What is the Scaphoid?
The scaphoid is a small bean-shaped bone in your wrist. It links the two rows of carpal bones together to create smooth movement of the wrist up and down and side to side. The scaphoid receives its blood supply from just one end, meaning the blood needs to filter through the bone to get to the other end.
This unusual blood supply can make healing difficult following some fractures of the scaphoid, depending on the location of the break. If a scaphoid fracture fails to heal (unite) it disrupts the co-ordinated movement of the carpal bones leading to premature arthritis and long term pain the wrist.
What Causes a Scaphoid Fracture?
Scaphoid fractures are a common injury, particularly amongst young males aged 15-25. They typically result from a high energy fall onto an outstretched hand such as falling off a skateboard. There is also a high incidence of scaphoid fractures in contact sports like AFL and Rugby.
What are the Signs of Scaphoid Fracture?
Scaphoid fractures are quite easily missed as they often do not produce a great deal of pain, so people may suspect that they have only sprained their wrist. Signs of scaphoid fracture may include swelling on the thumb side of the wrist, and tenderness in the hollow called the anatomical snuff box. Pain may be felt in this area during pinching and grasping.
Anatomical Snuff Box
How is a Scaphoid Fracture Diagnosed?
If a scaphoid fracture is suspected it is important to get an x-ray, however not all scaphoid fractures will show up immediately on x-ray. If the x-ray is clear but clinical signs suggest a scaphoid fracture, your wrist should be protected in a splint or cast and a follow-up x-ray, CT scan or MRI should be performed.
How is a Scaphoid Fracture Treated?
Treatment of a scaphoid fracture will depend on the precise location of the fracture within the scaphoid and whether the fracture has displaced (moved out of alignment).
If the bone is still in good alignment and the fracture is in a part of the bone with a good blood supply, the fracture can be managed in a cast or custom-made splint for 6-8 weeks. If the fracture is not in good alignment or is at the base of the scaphoid, surgery is required to provide the best chance for the fracture to heal.