A scaphoid fracture is one of the most commonly overlooked wrist injuries. Often caused by a fall onto an outstretched hand, this type of fracture may not cause severe pain or obvious swelling, leading many to mistake it for a minor sprain. However, if left untreated, it can lead to complications such as nonunion and avascular necrosis, which can significantly affect wrist function.
But what is a scaphoid fracture you may well ask? It is a break in the scaphoid bone, a small but essential bone in the wrist that connects the two rows of carpal bones and plays a key role in movement. Due to its poor blood supply, fractures in this bone can take longer to heal and some may require surgical intervention.
This blog will explore the signs of a scaphoid fracture, why early diagnosis is crucial and the most effective treatment options for ensuring a full recovery.
How Does a Scaphoid Fracture Happen?
The scaphoid bone is a small, boat-shaped bone located in the row of carpal bones at the base of the thumb. It plays a crucial role in wrist movement and stability. The most common way to break your scaphoid bone is by trying to break a fall with your hands. This is why athletes, cyclists and even those slipping on wet pavements are at high risk for scaphoid fractures.
The problem? Many people don’t realise they’ve sustained a fracture of the wrist because the pain may not be severe and swelling is often minimal. Unlike other fractures, a scaphoid fracture typically includes mild discomfort that can be ignored – until complications arise.
Scaphoid Fracture Symptoms: Why People Mistake It for a Sprain
It’s easy to assume that wrist pain after a fall is just a strain. However, the symptoms of a scaphoid fracture can be subtle but persistent. Signs to watch for include:
- Pain at the base of the thumb – particularly in the “anatomical snuffbox” (the small, hollow area on the thumb side of the wrist).
- Swelling and tenderness – though not always visible.
- Pain when gripping objects – particularly when applying pressure with the thumb.
- Pain when pushing off – example off a chair, desk etc
- Limited wrist movement – discomfort when bending or rotating the wrist.
Ignoring these signs can be dangerous, as a delayed diagnosis can lead to displaced scaphoid fractures, where the bone shifts out of place, making healing more complicated.
How to Diagnose a Scaphoid Fracture: Why X-Rays Aren’t Always Enough
If you suspect a scaphoid fracture, it’s crucial to go to the emergency department or see a specialist as soon as possible. However, diagnosing this injury can be tricky.
- Visible on X-ray? Not always: Some fractures, particularly occult scaphoid fractures, don’t immediately show up on X-rays. It is vital that the correct ‘scaphoid series’ of xray views are used to investigate. If pain persists despite a normal X-ray, further imaging such as an MRI or CT scan may be needed. Alernatively, a series of serial xrays may be useful.
- Scaphoid waist fracture vs. proximal pole scaphoid fracture: The location of the break matters. A proximal pole scaphoid fracture (closer to the forearm) is more serious due to the poor blood supply in this region, making healing more difficult.
- Distal scaphoid fracture vs. proximal scaphoid fracture: A distal scaphoid fracture (closer to the thumb) generally heals faster, while a proximal fracture carries a higher risk of complications.
Because of these factors, prompt and accurate diagnosis is essential for effective treatment.
Treatment Options: Splint, Cast, or Surgery?
Once a scaphoid fracture is confirmed, treatment depends on the severity and location of the break.
1. Splint or Cast: The Non-Surgical Route
- If the fracture is non-displaced (the bone pieces are still in alignment), a splint or cast is usually enough for healing.
- The wrist is immobilised for 6-12 weeks, depending on the type of fracture.
- Regular follow-ups are required to ensure proper healing.
2. Surgery: When a Cast Isn’t Enough
- Displaced scaphoid fractures or those at high risk of nonunion and avascular necrosis may require surgery.
- A small screw or pin may be inserted to stabilise the bone.
- After surgery, wrist movement is gradually restored through physiotherapy.
Ignoring a scaphoid fracture or not following medical advice can lead to long-term issues, including arthritis, chronic pain and limited wrist mobility.
Final Thoughts: When to Seek Medical Attention
A scaphoid fracture may not seem urgent at first, but early diagnosis and proper treatment are crucial for preventing long-term damage. If you experience persistent wrist pain after a fall, especially near the thumb, go to the emergency department or visit a hand specialist for an accurate assessment. The scaphoid is a small but significant bone – don’t ignore the warning signs!
Book an Appointment with Mr Goon
If you are suffering from a hand or wrist problem, please use the online form to contact us and arrange an appointment with Mr Goon. Alternatively, you can call us on 01707 443 444.
FAQs
What does a scaphoid fracture look like?
A scaphoid fracture may not always cause visible swelling or deformity. In some cases, bruising appears around the wrist, but the main indicator is tenderness in the anatomical snuffbox (the hollow at the base of the thumb).
What does a broken scaphoid feel like?
A broken scaphoid often causes a dull, persistent ache in the wrist, especially when gripping objects or applying pressure. Pain may be mild at first but can worsen over time if untreated.
Can a scaphoid fracture heal on its own?
No, a scaphoid fracture will not heal properly without treatment. Due to the poor blood supply to part of the scaphoid, some fractures take longer to heal and may require immobilisation in a splint or cast, or in some cases, surgery.
How long does it take to recover from a scaphoid fracture?
Recovery can take anywhere from 6 to 12 weeks, depending on the severity and location of the fracture. Displaced scaphoid fractures or those with poor healing potential may require surgery, which can extend recovery time.
Will I need to miss work or school with a scaphoid fracture?
This depends on your daily activities. If your job or studies involve manual work or prolonged wrist use, you may need to miss work or school during recovery, especially if surgery is required.
