Table of ContentsView AllTable of ContentsCauses and Types of Scaphoid FractureScaphoid Fracture SymptomsDiagnosisTreatmentRecoveryWhen a Fracture Doesn’t HealFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Causes and Types of Scaphoid Fracture
Scaphoid Fracture Symptoms
Diagnosis
Treatment
Recovery
When a Fracture Doesn’t Heal
Frequently Asked Questions
Cast immobilization is typically recommended for this type of fracture, but this can vary. Since scaphoid fractures can take a long time to heal, and may not do so completely, surgery may sometimes be required.
Jonathan Cluett, M.D.
Scaphoid fractures are generally classified as either displaced or nondisplaced:
The signs of a scaphoid fracture include:
Many patients are erroneously diagnosed with awrist sprainwhen in actuality they have a broken scaphoid bone.
The diagnosis is difficult because X-rays taken right after the injury may show no abnormality if the bone is not out of position. A scaphoid fracture that is not displaced may only show up on X-ray after healing has begun, which can be one to two weeks after the injury.
Because of this, it is not uncommon to treat a wrist injury with immobilization (as though it were a scaphoid fracture) for a week or two and then repeat X-rays to see if the bone is broken. An MRI can also be used to diagnose this injury without having to wait to repeat an X-ray.
When treating a scaphoid fracture, your healthcare provider will set specific goals. In addition to trying to regain mobility, treatment should relieve pain and help prevent the development of arthritis in your joint.
Usually, surgery is necessary to fully heal your wrist, but in some cases, a scaphoid fracture can be treated with just a brace.
Cast Immobilization
Surgery
If the scaphoid fracture is displaced, the risk of nonunion is higher, and your healthcare provider will recommend surgery to reposition the bones and hold them solidly in proper alignment. The surgery typically involves using a single screw to hold the bone together in the proper position.
There is some controversy about using surgery as an initial treatment of a fracture that is not out of position.The advantage is that there is less of a risk of nonunion and the time for immobilization can be dramatically reduced.
The disadvantage is that surgery always has risks, and while the complication rate of scaphoid fracture surgery is small, there is a possibility of complications, including injury to cartilage or tendons around the scaphoid and infection.
Many athletes or manual laborers choose to have surgery to allow a faster recovery.
After surgery, you will also need to wear a cast. It can then take up to six months for a fracture to heal, which is longer than other types of fractures.
As you heal, you’ll need to restrict your activity. This may include changes such as:
In addition, you should not smoke during recovery since it can slow down the healing process.
A scaphoid fracture may heal slowly (delayed union) or not at all (nonunion). This is especially likely if you are misdiagnosed or if treatment is delayed, and it is largely due to how blood is supplied to the bone.
The scaphoid bone has a retrograde blood supply, meaning that blood flow comes from a small vessel that enters the most distant part of the bone and flows back through it.
This unusual flow of blood presents a problem when there’s a fracture: Because of how tenuous the blood supply is, a bone break can easily sever it. This stops the delivery of necessary oxygen and nutrients to the bone cells, impeding healing.
The risk of developing a nonunion of the scaphoid depends most importantly on the location of the fracture in the bone. Other factors that can contribute to non-union include smoking, certain medications, and infection.
These injuries can be complex. Long-term pain and tissue death (avascular necrosis) can occur.
Lengthy treatment is often required to get the bone to heal. A bone graft is often used topromote healing at the fracturesite. Without proper treatment,wrist arthritisis likely to develop later in life.
A Word From Verywell
Scaphoid fractures are common wrist injuries, and the treatment may depend on a number of factors. Cast immobilization avoids surgical treatment and risks of infection and cartilage injury, but may require prolonged immobilization and lead to stiffness of the joint. Surgical treatment has risks associated with it, but may provide more predictable healing. Other factors, such as patient age, activity level, and fracture location and type, may all influence the recommended treatment as well.
