Scaphoid Fractures

The scaphoid is one of the small bones in the wrist (carpal bones), and the one that is most likely to break. The scaphoid is located on the thumb side of the wrist, in the area where the wrist bends.

Scaphoid fractures are the most commonly missed fractures and represent 60% to 70% of carpal fractures. They typically occur as a result of FOOSH.

Causes

The scaphoid is one of the small bones in the wrist (carpal bones), and the one that is most likely to break. The scaphoid is a kidney shaped bone and sits below the thumb. A scaphoid fracture often occurs when a individual falls on an outstretched arm. The scaphoid which is also known as the navicular is damaged.

Signs and Symptoms

• Tenderness with or without swelling in anatomic snuff-box (++++, 40% specific), or at scaphoid tubercle (++++, 57% specific).
• Other symptoms include swelling in the wrist, difficulty gripping objects, and tenderness or pain in the anatomical snuff box (a sunken space between tendons of the wrist)

Treatment

There are two general approaches for treatment of a scaphoid fracture. Often, orthopedists will initially treat the injury in a cast to see if the fracture heals in a timely manner. So long as the scaphoid fracture is not badly displaced (out of position), this is an excellent approach.

If the scaphoid fracture is displaced, the risk of nonunion is higher, and your doctor may recommend initial surgery to reposition the bones, and fix them into place. Or if the fracture does not heal with cast treatment (immobilization), surgery will be recommended. The surgery involves using either a screw or small pins to hold the bone together in the proper position. A bone graft may also be used to promote healing at the scaphoid fracture site. After surgery, a cast is used to immobilize the scaphoid bone and allow for healing.