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Scaphoid Fracture
Description
The scaphoid is a small, 'bean shaped' bone in the thumb side of the wrist. It is frequently broken, and is often a serious problem.
Common Causes
Usually a fall on the outstretched arm.
Symptoms
Pain in the wrist, usually at the base of the thumb ('snuff-box'). Pain is worsened with gripping or squeezing.
Physical Findings
Tenderness directly over the broken scaphoid. There is often swelling in the wrist, and pain with range of motion.
Workup
X-rays will usually show a fracture, especially if the pieces of the bone have moved (displaced fracture). Rarely, additional imaging studies such as a Bone Scan or CT scan is needed.
Non-Operative Treatment
For non-displaced fractures (when the broken pieces of bone are in the right position), cast immobilization will usually work.
Surgical Treatment
All displaced fractures, and certain non-displaced fractures need to be fixed, usually with a small screw or pin.
Comments
The scaphoid has a relatively poor blood supply, and these troublesome fractures often heal very slowly, or not at all. If the broken bone does not heal, or heals in a bad position, serious long-term damage to the wrist results, including post-traumatic arthritis.
Related Information
AAOS Online
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Wrist / Hand Injuries
