A scaphoid fracture is a fracture of one of the small bones in the wrist. Typically, this is a traumatic injury caused by a fall on an outstretched hand. There are many different degrees of severity when this type of injury is sustained and there may even be other bones that are broken (fractured) due to the same fall or injury mechanism.
Scaphoid fractures are most commonly diagnosed with x-rays. Patients will have significant pain with wrist motion, swelling and possibly bruising. The injured wrist is tender to palpation and most often will have significant pain with palpation of the anatomic snuff box. All patients diagnosed with a scaphoid fracture will have x-rays taken and some will need advanced imaging with a CT or MRI to visualize the extent of the fracture.
Depending on the severity of your injury you will either be treated with cast immobilization for approximately 8-10 weeks. Or you may require surgery. There are many different ways to surgically treat scaphoid fractures. Largely this depends on the age of the fracture and the degree of healing. In acute fractures that require surgery the use of headless compression screws placed inside the bone is an excellent technique that offers excellent rates of fracture union and minimal surgical dissection.
Most patients will be offered fracture fixation with a headless compression screw. The fracture is approached and reduced through a small 2-3cm incision placed on the dorsal side of the wrist. The screw is inserted through this same incision and carefully placed inside the bone so that it does not extend into any of the surrounding joints. Most of the time one screw is all that is needed; however, some patients may need 2 screws.
If you have had surgery you can expect to be immobilized for 6-8 weeks on average. Some injuries are more extensive and require longer periods of immobilization. Nearly all patients can expect to be sent to occupational therapy for treatment. This includes range of motion exercises, various other treatments for edema control, and eventual strengthening. Typically patients are returned to full activity at 10-12 weeks depending on their particular injury.
