What is Scaphoid Fracture

Scaphoid fracture is a break in one of the small bones of the wrist. The scaphoid bone is located on the thumb side of the wrist. It supports the other seven bones that make up the wrist.

The scaphoid bone has a poor blood supply, so it can take a long time to heal. You may need to wear a cast or splint for several months.

What are the causes?

This injury is usually caused by a fall onto an outstretched hand and arm. This type of injury may also occur if you are in a motor vehicle collision and you brace yourself with your hand.

What increases the risk?

The following factors may make you more likely to develop this injury:

• Playing contact sports.
• Skiing, skating, or rollerblading.

What are the signs or symptoms?

Symptoms of this injury include:

• Pain, especially when grasping or pinching with your thumb.
• Pain when pressing on the base of your thumb, especially in the hollow area at the base of your thumb when your thumb is extended outward.
• Swelling.
• Bruising.

How is this diagnosed?

This injury may be diagnosed based on:

• Your history of injury.
• A physical exam of your wrist and thumb.
• X-rays.
• CT scan or MRI. These tests are sometimes needed because this type of fracture may not show up on X-rays.

A scaphoid fracture may be hard to diagnose because pain may not start for a few days. Also, the fracture does not cause a deformity, and it may not limit movement.

How is this treated?

Treatment depends on the location of the fracture and whether the bone is out of place (displaced). Treatment may be surgical or nonsurgical:

• You may need a cast or splint from the middle of your forearm down to your wrist. Your thumb may be extended out and included in the cast or splint.
• While your fracture is healing, it may be treated with sound waves or electrical energy to stimulate healing.
• A displaced fracture may require surgery to put the pieces of bone back in proper position. Screws or wires may be used to hold the bone in place.
• You may need to do exercises (physical therapy) to restore wrist movement after your cast or splint is removed.

Follow these instructions at home:

If you have a cast:

• Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
• Check the skin around the cast every day. Report any concerns to your health care provider. You may put lotion on dry skin around the edges of the cast. Do not apply lotion to the skin underneath the cast.
• Do not let your cast get wet if it is not waterproof.
• Keep the cast clean.

If you have a splint:

• Wear the splint as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the splint if your fingers tingle, become numb, or turn cold and blue.
• Do not let your splint get wet if it is not waterproof.
• Keep the splint clean.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
• If your cast or splint is not waterproof, cover it with a watertight plastic bag when you take a bath or a shower.

Managing pain, stiffness, and swelling

• If directed, apply ice to the injured area.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times per day.
• Move your fingers often to avoid stiffness and to lessen swelling.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Driving

• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Ask your health care provider when it is safe to drive if you have a cast or splint on a hand that you use for driving.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you. You may need to limit activities such as contact sports, throwing, pushing, climbing, and using vibrating machinery.
• Do not lift anything that is heavier than 1 lb (0.5 kg) with the affected hand until your health care provider tells you that it is safe.
• Do exercises only as told by your health care provider.

General instructions

• Do not put pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not use any tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your pain or swelling gets worse even though you have had treatment.
• You have pain, numbness, or coldness in your hand or fingers.
• Your cast or splint becomes loose or damaged.

Get help right away if:

• You lose feeling in your hand or fingers.
• Your fingers or fingernails turn pale or blue.