What is scaphoid fracture?

Possible scaphoid fracture of the wrist: Overview

You may have a scaphoid fracture (also called a navicular fracture). This is a break in a small bone on the thumb side of your wrist. It can cause pain and swelling in the wrist and make it hard to move your wrist or thumb. Treatment for this type of break includes wearing an arm cast or splint and, in some cases, having surgery.

Even if the first X-rays don't show a break, there may be one. So the doctor will want you to wear a splint to protect the injured wrist. It is better to do this than risk not treating a fracture and possibly delay healing. You will need a follow-up X-ray in 1 to 2 weeks. Or the doctor may order another test such as an MRI.

It is important to follow the doctor's instructions, because parts of the scaphoid bone do not have a good blood supply. This can make healing slow and difficult if the bone is broken.

The doctor has checked you carefully, but problems can develop later. If you notice any problems or new symptoms, get medical treatment right away.

What are the symptoms of a scaphoid fracture of the wrist?

Because most scaphoid fractures do not cause the wrist to look broken and many cause only minor symptoms, it can be hard to know if your scaphoid bone is broken. If the bone is broken, you may have:

  • Pain, tenderness, or swelling on the thumb side of your wrist.
  • A hard time grabbing or gripping things or moving and twisting your wrist or thumb.
  • Bruises around your wrist.

It can be hard to tell the difference between a wrist that is sprained and one that is broken. If you have fallen on an outstretched hand and your wrist hurts, be sure to see a doctor to find out if you have any broken bones. Scaphoid fractures that are not treated properly can lead to long-term problems.

How is a scaphoid fracture of the wrist treated?

Treatment for scaphoid fractures includes wearing an arm cast or splint and sometimes having surgery. Even if the first X-rays or other imaging tests do not show a fracture, your doctor still may treat you to prevent possible problems with healing.

Right after the injury, you may wear a splint because your wrist is too swollen to put a cast on. You may also wear a splint if it is not clear whether your bone is broken. For the first few days, your doctor may tell you to keep your wrist higher than the level of your heart and to use cold packs or ice to reduce swelling. Your doctor may also prescribe a pain medicine or suggest a pain medicine that you can buy without a prescription, such as acetaminophen (for example, Tylenol) or ibuprofen (for example, Advil or Motrin). Be safe with medicines. Read and follow all instructions on the label.

In some cases, after the swelling is gone, the splint will be removed and a cast will be put on. The cast may enclose your thumb and may extend above your elbow. Some people only need to wear a cast for 6 weeks, while others may have to wear a cast for several months. How long your wrist takes to heal depends on how serious your fracture is. Regular visits to your doctor will help you to know how well your fracture is healing and learn how to care for your splint or cast.

In other cases, you may need surgery to put pieces of your bone in the proper place or to help your bone heal faster. You may also need surgery if part of your bone has died because it did not get enough blood. If you have surgery, you will need to wear a splint or cast afterward.

Once a splint or cast is removed, your arm or wrist may feel weak or stiff. Your doctor or a physical therapist can teach you exercises to strengthen your arm and wrist.

How is a scaphoid fracture of the wrist diagnosed?

Your doctor will ask about your symptoms and will check on your wrist and thumb movement. You will probably have an X-ray. You may also have an imaging test, such as an X-ray, a CT scan, or an MRI.

How can you care for your child's possible scaphoid fracture of the wrist?

  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
    • If your child is not taking a prescription pain medicine, ask your doctor if your child can take an over-the-counter medicine.
  • Put ice or a cold pack on your child's wrist for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when your child is awake) or until the swelling goes down. Put a thin cloth between the ice and your child's skin.
  • Prop up your child's wrist on pillows when your child sits or lies down in the first few days after the injury. Keep the wrist higher than the level of the heart. This will help reduce swelling.
  • Follow the doctor's directions for wearing a cast or splint.
  • Help your child heal with healthy habits.
    • Give your child a variety of healthy foods.
    • Keep your child away from smoke. Do not smoke or let anyone else smoke around your child or in your house.

What causes a scaphoid fracture of the wrist?

Most scaphoid fractures occur when you stretch your hand out in front of you to protect yourself from a fall. They can also occur when your wrist twists severely or is hit very hard. Scaphoid fractures often happen while a person is playing sports, such as football, soccer, or basketball, or during activities, such as in-line skating, skateboarding, or bike riding. They can also occur as a result of a car crash or a fistfight.

What is a scaphoid fracture of the wrist?

A scaphoid fracture is a break in a small bone on the thumb side of your wrist. This is also called a navicular fracture. Of the eight carpal bones in your wrist, your scaphoid bone is the one most likely to break.

It is important to find out if you have a scaphoid fracture, because these fractures need treatment to heal well. With proper treatment and follow-up, most scaphoid fractures will heal over time. Without treatment, and sometimes with treatment, healing can be slow and difficult because parts of the scaphoid bone don't have a good blood supply. If your bone does not heal well, you can have long-term pain, stiffness, or arthritis in your wrist.

Possible scaphoid fracture of the wrist: When to call

Call your doctor now or seek immediate medical care if:

  • You have problems with your cast or splint. For example:
    • The skin under the cast or splint is burning or stinging.
    • The cast or splint feels too tight.
    • There is a lot of swelling near the cast or splint. (Some swelling is normal.)
    • You have a new fever.
  • You have new or worse pain, swelling, or warmth in your wrist.
  • Your fingers turn cold or change color.
  • You have tingling, weakness, or numbness in your hand and fingers.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have problems with your cast or splint.
  • You do not get better as expected.

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.