Rachel Aliotta, M.D., is a hand and reconstructive surgeon with UAB Orthopaedic Surgery. Here, she answers some common questions about scaphoid fractures and how they’re treated. This information is based on the typical patient and may not apply to every case.
What is a scaphoid fracture?
A scaphoid fracture is a break in a small, peanut-shaped bone in the hand located between the fingers and the forearm. Breaking this bone affects the ability to move the wrist without pain.
How does this type of injury usually happen?
It often happens when falling on an outstretched hand or the wrist is jammed into an object at high speed or with a lot of force, such as hitting a handlebar or steering wheel during a vehicle accident.
What are the immediate symptoms?
Immediate symptoms include pain and swelling of the wrist, along with pain during motion, such as flexing the wrist down or extending it back. It also may be painful to try picking up objects, especially heavy ones.
How is a scaphoid fracture diagnosed?
X-rays are usually made of the wrist and hand, but X-rays often don’t show anything at first. So, if the wrist is sore, it’s important to wear a wrist brace that covers the scaphoid bone for 1-2 weeks or until another X-ray and exam can be performed. In some cases, advanced imaging such as a CT scan or MRI may be needed.
Does this injury require surgery?
Not in all cases. However, the scaphoid bone does not receive a good blood supply and can be difficult to heal, so immediate treatment is always recommended – regardless of the treatment type. Many factors are involved in the decision to have surgery, such as age, other medical issues or injuries, and daily use of the hand.
If the bone is displaced or not lined up with other bones in the hand, surgery is usually required. Surgery may or may not be advised based on the patterns of your specific fracture, and your doctor will discuss this with you and show you on the imaging scans. Surgery may be recommended if you are not healing with a cast or wish to return to activities faster.
What does recovery typically look like?
It usually takes about three months for the bone to heal. The wrist is immobilized in a splint or cast during much of this time, until it’s confirmed that the bone has healed. Hand therapy is started later, and this may add another three months to your functional recovery.
When can a person with a scaphoid fracture return to play or activity?
Again, bone healing usually takes at least three months (about 12 weeks). However, athletes who have surgery may heal faster and return to play in closer to eight weeks. Return to play is usually delayed until the bone is confirmed to have healed, though some athletes can resume playing in a protective cast once the fracture is addressed by their surgeon.
Can it be prevented?
Unfortunately, this injury cannot be easily prevented. Avoiding direct, high-impact falls on the wrist is the only true way to avoid this injury. However, wearing wrist guards or other protective gear during activities may help reduce the risk.
When should someone with a scaphoid fracture see an orthopaedic surgeon?
Prompt medical attention is an important factor in healing a scaphoid fracture, so anyone with this injury should seek immediate care from an experienced hand surgeon.
To make an appointment with UAB Orthopaedic Surgery, please call 205-930-8339 or schedule a visit online.