A scaphoid (carpal navicular) fracture is the displacement of one of the eight bones of the wrist joint. It is located between the radius bone of your forearm and the base of the thumb. You can identify it by holding your thumb in a "hitch-hiking" position.
The primary cause of scaphoid fractures is falling onto the ground with an outstretched hand. The injury is treatable and requires you to wear a cast for up to six months.
What Is a Scaphoid Fracture?
The term "scaphoid" originates from the word "boat" in Greek, because the shape of the scaphoid bone looks like a boat — long and curved. It keeps the motion of your wrist bones stable and coordinated.
When this bone gets displaced from its normal position, you feel severe pain in your hand and find it hard to lift heavy objects.
The scaphoid fracture can happen to people of all ages.
What Are the Types of Scaphoid Fractures?
Scaphoid fractures are divided into two types depending on their severity — how far the bone fragments have displaced from their original position.
- Non-displaced fracture. This type refers to the condition where the bone pieces or fragments stay in their correct position.
- Displaced fracture. This type refers to the situation where bone fragments move from their original line-up.
What Are the Causes of a Scaphoid Fracture?
A common primary scaphoid fracture cause is using the hand to brace when falling on the ground. This puts high pressure on the wrist that breaks the scaphoid.
Sports like skiing, snowboarding, skating, and gymnastics carry a greater risk of fracturing the scaphoid.
A hard hit directly on your wrist and car accidents can also lead to the displacement of the scaphoid bone.
How Is a Scaphoid Fracture Diagnosed?
Scaphoid fractures are usually difficult to identify. The scaphoid is relatively smaller than other bones of your hand, so the fracture may not be visible. The scaphoid area may not seem swollen, and you won't always feel severe pain.
As a result, people often ignore the scaphoid fracture and confuse it with a sprained wrist.
What Are the Symptoms of a Scaphoid Fracture?
The most common scaphoid fracture symptoms are:
- Swelling of the wrist after a heavy fall
- Bruising on the scaphoid area
- Pain and tenderness in the area just below the base of the thumb
- Unstable thumb or wrist movement
- Pain in hand when lifting or holding objects
What Type of Doctor Treats a Scaphoid Fracture?
If you have symptoms listed above after a fall or an accident, you may be referred to an orthopedic doctor. Orthopedic doctors treat bone fractures.
The doctor will do a physical examination and ask you to describe your pain to understand your condition. They might also order:
- X-rays. An X-ray will give your doctor a clear image of the structure of your scaphoid bone. It will help them determine how many broken pieces of the bone are displaced. In some cases, an X-ray doesn't show a scaphoid fracture right away. In this case, the doctor may recommend a cast or a splint for two to three weeks. After that, you have to revisit your doctor for a follow-up X-ray.
- Magnetic resonance imaging (MRI) scan. The MRI may show a scaphoid fracture quicker than an X-ray can.
- Computerized tomography (CT) scan. A CT scan can reveal the scaphoid fracture to help your doctor develop the best treatment plan.
What Is the Treatment for a Scaphoid Fracture?
If your doctor identifies a scaphoid fracture, you should get the right treatment immediately to avoid any future risks. The scaphoid fracture treated on time only takes about 12 weeks to recover.
On the other hand, an untreated scaphoid fracture may take six months to heal completely. That's why it's better to get an early diagnosis and treatment for scaphoid fractures. Your doctor might recommend any of the below scaphoid fracture treatments:
- Fracture near the thumb. The fracture is treated by putting the wrist in a long cast that covers the thumb and a little bit of elbow.
- Fracture near the forearm. If the scaphoid breaks from the middle or near the forearm, the recovery becomes more difficult. That's because these parts of the scaphoid bone have a low blood supply. The wrist is put in a cast that extends from the thumb to above the elbow.
- Bone stimulator. It is a small device that gives off light electromagnetic or ultrasonic waves to stimulate the healing process.
- Reduction. When the scaphoid breaks from the middle, doctors go for a surgical procedure known as reduction. In this procedure, the doctor brings back the bone into its original position by using anesthesia.
- Internal fixation. In some cases, the doctor uses metal implants, such as screws or wires to hold the scaphoid properly until it is fully healed.
- Bone graft. The doctor places a bone graft — a new bone — near the broken scaphoid during this procedure. This stimulates the healing process of the scaphoid bone.
