Scaphoid Fracture: What You Need to Know

Scaphoid fractures aren’t bumps and bruises. They account for 2.4% of all wrist fractures in the United States. Thousands of Americans break their scaphoid bones every year, yet 40% of people who have scaphoid fractures are misdiagnosed. 

If you hurt your wrist, you need to think about whether or not you have a scaphoid fracture. Do your research and answer some questions so you can get the help you need. 

What is the scaphoid bone, and what types of scaphoid fractures are there? How can you know if you have a scaphoid fracture? What treatment can you get for your broken scaphoid? 

Get the facts and you can make a complete recovery from a broken scaphoid in no time. Here is your comprehensive scaphoid fracture guide.

The Basics of a Scaphoid Fracture

The scaphoid bone is a small bone close to the base of your thumb. It builds the superstructure of your hand, allowing your hand to move around and protecting your wrist from damage. 

Your scaphoid bone has three parts. The distal pole is the closest end to your hand and fingers while the proximal pole is the closest end to your forearm. The waist of the scaphoid is the middle part of the bone.

A scaphoid fracture occurs when any part of your scaphoid bone breaks. Most people break the waist of the scaphoid. But you can break either pole or multiple parts of the bone.

The scaphoid bone is just one bone in your wrist, so you may break multiple bones at once. In order to get proper treatment, you should study the bones of the wrist and tell your doctor what other bones you think you have broken.

Types of Scaphoid Fractures

There are a few types of scaphoid fractures. A displaced fracture occurs when the pieces of your bone move apart from each other.

Gaps may form around or between the pieces, causing inflammation and swelling. You may need more extensive treatment in order to fix the displaced fracture.

Some displaced fractures are open fractures. A piece of bone may poke through the skin, causing bleeding and extreme pain. But most fractures are closed fractures with the skin not breaking, which can make it harder to notice displaced fractures.

A non-displaced fracture occurs when the bone pieces stay close together and in their original positions. Non-displaced fractures usually do not result in complications, and treatment is straightforward. However, you should still go to your doctor and get help.

An occult fracture is a fracture that a doctor cannot easily see. The fracture may be very small, or it may be at an angle that an x-ray cannot detect. 

Some occult fractures go undiagnosed, which can lead to significant complications, including intense pain. Go to your doctor if you notice any symptoms of a fracture or have been in a recent collision.

Scaphoid Fracture Causes

Scaphoid fractures often occur when you strike your wrist against something. Many people catch themselves with their arms when they fall toward the ground. This can break bones in your hands, wrists, and forearms. 

A similar phenomenon occurs during car accidents. Many drivers grip the wheel tightly as they collide with another car, which can cause them to break their wrists as their bodies are thrown forward. Your arm may collide with the door, dashboard, or another part of the interior, leading to a fracture.

Other people get their hands caught in doors, fracturing their bones. You can also break your bone if you try to catch a ball during a sports game. 

Risk Factors

Anyone can break their scaphoid bone. But some people are at a higher risk of breaking their bones and experiencing complications. 

36 million falls occur amongst older adults every year. Older adults tend to have weaker bones than younger people, making their scaphoid fractures worse. 

Athletes and people who engage in risky activities like skydiving are at a higher risk for scaphoid fractures. Even people who play non-contact sports are at a higher risk, as they can fall down while they are running. 

Osteoporosis reduces the mass of your scaphoid, making it extremely weak. If you have advanced osteoporosis, pushing your hand against a door or slamming it on a table may provide enough force to break your scaphoid.

Bone cancer can also reduce your bone density and make your scaphoid brittle. Chemotherapy and radiation treatment can affect your scaphoid fracture recovery as well.

Symptoms of a Fracture

The symptoms of a scaphoid fracture are similar to those of other bone fractures. You may feel pain in and around the area of your broken bone. You may feel searing, stabbing, or throbbing.

If you feel intense pain in your hand and fingers, you may have broken your distal pole. If you feel intense pain in your forearm, you may have broken your proximal pole. Tell your doctor exactly where your pain is so they can figure out what was broken.

The soft tissues in your wrist may begin to swell. If you press on the tissues, you may feel pain and tenderness. Your wrist may feel very warm.

You may develop a bump. A piece of bone may be underneath the bump, so do not press down on it. You may also notice a deformity in the shape of your wrist, which suggests that the bones are out of place.

The skin may become red or bruised. Your bruises may be blue, purple, or black. Do not apply pressure to your bruises, as this can break the blood vessels underneath your skin.

If you try to move your wrist, your pain may radiate through your hand. You may find it hard to move your wrist back and forth, and you may develop numb hands.

