A scaphoid fracture is a break in one of the small carpal bones in your wrist. Scaphoid fractures are one of the most common types of fractures to occur in the wrist, and these injuries can be notoriously difficult to treat. In this blog post, we will discuss the causes, symptoms, and treatment options for a scaphoid fracture. We will also explore the potential complications and recovery process associated with this type of broken bone.
The scaphoid bone is an essential component of the wrist, allowing for the delicate, yet intricate movements of the hand and fingers. Located right below the thumb, this tiny, kidney-bean-shaped bone fits neatly between the bones of the forearm and hand. Despite its small size, however, the scaphoid plays a critical role in wrist function, providing support and stability to this important joint.
A scaphoid fracture is a break in one of the carpal bones on the thumb side of the wrist. Fractures can occur at various locations along the bone. The most common type of fracture occurs in the middle portion of the bone, known as the "waist." However, fractures can also occur at the proximal and distal ends of the scaphoid.
An injury to the wrist can cause damage to the scaphoid bone. Oftentimes a scaphoid fracture is one of several injuries sustained during a fall or other accident. If left untreated, a broken scaphoid can lead to chronic pain in the hand and wrist that can be difficult to manage over time.
Scaphoid fractures are classified according to how far out of position the broken pieces of bone have moved:
Scaphoid fractures are one of the most common carpal bone fractures to occur in young adults¹. Typically, these fractures are caused by a fall onto an outstretched hand, which can damage the fragile scaphoid bone. This type of injury is especially common among athletes and workers who engage in activities that involve repetitive lifting or falling. Due to the highly complex structure of the scaphoid, even minor trauma can result in a fracture.
Symptoms of a scaphoid fracture include wrist pain and tenderness along the thumb side of the wrist, swelling and bruising around the wrist joint, and difficulty and pain when grasping objects or moving the thumb or hand. A scaphoid fracture can be difficult to diagnose because there are often no obvious deformities.
Unlike most other bones in the body, which receive a rich blood supply from many different vessels, the scaphoid bone is heavily dependent on just a few sources of blood flow. As a result, this bone can be difficult to heal, especially if the radial artery has been damaged.
One of the primary challenges in diagnosing scaphoid fractures is that they can be difficult to identify using traditional imaging methods like X-rays. Instead, doctors often rely on advanced diagnostic techniques such as Magnetic Resonance Imaging (MRI scan) and Computed Tomography (CT scan) to identify the location and severity of a fracture.
For many years, the traditional treatment for non-displaced scaphoid fractures was immobilization in a cast. This approach provided stability for the bone and allowed it to heal over time, typically taking several weeks or even months. However, there is a risk that this approach may not lead to full healing if the fracture site does not receive enough direct blood supply. In some cases, this leads to a condition called nonunion.
Fracture near the thumb (distal pole scaphoid fractures): In general, fractures closer to the thumb heal more quickly than those further away from it. This is due to several factors, including more efficient blood supply from the radial artery and better alignment of all the bones within the hand.
In most cases, patients with distal pole scaphoid fractures recover within a few weeks with appropriate treatment and rehabilitation. Common treatment options include immobilization via casts or braces and physical therapy to help restore range of motion and strengthen nearby muscles.
Fracture near the forearm (proximal pole scaphoid fractures): If the fracture is located near the middle of the bone, or at its waist, it will often struggle to heal properly due to limited blood supply. This part of the scaphoid lacks blood vessels that can deliver critical nutrients and oxygen to aid in healing.
Additionally, closer to the forearm, or proximal pole, of the scaphoid may also struggle to heal due to another factor: motion. Because this section is relatively mobile, any movement or twisting puts stress on an already-injured bone. This can slow down healing or even lead to further damage.
Bone stimulator: This is a small device that emits light electromagnetic or ultrasonic waves. A bone stimulator may help speed up the process of cell regeneration and tissue restoration. By stimulating blood flow and improving nutrient uptake at the site of the fracture, this device can help reduce pain and accelerate healing.
Surgical Treatment may be required if the fracture is severely displaced or if there is no improvement after several weeks of conservative treatment. Fortunately, advances in medical technology and orthopedic surgery have given us new tools for addressing scaphoid fractures.
Early corrective surgery can help restore proper alignment to this crucial bone and ensure proper healing. Although surgery is generally reserved for more severe or complex cases of scaphoid fracture, it may be an important tool in helping patients have a complete recovery from this injury and return to daily activities.
Reduction: Reduction during a surgical procedure is commonly used to treat fractures of the scaphoid bone. In a reduction procedure, the fractured bone pieces are repositioned into their proper position through manipulation.
Internal Fixation Surgery: In some cases, the orthopedic surgeon uses metal implants, such as screws or pins to hold the scaphoid properly until it is fully healed. Internal fixation helps to stabilize the bone so that it can heal properly.
Bone grafting: A bone graft is where the doctor inserts a new bone near the scaphoid, which can stimulate the healing process.
Stem Cells: Emerging techniques may use stem cells that promote healing and regeneration.
As anyone who has experienced a fracture can attest, the healing process can be long and challenging. Not only does it take time for your body to rebuild the damaged bones, but it also requires diligent care to prevent further complications. More serious complications of the scaphoid bone include:
Avascular Necrosis: is a condition that occurs when the flow of blood to the scaphoid bone is cut off due to injury. With avascular necrosis, the bone tissue can become necrotic and die.
Malunion: or the incorrect healing of a fracture, is a condition that can severely affect the movement and stability of the wrist. Symptoms may include pain and decreased range of motion, as well as problems gripping and holding objects.
Osteoarthritis: is a type of joint disease that can result from the wear and tear of the cartilage. This may result in discomfort, stiffness, and swelling in the joints of the wrist. Scaphoid fractures can cause the bones to rub against each other, leading to osteoarthritis. In some cases, surgery may be needed to repair the damage.
When you suffer a scaphoid fracture, it is essential to give your body the time and rest it needs to heal. Whether your treatment plan involves surgical or nonsurgical management, it is crucial that you follow all post-injury instructions carefully.
Depending on the severity of the break, it can take anywhere from 10 to 12 weeks to fully heal in uncomplicated cases. During this time, it is important to rest and avoid putting any stress or pressure on the wrist. This can slow down recovery and exacerbate symptoms such as pain and stiffness.
You will likely be required to wear a cast or splint for several months while your scaphoid fracture heals. Unlike many other types of fractures, scaphoid fractures tend to heal slowly. This is partly due to the fact that this particular bone receives relatively little blood supply, making bone healing more difficult than in other areas¹.
With proper care and treatment, it is possible to repair any damage that has been done to your scaphoid bone and prevent further problems with hand and wrist function in the future.
Traditional plaster casts for scaphoid fractures can be very uncomfortable, and it can be difficult to perform everyday tasks. The Cast21 cast alternative is a more comfortable option that allows you to heal without all the bulk. The Cast21 alternative is made from a lightweight material that is breathable and water-resistant, so you can shower and swim without worry. If you have a scaphoid fracture, the Cast21 product may be a better option for your healing journey. Talk to your doctor about whether a Cast21 alternative may be right for you.
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