What is a Scaphoid Fracture?

A scaphoid fracture is a fracture of the scaphoid bone, the largest of the small bones which make up the wrist. This bone articulates with the rest of the wrist and the hand to allow the hand to be bent and flexed in a variety of directions. There are several treatment approaches for scaphoid fractures, depending on the severity of the break, and getting treatment is important, because an untreated fracture can lead to arthritis later on.

This bone is located on the thumb side of the wrist, near the base of the wrist. It is shaped like a cashew, and it can sometimes be felt by palpating the wrist as it is bent or flexed. Most typically, scaphoid fractures occur when the wrist experiences a sharp impact, such as a fall, a slam into a wall, or a rap with something heavy. The bones in the forearm may be broken at the same time, in which case the scaphoid fracture will be diagnosed immediately.

Patients may not immediately notice that the scaphoid bone is broken. They may feel some soreness in the wrist, and the area can be reddened or bruised. A doctor may even determine that the wrist is sprained and recommend a splint or sling without realizing that there is a fracture in the wrist. Scaphoid fractures can generally only be diagnosed by looking at an X-ray of the wrist, in which the broken bone will be very evident.

This fracture can be tricky to heal, because the bone has a delicate blood supply. If the fracture is simple, it may be possible to simply cast the hand and allow it to heal naturally. A complex scaphoid fracture, however, will need to be pinned surgically, and in some cases a bone graft may be necessary to replace damaged parts of the bone.

Like other breaks, a scaphoid fracture can result in infection. Another potential complication is avascular necrosis, in which the supply of blood is interrupted and part of the bone dies. Nonunion, when the bone refuses to heal, can also occur. Critically, scaphoid injuries can result in the development of arthritis in the future if they are not handled properly at the time of the break. For this reason, it is very important to attend follow up appointments with an orthopedic surgeon after a scaphoid fracture has been identified and set, to confirm that it is healing properly.