The scaphoid is one of the smallest bones in the wrist. It is on the thumb side of the wrist where the wrist bends.
This type of fracture, or break in the bone, occurs most frequently when a patient falls and attempts to break the fall using his/her hands. Scaphoid fractures (also called navicular fractures) can also be a result of sporting collisions or motor vehicle accidents. The use of wrist guards during some activities like skating and boarding is a way to prevent this fracture from occurring.
Because falls are common, this type of fracture is not limited to a specific gender or age group, though men from 20 to 30 years of age are most likely to experience this injury.
Symptoms and Diagnosis
Usually, there are obvious physical symptoms of scaphoid fracture, including:
The physical signs of a fracture are usually the reasons that bring a patient into a physician’s office. However, a physical exam isn’t thorough enough to diagnose a fracture–especially a scaphoid fracture–because they are frequently misinterpreted as sprains.
A hand and wrist specialist, such as Dr. Leah Urbanosky of Hinsdale Orthopaedics, will order an x-ray in order to determine the location and severity of the break. Sometimes, a scaphoid fracture may not show up on an x-ray until a few weeks after the initial pain. In this case, Dr. Urbanosky would suggest the use of a splint until the x-ray can be retaken and reevaluated.
Once a physician has diagnosed a scaphoid fracture, there are several ways to treat the condition, both surgically and non-surgically.
Scaphoid fractures near the thumb heal the most quickly because this portion of the bone receives the most blood supply. A doctor will typically order an arm and hand cast to set the bone properly. If the fracture is near the forearm, however, this cast will include the arm, hand, and the thumb. It may also cover the elbow.
If a cast does not fully heal the scaphoid fracture, a physician may recommend surgery to fix the break. The procedure is based upon the location of the fracture and how severe it is. Typically, metal implants are used to hold the scaphoid in place until the bone heals.
Whether surgery is necessary or not, a cast is needed in order to allow the bone to heal. During recovery, lifting, contact sports, and climbing are all highly discouraged. Physical therapy is often required. Most cases return to normal within six months of care.
A fracture that fails to heal properly is called a non-union. Since the blood supply to the area is poor, this is fairly common with scaphoids. If the fracture cannot heal on its own, a bone graft may be applied. A bone graft includes the transfer of a piece of bone from elsewhere in the body into the scaphoid to promote healing.
Dr. Urbanosky is skilled in treating scaphoid fractures. If you think that you may be experiencing a hand fracture, contact Dr. Leah Urbanosky for a consultation: (815) 462-3474.
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