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Our wrists play a crucial role in nearly every daily activity. From typing at our desk jobs to setting the ball for our volleyball teammates, or bracing ourselves when we lose balance, the wrist is essential for hand functionality. However, this joint is also highly susceptible to injury. One common and significant wrist bone fracture is the scaphoid fracture. These fractures typically occur in young, active individuals when one of the wrist bones, the scaphoid, breaks. This wrist bone fracture usually results from falling onto an outstretched arm. The primary symptoms include swelling and pain in the wrist, just below the thumb.
Synopsis
Anatomy of the Wrist
The wrist consists of the lower part of the forearm bones (radius and ulna) and eight carpal bones. These carpal bones form two rows of four at the hand's base. The scaphoid, the largest carpal bone, is boat-shaped and located near the thumb in an area called the anatomical snuffbox. This bone plays a crucial role in wrist motion and stability, linking the wrist bones to the forearm and finger bones. Due to its position, the scaphoid has an uneven and limited blood supply.
Types of Scaphoid Bone Breaks
Scaphoid fractures fall into three categories based on their location:
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Distal fracture: The part of the scaphoid closest to the fingers
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Waist fractures: The middle part of the scaphoid, where most of these fractures occur
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Proximal fracture: The part of the scaphoid closest to the forearm
Doctors also classify these fractures based on severity and displacement:
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Non-displaced: The bone is fractured, but segments remain aligned
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Displaced: Broken bone fragments have moved from their normal position, potentially creating gaps
Causes of Scaphoid Fractures
A cracked scaphoid bone typically occurs when someone falls on an outstretched arm, with the weight landing on the palm. It's a common sports injury and can also result from vehicle collisions. Wearing a wrist guard during certain sports can reduce the risk of a wrist bone fracture.
Symptoms of a Scaphoid Fracture
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Swelling and pain in the broken bone area, particularly on the thumb side of the wrist
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Pain that worsens when performing actions like pinching, pulling, or grabbing objects
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Persistent wrist pain that doesn't subside over time
These symptoms are often mistaken for a sprain and patients should consult a doctor if pain persists.
Consult our orthopaedic hospital in Mangalore if you need a diagnosis and treatment for wrist bone fracture.
Diagnosis of Scaphoid Fractures
Doctors diagnose scaphoid fractures through:
1. Physical examination
The doctors will first check for injury by assessing the tenderness, swelling, bruising, and loss of wrist motion
2. Imaging
Doctors may then use imaging techniques to confirm and gauge the bone fracture: These techniques include:
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X-rays: This imaging determines bone displacement. However, this method is not preferred as many scaphoid fractures may not show up in an X-ray (occult fractures)
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Magnetic Resonance Imaging (MRI): An MRI assesses soft tissue structure and bone fractures, easily catching bone fractures.
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Computed Tomography (CT): A CT scan reveals fractures and bone displacement, and helps understand the extent of the wrist fracture
Scaphoid Fracture Treatment
Prompt and proper treatment is essential to avoid complications like avascular necrosis (death of bone fragments) and cartilage wear which can cause wrist arthritis. Common treatment strategies for a scaphoid bone fracture include:
1. Non-surgical approaches:
Wearing short casts and restricted activity will help treat nondisplaced scaphoid fractures near the thumb. For scaphoid fractures closer to the forearm, longer scaphoid plaster casts are the usual treatment route.
Doctors may also use bone stimulation techniques such as supplying low-intensity ultrasonic or pulsed electromagnetic waves to assist in healing the fracture
2. Surgical methods:
Surgery aids in realigning the displaced bones so that the scaphoid fracture can heal. Common surgical techniques include:
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Reduction: This is the process of manually manipulating the bone back into place using special instruments
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Internal fixation: In this method, the surgeon inserts screws, plates, or wires to hold fractured ends in place
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Bone grafting: This technique involves placing a donor bone around the fracture to stimulate healing.
Recovery from a scaphoid fracture can take up to six months and patients must wear a cast or splint until the fracture heals. Due to slow healing from a wrist bone fracture, patients should avoid intense activities like heavy lifting and contact sports. They should also practise physiotherapy and physical rehabilitation to help restore the range of motion of the finger and wrist strength.
Consult our orthopaedician in Mangalore if you need treatment for a broken scaphoid bone.
Conclusion
While wrist fractures are common, it is important to take scaphoid fractures seriously to avoid complications. If you experience persistent, severe wrist pain, consult our experts at the Department of Orthopaedics at KMC Hospital, Mangalore for proper diagnosis and treatment. With appropriate care, our experts can help you recover from a scaphoid bone fracture and regain a pain-free, active lifestyle
FAQ's
The symptoms can be similar, and the pain may not be severe initially.
Recovery can take several months, often up to 6 months or more.
While not always preventable, wearing wrist guards during certain activities can help reduce risk.
Yes, complications can include avascular necrosis (bone death) and arthritis.
Seek medical attention if you have persistent wrist pain after a fall or injury, especially if it doesn't improve within a few days.
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