In an open fracture, you may be able to see the bone. Your skin may be bleeding, and you can contain the bleeding with a tourniquet. Do not press down on the bone or move it out of place, as this may cause additional problems.

Diagnosis

A broken bone is a medical emergency, and you should go to the hospital, if not your personal doctor, immediately. A doctor will run imaging tests to see what bones are broken and if you have soft tissue damage. 

An x-ray creates two-dimensional images of your bones. If your doctor wants to examine your soft tissues, they may order an MRI. A CT scan produces three-dimensional images, which can help doctors diagnose occult fractures. 

Your doctor may perform a physical exam on your wrist. They may ask you to move your wrist gently or try to grip things with your fingers. This can help them see if your connective tissue or blood vessels are damaged.

Treatment 

Treatment can begin once you are diagnosed. Treatment solutions vary from person to person and depend on what type of fracture you have. Consider a few treatments and then talk to your doctor and a hand specialist about what you should do. 

Rest

If you have a non-displaced fracture without significant pain, your doctor will likely recommend rest. They will put a cast on you to immobilize your arm and prevent your bones from moving apart from each other. 

After you get your cast, you should go home and rest. Use your other hand to grab and hold objects.

You can return to work after a few days, though you should modify your activities so you are not straining yourself. Do not play any contact sports, but try to get some light exercise. 

Most fractures heal in four to six weeks. Your doctor will ask you to change your cast and clean your wrist so you don’t have a skin infection. You will also need to get additional CT scans to see how your bones are healing.

Medications

If you experience pain, you can take medications in order to dull it. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most common prescription for a bone fracture. NSAIDs include aspirin and ibuprofen.

Follow your doctor’s instructions for taking NSAIDs. Side effects include bleeding, so you should be careful if you have bruising or bleeding from your fracture.

Closed Reduction

Closed reductions are for fractures in the waist of the scaphoid. They are also for fractures in multiple areas of your scaphoid or displaced fractures. 

The procedure is non-invasive, but you may need to take an anesthetic so you don’t feel pain. Some doctors administer a local anesthetic, numbing your wrist and arm. If you are in extreme pain, you may receive general anesthesia so you sleep through the closed reduction. 

Your doctor will push on your wrist, realigning your broken bones. They will look at images to see where they need to apply pressure and how much pressure they need. They may need to work on both sides of your wrist or pull on a bone using their fingertips. 

After the closed reduction, you will wear a splint or cast for a few weeks. If your bones start to separate, you may need additional treatments.

Surgery

Surgery is a last resort. You may need an operation if rest is not working or if you have a displaced or open fracture. 

An internal fixation involves using plates, screws, or wires to hold pieces of bone in place. A surgeon will make incisions into your skin, move your bones into their correct positions, and then insert the fixation devices. 

You will receive an anesthetic so you do not feel pain during the operation. You may need to stay overnight in the hospital so the doctors can monitor you for signs of infection. But your hospital stay will be short, and you can finish your recovery at home. 

If you have an extreme displacement, you can receive a bone graft. A surgeon will take bone tissue from one part of your body and insert it into your wrist. This will join your fractured bones together and let them grow. 

A surgeon can take a graft from somewhere else in your body or from a donor. The procedure is an outpatient one, so you can go home the same day. You will need to immobilize your wrist and whatever area the surgeon grafts your bone from.

Fracture Prevention

If you’re at high risk for falls, you should install grip rails so you can move around your home easier. You can also use a walker or a wheelchair. 

If you play contact sports, you should wear wrist guards. If you get into a collision with someone, extend both of your arms out and bend your elbows to dissipate the force of the collision.

You can strengthen your wrist bones through a few simple exercises. Wrist extensions with dumbbells are easy to perform, even if you don’t have strong bones or muscles.

Grab a dumbbell, rest your forearm on a table so your hand is over the edge, and extend your wrist out. Lift your hand up while keeping your forearm on the table and then hold the position for a few seconds. Repeat this motion 10 to 15 times. 

Getting Help for a Scaphoid Fracture

A scaphoid fracture is a break in the scaphoid bone in your wrist. Most people injure their scaphoid in a fall or car crash. A fracture can cause pain, swelling, and mobility problems, especially if the bone pieces separate. 

Most people recover from fractures without complications. You may need to wear a cast for two months and take medication. Surgery is straightforward, setting the pieces of your bones in place so you can recover in a few weeks.

Assess your options with expert hand and wrist doctors. The Hand Surgery Specialists of Texas serves Houston residents. Contact us today.

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