Scaphoid Fractures

Scaphoid fractures - SIM Physiotherapy Frenchs Forest and Macquarie Park

What is a scaphoid fracture?

Scaphoid fractures are the most common carpal bone fracture, often occurring after a fall onto an outstretched hand. The scaphoid is one of the eight carpal bones of the hand, situated near the base of the thumb.

What are the causes of scaphoid fractures?

Scaphoid fractures typically occur due to falls onto an outstretched hand, sports injuries, or car accidents. The force transmitted through the wrist can cause the scaphoid bone to break.

What are the signs and symptoms of scaphoid fractures:

• Pain over the wrist or at the base of the thumb

• Swelling around the wrist

• Pain in the snuffbox

• Reduced grip strength

How to diagnose a scaphoid fracture:

1) X-rays can be used to diagnose scaphoid fractures however, in some cases, a fracture may not be visible due to its location and orientation of the wrist. It’s not uncommon to repeat the x-ray after 1-2 weeks as the fracture is sometimes more visible as this point in time.

2) MRI is the most sensitive test to diagnose a scaphoid fracture. This scan can be useful in identifying the severity of the fracture and any assosciated ligament injury such as as scapholunate injury.

3) CT scans are a useful scan to identify the fracture location, angulation, displacement, fragment size. Due to the radiation of the a CT scan, a x-ray and MRI is the preferred imaging tool in children and teenagers.

What is the treatment of scaphoid fractures?

The treatment for scaphoid fractures depends on various factors including the severity of the fracture, its location, and whether it's displaced or not.

In general, treatment options may include immobilisation with a cast or splint to allow the bone to heal, particularly for non-displaced fractures.

However, if the fracture is displaced, unstable or fractured through the proximal pole then surgery may be necessary to realign and stabilize the bone with pins, screws, or other fixation devices.

Scaphoid injuries and blood flow - SIM Physiotherapy Frenchs Forest and Macquarie Park

Why is it important to ensure a scaphoid fracture is not missed?

Avascular Necrosis (AVN): The scaphoid bone has a unique blood supply that makes it susceptible to complications if fractured. The blood supply enters the bone from the distal end, so fractures can disrupt blood flow, leading to avascular necrosis (death of bone tissue due to lack of blood supply) if not treated promptly. If not properly treated, scaphoid fractures can lead to long-term complications such as chronic wrist pain, arthritis, and limited mobility, emphasising the importance of prompt diagnosis and appropriate treatment.