Frequently Asked QuestionsThe waist is the middle section of the scaphoid bone. The term “scaphoid fracture” usually refers to a fracture of the scaphoid waist, since the middle of the scaphoid bone is the area that is most commonly broken. When a scaphoid fracture does not occur at the waist, this means the fracture is located in the proximal or distal ends of the bone.It is possible that a scaphoid fracture can causecarpal tunnel syndrome, but on its own, it is unlikely. Carpal tunnel syndrome is usually the result of multiple factors. This can include an overactive pituitary gland, rheumatoid arthritis, wrist swelling from an injury, and more. In many cases of carpal tunnel syndrome, it is difficult to pinpoint a single cause of it.
The waist is the middle section of the scaphoid bone. The term “scaphoid fracture” usually refers to a fracture of the scaphoid waist, since the middle of the scaphoid bone is the area that is most commonly broken. When a scaphoid fracture does not occur at the waist, this means the fracture is located in the proximal or distal ends of the bone.
It is possible that a scaphoid fracture can causecarpal tunnel syndrome, but on its own, it is unlikely. Carpal tunnel syndrome is usually the result of multiple factors. This can include an overactive pituitary gland, rheumatoid arthritis, wrist swelling from an injury, and more. In many cases of carpal tunnel syndrome, it is difficult to pinpoint a single cause of it.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Li H, Guo W, Guo S, Zhao S, Li R.Surgical versus nonsurgical treatment for scaphoid waist fracture with slight or no displacement: A meta-analysis and systematic review.Medicine. 2018;97(48):e13266. doi:10.1097/MD.0000000000013266American Academy of Orthopaedic Surgeons: OrthoInfo.Scaphoid Fracture of the Wrist.Nationwide Children’s Hospital.Scaphoid Fractures.National Institute of Neurological Disorders and Stroke.Carpal Tunnel Syndrome Fact Sheet.Additional ReadingMoon ES, Dy CJ, Derman P, Vance MC, Carlson MG.Management of nonunion following surgical management of scaphoid fractures: current concepts.J Am Acad Orthop Surg. 2013;21(9):548-557. doi:10.5435/JAAOS-21-09-548
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Li H, Guo W, Guo S, Zhao S, Li R.Surgical versus nonsurgical treatment for scaphoid waist fracture with slight or no displacement: A meta-analysis and systematic review.Medicine. 2018;97(48):e13266. doi:10.1097/MD.0000000000013266American Academy of Orthopaedic Surgeons: OrthoInfo.Scaphoid Fracture of the Wrist.Nationwide Children’s Hospital.Scaphoid Fractures.National Institute of Neurological Disorders and Stroke.Carpal Tunnel Syndrome Fact Sheet.Additional ReadingMoon ES, Dy CJ, Derman P, Vance MC, Carlson MG.Management of nonunion following surgical management of scaphoid fractures: current concepts.J Am Acad Orthop Surg. 2013;21(9):548-557. doi:10.5435/JAAOS-21-09-548
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Li H, Guo W, Guo S, Zhao S, Li R.Surgical versus nonsurgical treatment for scaphoid waist fracture with slight or no displacement: A meta-analysis and systematic review.Medicine. 2018;97(48):e13266. doi:10.1097/MD.0000000000013266American Academy of Orthopaedic Surgeons: OrthoInfo.Scaphoid Fracture of the Wrist.Nationwide Children’s Hospital.Scaphoid Fractures.National Institute of Neurological Disorders and Stroke.Carpal Tunnel Syndrome Fact Sheet.
Li H, Guo W, Guo S, Zhao S, Li R.Surgical versus nonsurgical treatment for scaphoid waist fracture with slight or no displacement: A meta-analysis and systematic review.Medicine. 2018;97(48):e13266. doi:10.1097/MD.0000000000013266
American Academy of Orthopaedic Surgeons: OrthoInfo.Scaphoid Fracture of the Wrist.
Nationwide Children’s Hospital.Scaphoid Fractures.
National Institute of Neurological Disorders and Stroke.Carpal Tunnel Syndrome Fact Sheet.
Moon ES, Dy CJ, Derman P, Vance MC, Carlson MG.Management of nonunion following surgical management of scaphoid fractures: current concepts.J Am Acad Orthop Surg. 2013;21(9):548-557. doi:10.5435/JAAOS-21-09-548
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