Scaphoid Fracture

Scaphoid Fracture

Overview

The scaphoid is a group of small bones in the wrist that make up the carpal bones. A scaphoid fracture is fairly common among athletes. The issue in its diagnose is that these fractures may not be visible on X-rays and therefore the person is treated as a case of a wrist sprain. In most cases, the patient will undergo X-rays and bone scans to determine the extent of the injury.

Types of Scaphoid Fracture

There are two types of scaphoid fractures. The first is a “displaced fracture”. This occurs when bone fragments move from their normal position. In such case, fragments may overlap, or gaps may occur between bones. The other type of scaphoid fracture is a “non-displaced fracture” In this type of fracture, bone cracks at one place and does not move to alter alignment.

Scaphoid Fracture

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Signs and Symptoms

  • The patients will notice pain within days following a fall.
  • There could be a severe pain when an individual tries to grasp something or move the thumb or wrist.
  • In some cases, there is no difficulty with motion and no visible deformity. Therefore, the patient assumes that it is a wrist sprain. One must see a doctor if the pain persists as quick treatment will help in avoiding potential complications.

Causes of Scaphoid Fracture

It is often caused by a fall on the outstretched hand with your weight landing on your palm. There is a chance that larger forearm bone breaks as it depends on the weight as well as the position of the hand on landing. Scaphoid fractures can also occur during motor vehicle collisions or high-energy sports activities such as snowboarding, skating, etc.

Diagnosis

This type of fracture is diagnosed by an X-ray of the wrist. But, in several cases is it is not apparent. For this reason, it is considered as a sprain and is also called as an occult fracture. If the patient feels tenderness directly over their scaphoid bone, then the doctor would recommend wearing a splint. However, if the pain does not subside, then an X-ray in one to two weeks can be used. Also, a CT scan can be considered in assessing a scaphoid fracture. In several cases, MRI can also be used as it can provide an immediate diagnosis.

Scaphoid Fracture

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Treatment

  • Treatment will depend on a number of factors such as when the injury occurred, whether the bone fragments are displaced and the location of the fracture.
  • A non-displaced one then it can be treated with a plaster cast.
  • A displaced fracture would result in the bones moving out of their normal position and if they are re-displaced within the plaster, then surgery would be the best option.
  • Fractures that are not treated properly can turn into non-union, which further results in persistent weakness in grip strength. At this stage, bone grafting may be required along with the fixation with the screw.

Recovery

No matter what the treatment is, whether nonsurgical or surgical, your doctor may ask you to wear a splint or cast for up to six months. These fractures have a slow healing process. Therefore, your physician would normally recommend for you to avoid following activities:

  • Participating in high-energy sports activity
  • Pulling, carrying, lifting or pushing heavyweight
  • Throwing with the injured hand

It is crucial to maintaining full finger motion, and for that, your doctor will refer you to an expert hand therapist. A professional therapist can help in regaining the motion as well as strength in your wrist. Also, your doctor can provide the rehabilitation program, which includes a series of motion exercises as well as strengthening exercises for the injured forearm, hand and elbow.