The Scaphoid is a small bone on the thumb-side the wrist, which is commonly fractured accounting for 15% of all acute wrist injuries. That said, it is often quite difficult to see the fracture on x-rays and therefore, these fractures can be easily missed even by experienced eyes!
Your surgeon will ask about your general health and activity levels before examining you, which may cause you some pain as they press on the scaphoid bone. They will review your current imaging and may request repeat x-rays or a CT scan if the diagnosis is unsure or surgery planned.
Types of Fracture
The scaphoid can be fractured in one of the three places
- Closest to the thumb – Distal pole fracture
- Closest to the wrist – Proximal pole fracture
- In the middle – Waist fracture
Most distal pole and waist fractures are managed without surgery in contrast to proximal pole fractures that are unlikely to heal because of poor blood supply and fixation gives them the best chance of healing.
Nonoperative in a cast
You will be in cast for a minimum of 6 weeks. Some fractures will still not heal following this, especially fractures closest to the wrist; they may require surgery.
Surgery is sometimes necessary to reduce the fracture if displaced or to allow early mobilization. Even with surgery there is still a risk the fracture might not heal. The risks of surgery include – infection, stiffness, painful scar and the scaphoid not healing requiring further surgery.
With immobilisation, the wrist becomes quite stiff quickly. Whether you have an operation or not this is the main reason why physiotherapy is vital to achieve the best outcome. We will review you around 6 weeks and 3 months with x-rays to check that the fracture is healing.
Mr Sam Vollans
Consultant Orthopaedic Surgeon
I graduated from the University of Leeds and completed my specialist training in Yorkshire. Following this, I undertook further training in both elective and trauma shoulder & elbow surgery in Sheffield with David Stanley, David Potter and Amjid Ali.
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