stability of your hand and wrist. While this injury is relatively common, particularly among athletes or those who engage in activities involving repetitive wrist motion, it can also happen in everyday situations, such as falling onto an outstretched hand.
In this blog, we’ll take a closer look at what a scaphoid fracture is, how it occurs, its symptoms, diagnosis, treatment options, and tips for recovery.
What is a Scaphoid Fracture?
The scaphoid is one of the eight small bones that make up the wrist. It sits between the radius (forearm bone) and the bones in your hand. This bone is particularly vulnerable because it’s located near the base of the thumb, and it is often affected by direct trauma to the wrist, like during a fall where your hand is outstretched.
A scaphoid fracture typically happens when you fall onto your outstretched hand (FOOSH injury), which can lead to the bone breaking. This fracture can vary in severity, from a small crack to a complete break. Because the scaphoid is positioned in a way that restricts blood flow to its bone tissue, fractures can sometimes take longer to heal and may require more care than fractures in other bones.
Symptoms of a Scaphoid Fracture
The symptoms of a scaphoid fracture can sometimes be subtle, especially in the early stages. While some people may experience immediate pain and swelling after the injury, others may not feel significant discomfort until days or even weeks later. Common symptoms include:
- Pain in the Wrist: This is usually localized around the base of the thumb or in the snuffbox area. The pain can worsen when you move your wrist or press on the area.
- Swelling: The wrist may become swollen, especially around the thumb side.
- Bruising: In some cases, bruising may appear near the injured area.
- Difficulty Moving the Wrist: It may be difficult to bend or rotate your wrist, particularly when gripping or lifting objects.
- Tenderness: If you press on the area around the scaphoid bone, it will likely feel tender to the touch.
How is a Scaphoid Fracture Diagnosed?
If you suspect you have a scaphoid fracture, it’s essential to see a healthcare provider as soon as possible for an accurate diagnosis. The process typically includes:
- Physical Examination: A doctor will examine your wrist, checking for tenderness, swelling, and signs of limited movement.
- X-rays: X-rays are commonly used to confirm the presence of a scaphoid fracture. However, in some cases, the fracture may not show up immediately on an X-ray, especially if it’s small or hasn’t caused significant displacement. If an X-ray doesn’t reveal the injury, further imaging such as an MRI or CT scan may be needed to confirm the fracture.
- Clinical Tests: Your doctor might perform specific tests, such as pressing on certain parts of your wrist to see if it reproduces the pain, helping them pinpoint the injury.
Treatment of a Scaphoid Fracture
The treatment for a scaphoid fracture depends on the type and location of the fracture. There are two main categories of treatment: non-surgical and surgical.
Non-Surgical Treatment
In many cases, a scaphoid fracture can be treated without surgery, especially if the fracture is stable and the bone is not displaced (misaligned). Here’s what non-surgical treatment typically involves:
- Immobilization: Wearing a cast or splint is usually the first step. The wrist will typically be immobilized for about 6 to 8 weeks, depending on the severity of the fracture. This helps the bone heal properly and prevents further injury.
- Regular Follow-ups: During the healing process, your doctor will want to check the bone regularly to make sure it’s healing correctly. This may include additional X-rays to ensure the bone is aligning properly.
- Pain Management: Your doctor may recommend over-the-counter pain relievers to manage discomfort. Elevating the wrist and applying ice can also help reduce swelling.
Surgical Treatment
In some cases, surgery is necessary, especially if the fracture is displaced or if non-surgical methods haven’t led to sufficient healing. Surgery may involve:
- Fixation with Screws or Pins: In this procedure, the fractured pieces of the scaphoid are realigned, and metal screws or pins are inserted to hold the bone in place as it heals.
- Bone Grafting: In more complicated cases, especially if the blood supply to the bone has been compromised, a bone graft might be needed to promote healing.
Surgical treatment may also be recommended if the scaphoid fracture leads to complications such as nonunion (when the bone doesn’t heal correctly) or avascular necrosis (when the bone tissue dies due to lack of blood flow).
Recovery and Rehabilitation
Whether you undergo non-surgical or surgical treatment, recovery from a scaphoid fracture can take time. Since the scaphoid bone has a limited blood supply, it can be slow to heal. Here’s what you can expect during the recovery process:
- Casting Period: If treated with a cast, the first 6 to 8 weeks will involve keeping your wrist immobilized. During this time, you’ll likely need to avoid using your hand and wrist for activities like lifting or sports.
- Physical Therapy: After the cast comes off, your doctor may recommend physical therapy to help restore movement, strength, and flexibility to your wrist. This is an important step to prevent stiffness and regain full functionality of the wrist.
- Follow-Up Visits: Your doctor will schedule follow-up appointments to monitor your recovery and ensure the fracture is healing properly. If you had surgery, additional X-rays or scans may be needed.
- Return to Activity: Depending on the severity of the fracture and the treatment method, full recovery can take several months. It’s essential to follow your doctor’s advice regarding when it’s safe to return to regular activities, particularly sports or heavy lifting.
Preventing Future Injuries
Once your scaphoid fracture has healed, it’s a good idea to take steps to prevent future injuries. You can do this by:
- Wearing Protective Gear: If you’re an athlete, using wrist guards or other protective equipment can help reduce the risk of future fractures.
- Strengthening Exercises: Regular wrist-strengthening exercises can help improve the stability and resilience of your wrist.
- Safe Falling Techniques: If you participate in activities with a higher risk of falling, such as skiing or cycling, learning safe falling techniques (like protecting your wrist) can help reduce the risk of injury.
Conclusion
A scaphoid fracture can be a painful and sometimes tricky injury, but with the right treatment and care, most people can recover fully and regain function in their wrist. Early diagnosis and appropriate treatment, whether surgical or non-surgical, are key to preventing long-term complications such as stiffness, arthritis, or permanent pain. If you suspect you have a scaphoid fracture, seek medical attention promptly to ensure the best possible outcome for your wrist health.
Schedule your appointment today at R3 Hospital for expert guidance!
