The orthopedic specialists at Hand to Shoulder Center of Wisconsin are here to diagnose and treat your scaphoid fractures. Contact Hand to Shoulder Center of Wisconsin in Appleton or Green Bay to schedule an appointment with one of our orthopedic doctors or occupational and physical therapists to treat your wrist fracture.
What is a Scaphoid Fracture?
The scaphoid bone (Fig. 1), also known as the navicular bone, is a small, kidney-shaped bone located on the radius (thumb) side of the wrist. It lies between the base of the thumb and the radius, in the “anatomical snuff box.” The wrist joint is made up of eight tiny bones known as the carpals (scaphoid, capitate, hamate, lunate, pisiform, trapezium, trapezoid, and triquetrum) and two larger forearm bones, the radius and ulna. The radius is located on the thumb side of the forearm bones, and the ulna on the little finger side of the forearm. The eight carpal bones are arranged in two rows, one on top of the other with the scaphoid bone linking and stabilizing the two rows.
Scaphoid fractures are common injuries to the wrist. A scaphoid fracture typically occurs when the scaphoid bone is stressed during a fall on to an outstretched hand.
A scaphoid bone fracture can occur at multiple locations within the scaphoid bone.
Scaphoid Fracture Symptoms and Scaphoid Non Unions
Fractured wrist symptoms involving a scaphoid fracture may include wrist pain with movement, swelling, and tenderness of the hand and wrist on the thumb side of the wrist. Bruising may occur however, typically, no visual deformity is seen at the wrist.
In some scaphoid fracture cases, symptoms of a fractured wrist may be mild. An individual may choose not to seek medical treatment. If left untreated, the fractured scaphoid bone can sometimes remain unhealed, painful, and symptomatic. An unhealed chronic scaphoid fracture is referred to as a scaphoid non union. If left untreated, a scaphoid non union can result in early arthritis in the wrist and painful limited range of motion.
Scaphoid Fracture Treatment
At Hand to Shoulder Center of Wisconsin, our fellowship-trained orthopedic surgeons evaluate past and present medical history. X-rays are taken when signs of a fractured wrist are present. X-rays typically will detect the fracture, however, a Magnetic Resonance Imaging (MRI) or Computerized Tomography Scan (CT) may be ordered if more detailed views of the fracture are needed to help determine the best treatment option. Surgical and non-surgical treatment varies depending on the pattern of the fracture.
Non-surgical scaphoid fracture treatment – If the acute fractured scaphoid bone remains aligned, a scaphoid fracture splint (Fig. 2) or plaster cast may be applied for immobilization of the injury. Typical healing time may range from 6-12 weeks.
While certain scaphoid fractures don’t require surgery, many fractures do require surgery to properly realign and stabilize the broken bones. In some scaphoid fractures when the bone is misaligned (displaced), surgery is advised. A small screw will be inserted into the scaphoid bone fragments to hold the pieces together to restore the alignment. Some scaphoid fractures, especially non unions require bone grafting. Casting and/or splinting will then be applied for the duration of the healing process.
Surgery for a scaphoid fracture is generally performed as an outpatient procedure. The surgeons at Hand to Shoulder Center of Wisconsin perform surgeries at Woodland Surgery Center and the three Fox Valley hospitals. Following surgery, hand therapy is strongly recommended to help regain muscle strength and mobility.
Once the patient is cleared by the physician, a licensed physical or occupational therapist will start a supervised rehabilitation program. Your therapist at Hand to Shoulder Center will concentrate on range of motion and strengthening exercises (Fig. 3-5) to achieve improved function of the wrist and hand. Patients can continue to use a protective brace during activities to assist in pain control and to relieve stress on the wrist after initiating therapy rehabilitation.
A scaphoid fracture is a complex injury for the wrist. Outcomes can vary depending upon fracture patterns and locations. It is an injury that requires prompt appropriate care.