Scaphoid Fracture

A scaphoid fracture is a break in one of the small bones of the wrist, commonly caused by a fall onto an outstretched hand and prone to healing complications if missed.

Pain and swelling on the thumb side of the wrist, tenderness in the "anatomical snuffbox," and pain with gripping or wrist movement following injury.

Most commonly caused by a fall onto an outstretched hand, particularly with the wrist bent backward.

Seek assessment for any wrist pain after a fall, even if initial X-rays appear normal, as scaphoid fractures can be difficult to see early.

Clinical examination for tenderness in the anatomical snuffbox and pain with axial thumb loading.

X-rays are the first step, but MRI or CT is often needed as scaphoid fractures may not be visible on initial X-rays.

Non-displaced fractures are often treated with cast immobilization, sometimes for six to twelve weeks given the bone's limited blood supply.

Surgery is considered for displaced fractures, or to allow earlier mobilization in certain patients.

Percutaneous or open screw fixation stabilizes the fracture to promote healing and allow earlier return to activity.

Healing can take longer than other wrist fractures due to the scaphoid's blood supply, often eight to twelve weeks or more.

Most fractures heal well with appropriate treatment, though delayed diagnosis can lead to nonunion or later arthritis.

Nonunion (failure to heal), avascular necrosis, and later wrist arthritis if the fracture is missed or inadequately treated.