Scaphoid Fractures

What is it?

The Scaphoid is one of the bones in the wrist. It is located at the base of the thumb.

Fractures occur typically after a fall. There is often tenderness and pain, which can radiate into the thumb or up the forearm. There is also often bruising, swelling and a reduction in the movements of the wrist and thumb.

What are the symptoms?

Scaphoid fractures can cause pain, swelling, stiffness, bruising and reduction in movements of the wrist and thumb.

Scaphoid fractures can be associated with other injuries, such as wrist fractures or dislocations. In isolated scaphoid fractures, it may occasionally be difficult to diagnose initially. X-rays will be taken by initially by the Emergency Department or your Orthopaedic Surgeon. If these do not show an obvious injury, it may be necessary to get further scans, such as CT or MRI, to confirm the diagnosis of Scaphoid Fracture.

what is the treatment?

If a scaphoid fracture is untreated, these can go on to non-union, meaning it doesn’t heal. In the short term, patients can still function quite well with a non-union. However, in the long-term, early arthritis always develops after 5-10 years, leading to weakness, stiffness and ongoing pain.

Treatment for scaphoid fractures depends on how badly it is broken. For breaks that are just a crack, like a crack in a vase, a plaster-cast is generally all that is required.

For breaks where the bone has moved apart, or if a patients wishes for quicker healing, an operation is required. The arm is numbed and a small incision is made over the scaphoid. Then a special headless compression screw is inserted to hold the fragments together to allow healing.

For old fractures that failed to heal or were missed at the initial injury, an operation with bone graft may be needed. This can be done through keyhole surgery. In difficult cases, an incision may be needed over the wrist to fix these fractures in an ‘open’ technique.

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