Scaphoid Fracture: Symptoms, Causes, Treatment

What are the symptoms of a scaphoid fracture?

A scaphoid fracture, which affects the scaphoid bone in the wrist, can present with various symptoms. Common signs and symptoms include:

• Wrist Pain: Pain is typically localized to the wrist, particularly on the thumb side (radial side). The pain may worsen with movement or pressure.
• Swelling: Swelling around the wrist, often more prominent on the thumb side, may be observed.
• Tenderness: Tenderness over the scaphoid bone, which is located in the anatomical snuffbox of the wrist, can be a key indicator of the fracture.
• Limited Range of Motion: Reduced ability to move the wrist or thumb due to pain and swelling.
• Bruising: In some cases, bruising may be present around the wrist.
• Difficulty Grasping or Holding Objects: Pain or discomfort while trying to grasp or hold objects can occur due to the fracture.
• Decreased Strength: A noticeable decrease in grip strength or overall wrist function may be experienced.

A scaphoid fracture can sometimes be difficult to diagnose because the symptoms may resemble other wrist injuries, and initial X-rays might not always show the fracture. If a scaphoid fracture is suspected, especially with symptoms that don’t improve, it is important to seek medical attention. Advanced imaging, such as MRI or CT scans, may be necessary for a definitive diagnosis.

What are the causes of a scaphoid fracture?

A scaphoid fracture typically occurs due to trauma or injury to the wrist. The primary causes include:

• Falls: Falling onto an outstretched hand is the most common cause. The impact forces are transmitted through the wrist, often causing a fracture in the scaphoid bone.
• Direct Trauma: A direct blow or impact to the wrist or hand, such as from a sports collision or an accident, can lead to a scaphoid fracture.
• Sports Injuries: Activities that involve high-impact or repetitive stress on the wrist, such as football, basketball, skateboarding, or skiing, can increase the risk of scaphoid fractures.
• Repetitive Strain: Repetitive stress or strain on the wrist from certain activities or occupations can weaken the scaphoid bone, making it more susceptible to fractures.
• Motor Vehicle Accidents: High-impact accidents, such as those involving cars or motorcycles, can cause significant trauma to the wrist and lead to a scaphoid fracture.
• Sports or Exercise Accidents: Activities like gymnastics, weightlifting, or other forms of exercise that put significant stress on the wrist can also contribute to scaphoid fractures.

In some cases, scaphoid fractures can occur with relatively minor trauma, particularly if the bone is already weakened due to conditions such as osteoporosis or other underlying health issues. Proper treatment and early diagnosis are important to prevent complications and ensure proper healing.

What is the treatment for a scaphoid fracture?

Treatment for a scaphoid fracture depends on the severity of the fracture, its location, and whether there is displacement or involvement of the surrounding structures. Here’s a general approach to treatment:

• Non-Surgical Treatment: For stable, non-displaced fractures, treatment often involves:
• Immobilization: The wrist is immobilized with a cast or splint, typically for 6 to 12 weeks, to allow the bone to heal. A thumb spica cast is commonly used to stabilize the scaphoid and surrounding areas.
• Pain Management: Over-the-counter pain relievers or prescription medications may be used to manage pain and reduce swelling.
• Follow-Up Care: Regular follow-up visits with a healthcare provider are necessary to monitor healing through X-rays or other imaging.
• Surgical Treatment: If the fracture is displaced, unstable, or not healing properly with conservative treatment, surgery may be required:
• Internal Fixation: The fracture may be stabilized with screws, plates, or pins to hold the bone in place and facilitate proper healing. This is typically done through an open reduction, where the surgeon makes an incision to directly access and repair the fracture.
• Bone Grafting: In some cases, bone grafting may be performed to promote healing if there is significant bone loss or non-union of the fracture.
• Rehabilitation: After immobilization or surgery, physical therapy may be recommended to restore wrist function, strength, and range of motion. This helps in regaining full use of the wrist and preventing stiffness.
• Monitoring for Complications: Regular monitoring is essential to ensure the fracture is healing properly and to address any complications, such as avascular necrosis (loss of blood supply to the bone) or non-union (failure to heal).

Early diagnosis and appropriate treatment are crucial for optimal recovery and to minimize long-term complications. If you suspect a scaphoid fracture or have wrist pain following an injury, seeking prompt medical attention is important for effective management.