Scaphoid Fractures: Causes, Diagnosis, and Treatment
A scaphoid fracture is a break in the scaphoid bone of the wrist, which is located between the forearm and hand. This bone spans both rows of carpal bones, making it more vulnerable to injury. The scaphoid bone is the most commonly fractured carpal bone due to its position and the forces it absorbs during certain types of wrist injuries.
How Do Scaphoid Fractures Occur?
Scaphoid fractures are most commonly caused by a fall onto an outstretched hand. While you may experience immediate pain, it often decreases after a few days or weeks. Bruising is rare, and swelling is minimal. Since there is usually no visible deformity, many people mistake the injury for a sprain and delay treatment. In some cases, individuals may not realize they have fractured the bone until months or even years later.
Diagnosis of Scaphoid Fractures
Scaphoid fractures are typically diagnosed through x-rays of the wrist. However, if the fracture is non-displaced, early x-rays may not show the break. This can lead to a misdiagnosis as a sprain. If you experience significant tenderness directly over the scaphoid bone (located on the thumb side of the wrist), this could indicate a fracture and should be treated with a splint.
If an initial x-ray doesn’t reveal the fracture, re-evaluation and additional imaging techniques may be necessary. Your doctor may recommend a CT scan, bone scan, or MRI if the condition is still suspected after initial treatments.
Treatment for Scaphoid Fractures
If the fracture is non-displaced, it can typically be treated with immobilization in a cast. The cast will usually cover the forearm, hand, thumb, and possibly the elbow during the first phase of healing. While some fractures heal in as little as six weeks, healing may be delayed, especially if blood supply to the bone is compromised. In such cases, a bone may even die due to the lack of circulation, particularly at the forearm side of the bone.
If surgery is required, the doctor may insert screws or pins and possibly use a bone graft to help stabilize and heal the fracture. This is often recommended even in non-displaced fractures to avoid prolonged casting and potential complications.
Complications from Scaphoid Fractures
- Non-union: If the fracture doesn’t heal properly, it can result in a non-union. This can lead to abnormal motion, bone misalignment, and eventually arthritis.
- Avascular Necrosis: Lack of blood supply can cause part of the bone to die, leading to collapse and, eventually, arthritis. Surgery may be needed to restore circulation.
- Post-Traumatic Arthritis: If arthritis develops due to a scaphoid fracture, surgery may be necessary to remove degenerated bone or fuse the wrist joint.
If you suspect you may have a scaphoid fracture or are experiencing persistent wrist pain, contact South Florida Hand and Orthopaedic Center today. Our expert physicians can provide a comprehensive evaluation and recommend the best treatment options for your condition.