Scaphoid Fractures
What are scaphoid fractures?
Scaphoid fractures occur when the scaphoid bone in the wrist breaks. The scaphoid bone is located on the side of the wrist near the thumb and above the radius bone. The wrist is made up of several joints that work together to aid in hand movement. These allow the hand to move side to side and back and forth and allow for flexibility and strength in the hand. It also contains other bones, tendons, ligaments, nerves and blood vessels. One of the carpal bones, the scaphoid has a long-curved shape and aids in the motion and stability of the joint.
What are the causes and symptoms of scaphoid fractures?
Scaphoid fractures are often caused by falls on an outstretched hand. This type of fracture can also occur due to sports activities or events such as car accidents. The scaphoid is often broken in the mid-portion of the bone, though the fracture can also occur at the distal and proximal ends. Fractures to the scaphoid are classified by the severity of the break and how far the fractured pieces of bone have moved. Fractures can be displaced or non-displaced. Displaced fractures occur when the bones have moved out of the normal location, and in certain cases, there are gaps between the broken bones. Due to movement after the fracture, these bones may also overlap. Non-displaced fractures occur when the bones have broken but have not moved out of alignment. Symptoms of scaphoid fractures include pain and swelling. Pain can be mild, and some scaphoid fractures can be initially mistaken for sprains.
How are scaphoid fractures diagnosed and treated?
To diagnose scaphoid fractures, a doctor will first conduct a physical exam. The physician will ask the patient about their symptoms and how the injury occurred, as well as examine the wrist and check to see if there is pain and tenderness directly over the scaphoid bone. They will also assess the wrist to see if there is any loss of motion. Imaging tests such as X-rays, MRIs or CT scans may be ordered to diagnose scaphoid fractures and examine the area for any additional injures.
Treatment for scaphoid fractures depends on the location of the fracture, if the bone fragments have been displaced and how old the injury is. The patient may need a cast or splint. Commonly, surgery is required for these injuries.
Learn more about this condition from the American Academy of Orthopaedic Surgeons.
What is scaphoid fracture fixation surgery?
A scaphoid fracture occurs when the scaphoid bone in the wrist breaks. The scaphoid bone is located on the side of the wrist near the thumb. Scaphoid fractures are often caused by falls on an outstretched hand, and the scaphoid is often broken in the mid-portion of the bone. Fractures can also occur at the distal and proximal ends of the bone. Scaphoid fractures are classified by the severity of the break and how far the pieces have moved. They are also labeled as displaced or non-displaced fractures. Symptoms of a scaphoid fracture include pain and swelling. Pain can be mild, and scaphoid fractures are sometimes initially mistaken for sprains. Scaphoid fractures can be diagnosed with an X-ray. A scaphoid fracture fixation is an open reduction internal fixation procedure, meaning that an incision will need to be made in order to repair the fracture with surgical hardware such as screws.
What is a scaphoid fracture fixation procedure like?
After receiving a diagnosis, the patient will likely begin treatment for their fracture as soon as possible. The patient will be placed under anesthesia for the procedure, and their hand will be cleaned and sterilized. The surgeon will also place a tourniquet above the wrist in order to minimize any blood loss and then make an incision. A fluoroscope, a machine that takes real-time X-rays, may be used and will help the doctor view the bones and correctly align the fractured pieces. The surgeon will then place a guide wire through the bones, which will assist in keeping them in place while any screws are placed. The scaphoid bone is repaired, and the incision is then closed. The doctor will then bandage the hand. Patients are usually allowed to return home the same day of surgery. Pain medication may be prescribed, or a doctor may recommend over-the-counter medication. Patients may also need to work with a hand therapist to regain optimal range of motion.
