Scaphoid Fracture


 

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.

 

Injury Comment

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.