Scaphoid fractures are the most common fractures in the wrist and are mostly seen in young adults. Men are more likely to fracture this bone than women. Although the bone is small, it takes twice as much force to break the scaphoid bone than to break one of the bigger forearm bones. Because it takes a lot of force to break this bone most patients who have fractured their scaphoid have done so while playing football, basketball or riding a motorcycle or in an automobile accident. Typically the patient falls on the hand (fig. 1) and hyperextends the wrist joint.
Because the bone is inside the wrist joint (fig. 2) it is somewhat protected and the patient very frequently overlooks the fracture because it feels like a sprain. In many cases the only symptoms are a little swelling and a variable amount of pain. The swelling typically will go away in a few days.
Unlike the finger, hand and forearm bones, scaphoid fractures seldom show any obvious deformity of the wrist. In essence; it does not look broken. Because of this, it is fairly common for the diagnosis to be delayed for some time after the initial injury because the patient thinks it is just a common wrist sprain.
WHAT CAN BE DONE?
Non displaced fractures (THE BONE IS NOT OUT OF ALIGNMENT) which are diagnosed early have a good chance of healing. For a non displaced fracture the patient is placed in a cast for three months. However, in some cases (approximately 10% ) it can take longer than six months for the bone to heal.
Another approach is to stabilize the bone with a special screw. This is an out patient procedure where the surgeon inserts a small screw through the skin into the bone (Fig. 3) using a fluoroscope (type of x-ray machine). After the procedure is done the surgeon will place you in a splint and you will be able to go home the same day. Normally
Because the bone is inside the wrist joint (fig. 2) it is somewhat protected and the patient very frequently overlooks the fracture because it feels like a sprain. In many cases the only symptoms are a little swelling and a variable amount of pain. The swelling typically will go away in a few days.
Unlike the finger, hand and forearm bones, scaphoid fractures seldom show any obvious deformity of the wrist. In essence; it does not look broken. Because of this, it is fairly common for the diagnosis to be delayed for some time after the initial injury because the patient thinks it is just a common wrist sprain.
WHAT CAN BE DONE?
Non displaced fractures (THE BONE IS NOT OUT OF ALIGNMENT) which are diagnosed early have a good chance of healing. For a non displaced fracture the patient is placed in a cast for three months. However, in some cases (approximately 10% ) it can take longer than six months for the bone to heal.
Another approach is to stabilize the bone with a special screw. This is an out patient procedure where the surgeon inserts a small screw through the skin into the bone (Fig. 3) using a fluoroscope (type of x-
you will be allowed out the cast within three weeks to begin supervised flexibility exercises by a hand therapist. Complete use in sports is not allowed until motion and strength are restored and the x-ray shows that the bone has healed , this can take up to 12 weeks after the operation.
Fig. 1
Fig. 2
SCAPHOID FRACTURES